Martinsburg College
341 Aikens Center
Martinsburg, WV 25404
Tel. (304) 263-6262
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* First Name: * Last Name:
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* Address of Current Location*:    Apt/Unit:
*Students are required to inform the institution of any change of address during their program.
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* Have you taken a program at Martinsburg College in the past?
* End of Active Service Date (for Military Service Members):              
The federal government requires postsecondary educational institutions to collect data on race and ethnicity for reporting purposes only. Please respond to the following questions:
* Are you Hispanic or Latino?
* Please select one or more of the categories listed below with which you identify: American Indian or Alaska Native
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  * Have you ever attended a college or university or other training/vocational school after high school?
Please indicate yes if you have attended a university or college or a postsecondary school for occupational training even if you did not complete the program? If you have never attended any institution, please indicate no.
  * Are you a high school graduate or earned a GED?
  * Are you enrolling at Martinsburg College within 12 months of graduating high school or receiving your GED?

I am hereby enrolling in the academic program outlined below and my enrollment is subject to the terms and conditions stated in this enrollment agreement.

Program Enrollment
*Program Selected:      
Total Program Price:     $
*Preferred Start Date:       Scheduled End Date:
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Corporate Billing   Credit Card   Check   Tuition Assistance   MYCAA   G.I. Bill Funding  
Institutional Payment Plan/Institutional Loan   Other:  *If Other, please specify.
(If method of payment is T.A., school will invoice branch of service/company directly upon receipt of an approved tuition assistance authorization.)

Cancellation Policy

A student has five (5) calendar days after signing an enrollment agreement to cancel enrollment in any manner and receive a full refund of all monies paid to the institution.

A student requesting cancellation more than five calendar days after signing an enrollment agreement, but prior to beginning a course or program, is entitled to a refund of all monies paid minus a one-time administrative fee per program of no more than 20 percent of the tuition and not to exceed more than $200 per program.

Refund Policy:

When a student cancels after completing at least one assignment but less than 50 percent of the graded assignments, the institution may retain the administrative fee of no more than 20 percent of the tuition, not to exceed $200 per program, plus a percentage of tuition paid by the student in accordance with the following schedule:
Percentage Completed by the Student Percentage of Tuition Returned to the Student (or Third-Party Funding Agency) Minus the Administrative Fee Percentage of Tuition Retained by the Institution
Up to 10% 90% 10%
>10% - 25% 75% 25%
>25% - 50% 50% 50%
>50% - 100% 0% 100%

Sample Refund Calculation:

Total Number of Graded Assignments = 25

For students who complete 2 out of the 25 graded assignments: 2/25 = 8%

Tuition = $4500 – $200 administrative fee = $4300 x 10% = $430.00 + $200 administrative fee = $630. Total retained by the institution = $630. Total returned = $3870.

For students who complete 6 out of the 25 graded assignments: 6/25 = 24%

Tuition = $4500 – $200 administrative fee = $4300 x 25% = $1075 + $200 administrative fee = $1275. Total retained by the institution = $1275. Total returned = $3225.

For students who complete 12 out of the 25 graded assignments: 12/25 = 48%

Tuition = $4500 – $200 administrative fee = $4300 x 50% = $2150 + $200 administrative fee = $2350. Total retained by the institution = $2350. Total returned = $2150.

For students who complete 20 out of the 25 graded assignments: 20/25 = 80%

Tuition = $4500 – $200 administrative fee = $4300 x 100% = $4300 + $200 administrative fee = $4500. Total retained by the institution = $4500. Total returned = $0.

Refunds will be made within 20 days after receipt of a written notification of withdrawal or within 30 days of a cancellation or withdrawal request made in any manner. If no notification of termination is received by the school, refunds will made within thirty (30) days of the date of determination that the student has withdrawn from the program.

Students have the right to withdraw from the program at any time. However, the refund period ends in conjunction with the initial enrollment termination date which is located below. If you do not complete your program within the time allotted prior to the termination date of the enrollment agreement, no refund will be issued. The termination date of this enrollment agreement is 1.5 times the scheduled enrollment period which is .

General Information
All students must read and sign the Equipment Return Policy prior to starting their course. Courses are offered via distance learning. The student has the right to withdraw from the program at anytime. The student has the responsibility of informing the institution that s/he wants to withdraw. All equipment and materials on loan to the student must be returned to the institution at the time of withdrawal or the student will be billed for their replacement cost. (Please see the Equipment Return Policy.) The student has the responsibility for maintaining the academic schedule and submitting required coursework on time. Please click here for the complaint policy. The institution has the responsibility to support the student`s academic program and to communicate to the student his/her academic progress. For students interested in utilizing an Institutional Payment Plan/Institutional Loan, please click here for disclosure information. Students who choose to utilize an institutional loan will be required to sign a Retail Installment Contract (RIC) in addition to the Enrollment Agreement. Please click here for a sample Retail Installment Contract.

Martinsburg College cannot guarantee the transferability of credits to a college, university or institution. The acceptance of credits/coursework earned at Martinsburg College is determined by the receiving institution.

* I confirm that I have reviewed the Standardized Cost Form.

* I confirm that I have reviewed the Personalized Shopping Sheet and have received the information sheet for students utilizing Veterans benefits

* I authorize Martinsburg College to release and forward course enrollment information including course withdrawal, course cancellation, course completion or failure, grade, verification of degree or certificate completion, billing information, and any other required information to the Department of Defense and/or the TA issuing Service`s education office or funding agency.

* By checking this box, I am signing that I, , understand and agree to comply with the terms and conditions of this enrollment agreement, including the Cancellation and Refund Policy. I affirm that I have received access to the catalog and the complaint policy. I understand the rights, responsibilities, and obligations of both the student and the institution. I understand that this contract is legal and binding once submitted by me and accepted by the institution. If third party approval for tuition funding is required, this agreement is not binding until such approval is granted.

I understand that electronically typing my name into this document is considered to be the same legally-binding effect as signing my signature using pen and paper.