The Optimal Performance Institute / 2009

APPLICATION FOR ADMISSION/ Scholarship

First Name ______________________ Middle Name _____ Last Name ___________________________

Mailing Address ______________________________ City _______________ State ____ Zip _________

Home Phone ___________ Employer ____________________________ Work Phone ________________

Email Address _________________________ Birthdate ______________ Marital Status ______________

High School _________________________________ City ________________ State ____Zip ________

“I qualify for the tuition reduction scholarship because I have a certification from this organization:” Circle:

ISSA, ACE, NATA, NASM, NSCA, NFPT, IFPA, ____________ (other) Send documents with application.

You also qualify for the scholarship if you are a member of the military. Check here____ Send proof to OPI.

COLLEGE EDUCATION

Name of School	Degree or Major	Dates Attended	Degree Earned
(A)
(B)
(C)

TUITION AND PAYMENT PLANS

I am applying for admission to the following Optimal Performance Institute Degree Program. Upon acceptance of my application, please send me the initial courses, a Letter of Acceptance and a Student Identification Number. Thereafter, upon receipt of each of the Final Examinations, please send the next course in my program. Tuition must be paid in accordance with our policies (see catalog).

Please check the program you are applying for:

£ Associate Degree in Personal Fitness Training (minor in Entrepreneurship) 60 credits

r Baccalaureate Degree in Health & Fitness (minor in Nutrition) 60 credits*

(*a minimum of 60 credits are required prior to admission, for a total of 120 credits for degree)

Masters Degrees:

r MA in Applied Sports Psychology 30 credits (plus Bachelor’s degree)

r MS in Nutrition & Exercise 30 credits (plus Bachelor’s degree)

New applicants may begin up to 9 months after their official acceptance.

I will pay my tuition according to the following payment plan: (Visa, Mastercard, American Express, Check, Money Order Accepted)

See the Reverse side for YOUR reduced tuition Scholarship.

q AA Degree program Total tuition: $14,700 ($367.50 per course – 60 credits total)

q Bachelor Degree completion program: Total tuition $14,700 ($367.50 per course – 60 credits = 120 for the degree)

q Master of Arts in Applied Sports Psychology or Master of Science in Nutrition and Exercise $11,850 (30 credits)

Tuition includes all test materials. Textbooks and technology fees are the student’s responsibility. A nonrefundable application fee of $50 must accompany your application or it will not be reviewed.

SAMPLE SCHEDULE OF FEES AND CHARGES for BACCALAUREATE DEGREES: The student is responsible for the following fees and charges for their first term: (this is a sample only - required by CA State). Please see the bottom for actual fees.

Application Fee $ 50.00

First Course Tuition $ 735.00 (or $367.50 x 2)

Textbooks/Materials $ 40.00 (varies per course, often paid to 3^rd party vendor)

(initial) TOTAL CHARGES $ 825.00 (Student is only charged $50 initially. Then OPI bills according to the payment option on this form as student registers for each course (or one time), not the fees listed above.

BUYER’S RIGHT TO CANCEL & REFUND INFORMATION:

You have the right to cancel this enrollment agreement and obtain a refund. Requests for cancellation and refunds should be made to Records Keeper, The Optimal Performance Institute, 1030 E. El Camino Real #322, Sunnyvale, California 94087. If you cancel this agreement prior to the eighth business day after the first lessons were mailed, you have the right to a full refund of all charges less the amount of the Application fee, $50, and any materials fees paid.

EXAMPLE REFUND:

Student registers for a course at the time of enrollment based on the tuition paid. Student pays bachelor’s tuition for the first course of: $735.00 (or 2 payments of $367.50). Should a student wish to withdraw from their program, they will be responsible for any courses registered for and time elapsed in the course. If a student withdraws from a course in writing with confirmed receipt, an appropriate refund will be made. Refunds shall be made within 30 days following the date upon which the student’s withdrawal has been determined. (CEC 94312 cd). With the special scholarship program, enrollment and tuition payment is final.

NONREFUNDABLE FEES:

Include all postage and handling fees, foreign and domestic; application fee; transcripts; late fees; and returned check fees.

I understand that I have entered into a legal contract with the Optimal Performance Institute upon acceptance of this application and that all financial obligations to the Optimal Performance Institute must be met before any letter of completion will be forwarded to me or any board, employer or committee, nor will course content verification letter or transcript of credits be issued. Courses which have not been paid for will not appear on any official transcript. I understand that if I am not a California resident that I am not eligible for protection under or recovery from the Student Tuition Recovery Fund. I understand that OPI has the right to change its policies and that I am agreeing to those changes when notified in writing.

My signature below certifies 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.

Total Tuition to be paid at one time is: (select one) ONE TIME, PAID IN FULL TUITION

□ $ 4,950 (AA) □ $4,950 (BS) □ $5,950 (MA/MS) __

Scholarship Option 2

__ $249.85 per month over 40 months – this option is excellent for those wanting reduced tuition and monthly payments.

“I understand that my tuition is paid in full for all the required courses. I understand that once I submit this application and it has been accepted, I will be responsible for completing the program unless I formally withdraw. I understand the time-line for degree completion and that I have 40 months to complete AA , BS degrees and Master’s degrees. ”

Applicant’s Signature ____________________________________________________________

Date ____________________________________

I certify that the Optimal Performance Institute has met the disclosure requirements of Education Code 94312 of the Private Postsecondary and Vocational Reform Act of 1989.

(Official Only) Accepted by the Institute by ________________________ Title _____________________ Date __________

The Optimal Performance Institute, 1030 E. El Camino Real # 322, Sunnyvale, CA 94087, (866)796-6716

NO APPLICATION WILL BE ACTED UPON UNLESS ACCOMPANIED BY APPROPRIATE APPLICATION FEE AS INDICATED ABOVE.

NOTICE: ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAIMS AND DEFENSE WHICH THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICES OBTAINED PURSUANT HERETO OR WITH THE PROCEEDS HEREOF. RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR HEREUNDER.

Please, charge my tuition / tuition deposit to my: r Visa r MasterCard r American Express

Account Number _______________________________________________ Expiration Date _____________________

Signature ______________________________________________________________ Date ______________________

Mail this application to: The Optimal Performance Institute /Admissions

1030 E. El Camino Real

Ste. 322

Sunnyvale, CA 94087