Submission of this form indicates I understand the following:
• The registration is complete, and I am accountable for the tuition and fees associated with the enrolled program. Should I officially drop, withdraw/cancel, or not complete the program, any refund in tuition will be determined by the date I submit my request to the Nebraska Health Care Association. If the official cancellation request occurs within 72 hours of registration/enrollment, a full refund is appropriate.
• The personal information is correct as shown; changes in the personal information must include the appropriate documentation.
• It is the policy of the Nebraska Health Care Association to provide equal opportunity and nondiscrimination in admission, attendance, and employment matters to all persons without regard to race, color, gender, religion, national origin, or disability. Inquiries concerning the Nebraska Health Care Association policies on equal opportunity and nondiscrimination should be directed to the Director of Professional Development, 1200 Libra Drive, Suite 100, Lincoln, Nebraska 68512, phone 402-435-3551, fax 402-475-6289, or email email@example.com.