CAPSCARE  Academy for Health Care Education

 
 

Electronic Signature Page


 

Your seat in the class or on-line is determined by your signature of this form. Please understand there is no refund within 24 hours of signing up for the course on-line, in person or over the phone. You also certify that you are taking this course of your own free will. If this course is a board-required course for you, you certify that you will fax the letter from the board to 561-547-7373 before you begin your board mandated clinical rotation. If this class is not a requirement for you,you certify and understand you are taking this course to further your skills and gain an education in order to pass the state boards or complete a CEU requirement. You understand that CAPSCARE is not responsible for registering your information to the board of nursing, unless you are a board mandated RN or LPN remedial/refresher student.

 

Choose from the drop down box which class you are enrolled in.

In the SUBJECT box: Please print your full name and class.

HIT SUBMIT

PLEASE READ AND SIGN UPON COMPLETION OF PAID REGISTRATION. YOUR SUBMISSION OF THIS PAGE CONSITUTES THAT YOU HAVE READ AND UNDERSTAND THE RULES AND REGULATIONS OF THE COURSE AND THE REFUND POLICY.  THANK YOU


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