EECSI/REG/V1/2013
Registration Form
Executive Education . Continuing Education . Community Services
Personal Information
Effat University ID: Nationality ID:
First Name: Middle Name: Last Name:
Date of Birth: Place of Birth: Nationality:
Telephone: Mobile: Fax:
E-mail:
Education
□ Secondary □ College degree (Please specify) □ Higher Education (Please specify)
General Information
How did you know about us?
□ Facebook □ SMS □ Magazines □ Other (please specify)
□ Twitter □ WhatsApp □ Newspapers
□ LinkedIn □ Effat University call □ Brochures or EECSI Newsletter
□ Instagram □ Effat University Website □ In Campus ads
Person to contact in case of emeregency
Name: Relationship: Telephone:
Mobile:
Course Information
Program Title
Program Code & No.Program End and Start Date
No. of Hrs Days Timing
Fees
Student signature……… EECSI Registration Office………..………
Date……….. Date……….
Start / / 20_ End / / 20_
Note: Effat employees must obtain the supervisor’s approval
Supervisor signature………... Date………...…...
EECSI/REG/V1/2013
Refund Policy
1. Fees and charges
o All programs regardless of duration are paid in full two weeks before the start date of the program and before the end of the add/withdrawal date (14 days before program starting date). No students are allowed to attend a program prior to fully paying the program fees.
o No installments are allowed for any of the EECSI programs.
2. Cancellations and Refund
o Eligibility: participants who wish to withdraw from a program fill out a “Request for Refund of Program Fees” form where the applicant states his/her justification. The application must be approved by the Director of the EECSI prior to implementation.
o Method and Timing of payment: Refund is issued by cheque in the name of the person/company from whom the fees were collected. Refund is issued within one month from submitting the
“Request for Refund of Program Fees” form signed by the participant and authorized by the Director of the EECSI. Cash refund is issued only in person.
o In cases where the EECSI cancels a scheduled program the applicant is automatically refunded. No need for filing the “Request for Refund of Program Fees”.
o If the applicant wishes to withdraw from the course, the following refund terms and conditions apply as stated in the “Registration Form”.
Timing of Request for Refund Penalty Refund
Two weeks before program starting date (add/withdrawal period) 0 % 100 %
Within two weeks from program starting date 25 % 75 %
Between course starting date and up to or equal 25% of course hours 50 % 50 %
After 25% of program hours (includes absence) 100 % 0 %
Student signature……… EECSI Registration Office………..……….
Date……….. Date……….
