Online Application

Congratulations on taking your first step to a rewarding career in the health field. Once you complete the application, we will contact you to verify all the information provided.

Please fill out the form completely. once you complete the application, you will be taken to a checkout page.

How did you hear about Quest Nursing Education Center?*
- Google Search/Internet/Online
- Flyer
- Walk in
- Friend
Did your friend discover Quest Nursing Center online?*
- Yes
- No
Name*
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Email*
Enter Email Confirm Email
Date of Birth*
MM slash DD slash YYYY
Phone Number*
Alternate Phone Number
Address*
Street Address Address Line 2 City State ZIP Code
Select a Course*
- CNA Course
- EMT Course
- IV Therapy/Blood Withdrawal
- Home Health Aide - 40 Hour (Day Course)
Which date do you prefer for your daytime CNA course?*
Which date do you prefer for your EMT course?*
Which date do you prefer for your IV Therapy course?*
Which date do you prefer for your HHA 40 HR Day Course?*
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Which date do you prefer for your HHA 40 HR Evening Course?*
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Which date do you prefer for your HHA 120 HR Day Course?*
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Which date do you prefer for your HHA 120 HR Evening Course?*
Which Date would you like to take BLS CPR For The Health Care Providers*
Which Date would you like to take CPR - AED - FIRST AID Course*
How many 8 hour Continuing Education days?*
Please enter a number from 1 to 4.
Which date do you prefer for your CE In-class program*
- Nov 14 (8am - 4:30pm)
- Nov 21 ( 8am- 4:30pm)
- Dec 12 ( 8am- 4:30pm)
- Dec 19 ( 8am- 4:30pm)
Which CNA Exam Review Course do you want to take?*
- CNA Exam Review - Theory (8am - 12pm)
- CNA Exam Review - Skills (12:30pm - 4pm)
Which date do you prefer for CNA Exam Review Course?*
Your Total
$0.00
Enter your CNA/LVN license #:*
I have Valid Social Security Number*
- Yes
- No
I am legally able to work in the United States*
- Yes
- No
Have you been convicted of any crime other than a minor traffic violation?*
- Yes
- No
Please explain*
I certify under penalty of perjury that the above information provided by me the applicant is true and correct. I understand that falsifying any information is grounds for immediate dismissal without a refund. PLEASE TYPE IN YOUR FULL NAME:*
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Refund Policy: Please Read Carefully

This policy applies to students who withdraw from attending the educational program.

A student shall be considered to have withdrawn from an educational program when he or she withdraws or is deemed withdrawn by the institution; It is when a student is unable to continue attendance in the educational program regardless of reason. The refund policy applies as follows:
*There is no refund for a student who has completed 60% or more of an educational program For students who complete less than 60% of an Educational Program, the following applies:

Students will receive a refund of amounts paid to the School in excess of their calculated Cost of Instruction.
[Cost of Instruction = (Cost per clock hour) x number of hours attended.]
Total Course Tuition paid by Student - Cost of Instruction = Refund due
-Once fees become non-refundable, they do not figure into refund calculations
-(Please review the breakdown of charges for the program you are enrolling in to identify the non-refundable fees and associated time-frame and cost per clock hour).
-Tuition Paid on behalf of a student by a third party will be subject to this same refund policy stated here.
-If an institution has collected money from a student for transmittal on the student's behalf to a third party for a bond, library usage, or fees for a license, application, or examination and the institution has not paid the money to the third party at the time of the student's withdrawal or cancellation, the institution shall refund the money to the student within 45 days of the student's withdrawal or cancellation

-In the event the calculated refund amount is less than the student's current unpaid balance, a refund will not be issued. The student remains responsible for the amounts due to the School.

-If the student has received federal student financial aid funds, the student is entitled to a refund of moneys not paid from federal student financial aid program funds.

-Refunds will be issued to the original payer of the tuition.

-Refunds will be made within 45 days of the Determination Date of Withdrawal.

-For students who withdraw prior to attending the program, the determination date of withdrawal will be based on the date withdrawal/cancellation notice is received from the student or the day before the educational program is to start; whichever is earlier. ALL notices to withdraw/cancel must be in writing and can be submitted in person to the admission office or via email at questnec@gmail.com
By Checking the box below I certify that I have read, understood, and agreed to my rights and responsibilities and that the institution’s cancellation and refund policies have been clearly explained to me.*
- I have read the refund policies and agree to them
Total
$0.00
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