Notice to Students

  1. Do not sign this agreement before you have read it or if it contains any blank spaces.
  2. This agreement is a legally binding instrument and is only binding when the agreement is accepted, signed, and dated by the authorized official of the school or the admissions officer at the school's principal place of business. Read all pages of this contract before signing.
  3. You are entitled to an exact copy of the agreement and any disclosure pages you sign.
  4. This agreement and the school catalog constitute the entire agreement between the student and the school.
  5. Any changes in this agreement must be made in writing and shall not be binding on either the student or Chicago Community Learning Center unless such changes have been approved in writing by the authorized official of the school and by the student or the student's parent or guardian. All terms and conditions of the agreement are not subject to amendment or modification by oral agreement.
  6. The school does not guarantee the transferability of credits to another school, college, or university. Credits or coursework are not likely to transfer; any decision on the comparability, appropriateness and applicability of credit and whether credit should be accepted is the decision of the receiving institution.

Student's Right to Cancel

The student has the right to cancel the initial enrollment agreement until midnight of the 15 business day after the student has been admitted. If the right to cancel is not given to any prospective student at the time the agreement is signed, then the student has the right to cancel the agreement at any time and receive a refund on all the monies paid to date within 10 days of cancellation. Cancellation should be submitted to the authorized official of the school in writing.

Enrollment Agreement

Form 1/8
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PROGRAM INFORMATION

FINANCIAL AID & TUITION

Chicago Community Learning DOES NOT offer Title IV Financial Aide at this time.

STUDENT ACKNOWLEDGMENTS

I hereby acknowledge receipt of the school's catalog, which contains information describing programs offered, and equipment or supplies provided. The school catalog is included as part of this enrollment agreement, and I acknowledge that I have received a copy of this catalog.

I have carefully read and received an exact copy of this enrollment agreement.

I understand that the school may terminate my enrollment if I fail to comply with attendance, academic, and financial requirements or if I fail to abide by established standards of conduct, as outlined in the school catalog. While enrolled in the school, I understand that I must maintain satisfactory academic progress as described in the school catalog and that my financial obligation to the school must be paid in full before a certificate or credential may be awarded.

I hereby acknowledge that the school has made available to me all required disclosure information listed under the Consumer Information section of this Enrollment Agreement.

I understand that Chicago Community Learning Center does not guarantee transferability of credit and that in most cases, credits are not likely to transfer to another institution. In cases where transferability is guaranteed, Chicago Community Learning Center must provide me copies of transfer agreements that name the exact institution(s) and include agreement details and limitations.

I understand that the school does not guarantee job placement to graduates upon program completion.

I understand that complaints, which cannot be resolved by direct negotiation with the school in accordance to its written grievance policy, may be filed with the Illinois Board of Higher Education, 1 N. Old State Capitol Plaza, Suite 333, Springfield, IL 62701 or at www.ibhe.org.

The student acknowledges receiving a copy of this completed agreement, the school catalog, and written confirmation of acceptance prior to signing this contract. The student by signing this contract acknowledges that he/she has read this contract, understands the terms and conditions, and agrees to the conditions outlined in this contract. It is further understood that this agreement supersedes all prior or contemporaneous verbal or written agreements and may not be modified without the written agreement of the student and the School Official. The student and the school will retain a copy of this agreement.

Medical Evaluation / Physical Examination Form

Form 2/8

PART I: To be completed by student

STUDENT INFORMATION

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Person to Notify in Case of Emergency

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Health History

ESSENTIAL TECHNICAL STANDARDS

The attendance requirements and stamina demand require the Nursing Assistant and Allied Health students to be in good physical and mental health. In the interest of the student's personal safety and the safety of patients and clients, and other healthcare workers, students must meet, with or without reasonable accommodation, the Essential Technical Standards before admission into the program is finalized. Students are required to complete a self-assessment of their capability to meet these standards. Please read the Essential Technical Standards carefully, and initial each technical standard, only if you can comply with the standard. Students must present a completed copy of the Essential Technical Standards to their Healthcare Provider for review at the time of their physical examination. When complete, please sign, date and upload it into your Electronic Profile. If a student cannot meet one or more of the standards, they must meet with the Director of the Program for which they have applied to discuss reasonable accommodations.

