Application for Admission

Last Name:
Other Names Used (e.g. maiden name):
Street Address
City:
Email Address:
Primary Phone Number:
Alternate Phone Number:
DRM International Learning Center requests your Social Security number and birth date to comply with our reporting requirements. Your Social Security number will not be used as your primary student identification number. You will need to provide this before classes begin.
Date of Birth: (MM-DD-YYYY)
In order for DRM ILC to properly verify your address, please present your driver's license, a Michigan ID card, or a voter registration card before class start date.

Individual to notify in case of an emergency

Relation:

How did you hear about our school?

Refund Policy

The tuition and fees paid by the applicant shall be refunded if the applicant is rejected by the school before enrollment. DRM ILC will notify each applicant who is rejected by the school before the enrollment date. An application fee of not more than $25 may be retained by the school if the application is denied. All tuition and fees paid by the applicant shall be refunded if requested within 3 business days after signing a contract with the school. All refunds shall be returned within 30 days. Delays may occur in processing if a student has not provided the school with a current address.

DRM International Learning Center does not discriminate in its educational programs, activities, admissions, or employment on the basis of race, color, sex, national origin, handicap, sexual orientation, age, political affiliation, or beliefs as required by Title VI of the Higher Education Amendments, Title IX of the Civil Rights Act, Section 504 of the Rehabilitation Act. Questions concerning DRM ILC's non-discrimination policies may be addressed to the Office of Admissions, 517-882-3544.

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Have you ever been convicted of a crime, misdemeanor, or felony? No Yes
If yes, please explain:

Gender: Male Female

Ethnic Background: (optional)
Asian or Pacific Islander
Black, non-Hispanic
Hispanic
Native American or Alaskan Native
White, non-Hispanic

When I first attend classes at DRM ILC, my education level will be:
Still attending high school (requires high school signature below)
High school graduate or GED
Non-high school graduate
Associate degree or less
More than 2 years, but less than a 4 year degree
Four-year college graduate
More than 4 years of college

Current/Last high school attended:

Year you received or expect to receive your High school diploma or GED:

Course Selection:

CNA Training   $1324.00

Select Course Start Date Monday, June 17, 2013Monday, July 22, 2013Monday, September 23, 2013Monday, October 28, 2013Monday, November 18, 2013Monday, December 16, 2013

CNAplus™ Training   $4924.00
Select Course Start Date Wednesday, May 29, 2013Friday, July 05, 2013Wednesday, August 07, 2013Wednesday, September 04, 2013Wednesday, October 09, 2013Wednesday, November 13, 2013


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