TASA School and Student Forms — Enrollment Application

1. Program Information

Program Name

Major Appliance Repair Technician — 3-Week Intensive

Desired start and end date

How did you hear about TASA?

Referral Name (if applicable)

2. Applicant Information

First Name

Middle Name

Last Name

Date of Birth

Social Security Number (last 4)

Email Address

Phone Number

3. Mailing Address

Street Address

City

State

ZIP Code

4. Emergency Contact

Full Name

Relationship

Phone Number

Email

5. Education & Employment Background

Highest Education Level Completed

Currently Employed?

Admission requires an official high school transcript, GED transcript, or college transcript. A copy of a transcript is not acceptable under North Carolina State Board of Proprietary Schools requirements.

Current Employer & Occupation (if applicable)

Previous Technical Training or Trade Experience

6. Additional Questions

Do you have any physical limitations that may affect your participation in hands-on training?

Have you ever been convicted of a felony? (A "yes" answer does not automatically disqualify admission.)

What are your goals after completing the program?

7. Tuition & Payment Plan Acknowledgment

The published program cost is $4,000 tuition plus a $200 application fee, for a total required program cost of $4,200. The $200 application fee is due with the application/enrollment process. After acceptance, 50% of tuition ($2,000) is due when the Enrollment Agreement is signed and the remaining 50% of tuition ($2,000) is due 14 calendar days before the first day of class. This application is not an Enrollment Agreement and does not by itself obligate me to enroll or reserve a seat. I understand that the signed Enrollment Agreement and TASA's published refund policy control.

I understand that by submitting this application, I am not obligated to enroll, nor is TASA obligated to accept me. I understand that this application is subject to review and that I may be contacted for an interview. I certify that all information provided is true and accurate to the best of my knowledge. I understand that providing false information may result in denial of admission or dismissal from the program.