PART I (CON'T): To be completed by student. Initial ONLY if you can comply with the standard.

Please check the box next to each standard if you can comply.

The information provided is true and correct to the best of my knowledge. I am aware that ANY change in my physical or mental health status, including pregnancy and/or medication use must be immediately reported to the Director of the Nursing or Allied Health Program to which I am assigned. Chicago Community Learning Center has my permission to release these test results to the clinical education agencies to which I am assigned. My Healthcare Provider may release health related information to the Director of the Program in which I am enrolled.

Emergency Contact Form

Form 3/8

Please provide details for up to three emergency contacts.

Emergency Contact 1

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Emergency Contact 2 (Optional)

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Emergency Contact 3 (Optional)

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Student ID Form

Form 4/8

My student ID is my responsibility to have on and visible during class and during clinical.

Uniform Size Form

Form 5/8

Please select your uniform size based on the chart below. Note: Top and Pants must be the same size. Uniform comes in a set and cannot be separated.

Unisex Scrub Set Size Chart:

Size XXS XSM SML MED LGE XLG 2XL 3XL 4XL 5XL 6XL
Chest 28-30 31-33 34-36 37-39 40-42 43-45 46-48 49-51 52-54 55-57 58-60
Waist 28-30 31-33 34-36 37-39 40-42 43-45 46-48 49-51 52-54 55-57 58-60
Hip 28-30 31-33 34-36 37-39 40-42 43-45 46-48 49-51 52-54 55-57 58-60
Center Back Length 25 25.5 26.5 27.5 28.5 29.5 30.5 31.5 32.5 33.5 34.5

SIZE TIP: If you're a guy ordering unisex fits scrubs, they should ideally be true to size. For the ladies, consider ordering one size smaller than you would in a women's fit scrub top or pants.

Consent to Test and Release Information

Form 6/8

I grant the Chicago Community Learning Center, Chicago Campus Permission to:

  • Administer, score, and interpret assessment test of interest, and abilities related to my employment, training, and services needed.
  • Use the results of the test given to me to make decisions about training programs, referrals, and other related services.
  • Obtain information from and/or release information to any of the following:
    • Agencies
    • Employers
    • School/Colleges
    • Institutions/Business UI Wages
    • Transmit file to TARA

This information may be used to assist my eligibility determination, my progress in WIA funded activities, and /or provided verification of employment.

Background Check Form

Form 7/8

Please review and print the Illinois Department of Public Health Health Care Worker Background Check Authorization and Disclosure form. You will need to complete this form manually.

Student Acknowledgement Form

Form 8/8

The Applicant Understands:

  1. Chicago Community Learning Center is an Illinois Board of Higher Education (IBHE) Licensed facility as a Private Vocational School in Health-Career Education; we do not accept credit from previous education entities or any experimental learning, or CLEP.
  2. Chicago Community Learning Center only assists with Job Placement in the Field of health-care study, but we DO NOT guarantee job placement.
  3. Chicago Community Learning Center reserves the right to discontinue training for unsatisfactory progress, non-payment of fees or failure to abide by school guidelines.
  4. Chicago Community Learning Center reserves the right to reschedule the training start date when the number of participants scheduled is too small.
  5. Under WIOA tuition ITA, Chicago Community Learning Center only pays for License exams once for C.N.A State License, Patient Care Technician License with EKG & Phlebotomy. Retakes of any license exam is the responsibility of the student.

Connect with us

Main Campus
840 W. Irving Park Rd, suite 203, Chicago Illinois

Ever Green Campus
9730 S Western Ave, suite 502, Evergreen Park, Illinois

  • +1 (773) 506 1503

  • +1 (773) 506 1528

  • info@cclctraining.org

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