OKLAHOMA HORSESHOEING SCHOOL, INC.
MAIL-IN TUITION ASSISTANCE LOAN APPLICATION

APPLICANT INFORMATION

Full Name:

Social Security Number:

Home Phone Number:

Fax Number:

E-mail Address:

Date of Birth:

Drivers License Number:

Present Address:

How many years have you lived here?:

Previous Address:

How many years have you lived there?:

Are you married? Yes No

Name and Address of Employer:

Your Position/Title:

Years employed:

Name of Supervisor:

Business Phone Number and Extension:

Name and Address of Previous Employer:

Present Monthly Net Salary and/or Commission:

Number of Dependents:

List Ages of Dependents::

Alimony, Child Support, or Separate Maintenance Income Need Not be Revealed if You Do Not Wish to Have Considered as a Basis for Repaying This Obligation.

I am receiving Alimony, Child Support, Separate Maintenance Received under: Court Order Written Agreement Oral Understanding

Other Income (per month):

Source(s) of other income:

Is any income Listed in this Section Likely to be Reduced Before the Credit Requested is Paid off? Yes No

If the answer to the previous question is "Yes," please explain:

Name of Nearest Relative Not Living With You:

What is their relationship to you?

Relative's Address:

Relative's Phone Number:

Applicant's Asset Information

Cash on Hand and On Deposit in Banks: .. Subject to Debt: Yes No .. Name of Owner(s):

Deposits with Savings & Loans & Credit Unions: .. Subject to Debt: Yes No .. Name of Owner(s):

Automobiles (List: Make, Model, Year, Value): .. Subject to Debt: Yes No .. Name of Owner(s):

Cash Value of Life Insurance (List: Issuer, Face Value): .. Subject to Debt: Yes No .. Name of Owner(s):

Real Estate (List location, Date Acquired, Net Value): .. Subject to Debt: Yes No .. Name of Owner(s):

Other Assets Owned, and Estimated Values:

Applicant's Credit References (Paid Accounts)

Name of Creditor:
Type of Debt:
Name of Account:
Original Amount of Debt:
Date Paid Off:

Name of Creditor:
Type of Debt:
Name of Account:
Original Amount of Debt:
Date Paid Off:

Are There Any Unsatisfied Judgements Against You? Yes No
If "Yes," in what amounts, and to whom are they owed?:

Have You Been Declared Bankrupt in the Last 14 Years? Yes No
If "Yes," in what amount, when, and where?:

Do you have any other obligations?:

Are you obligated to pay Child Support, Alimony, Separate Maintenance? Yes No

If "Yes," to whom is it being paid?

How much are you paying, and how often?

CO-SIGNER INFORMATION

Full Name:

Social Security Number:

Home Phone Number:

Date of Birth:

Drivers License Number:

Present Address:

How many years have you lived here?:

Previous Address:

How many years have you lived there?:

Are you married? Yes No

Name and Address of Employer:

Your Position/Title:

Years employed:

Name of Supervisor:

Business Phone Number and Extension:

Name and Address of Previous Employer:

Present Monthly Net Salary and/or Commission:

Number of Dependents:

List Ages of Dependents::

Alimony, Child Support, or Separate Maintenance Income Need Not be Revealed if You Do Not Wish to Have Considered as a Basis for Repaying This Obligation.

I am receiving Alimony, Child Support, Separate Maintenance Received under: Court Order Written Agreement Oral Understanding

Other Income (per month):

Source(s) of other income:

Is any income Listed in this Section Likely to be Reduced Before the Credit Requested is Paid off? Yes No

If the answer to the previous question is "Yes," please explain:

Name of Nearest Relative Not Living With You:

What is their relationship to you?

Relative's Address:

Relative's Phone Number:

Declaration of Applicant and Co-Signer

Everything that I have stated in this application is correct to the best of my knowledge. I understand that Oklahoma Horseshoeing School will retain this application whether or not it is approved. Oklahoma Horseshoeing School is authorized to check my credit and employment history and to answer questions about its credit experience with me.

Applicant: I declare that I have read and understand the statement above: Yes
Signature: Date:

Co-Signer: I declare that I have read and understand the statement above: Yes
Signature: Date:

Fill in all the blanks on this page as completely as possible.
Be sure you have read all of the "Conditions" on this page.
Use your printer to print out two copies of the completed page, sign the form where necessary, and keep one copy for your records.
Mail one copy to Oklahoma Horseshoeing School, Inc., 26446 Horseshoe Circle, Purcell, OK 73080 USA.

Check the appropriate box(es) for the course(s) in which you want to enroll.

Basic Horseshoeing - 2 Weeks (108 hours)

Tuition: $1,300.00
Choice of class dates: 1st: 2nd:
I am submitting my $150 tuition deposit. I will pay the balance of tuition of $1,150.00 on the first day of class.

Professional Horseshoeing - 8 Weeks (432 hours)

Tuition: $3,600.00
Choice of class dates: 1st: 2nd:
I am submitting my $150 tuition deposit. I will pay the balance of tuition of $3,450.00 on the first day of class.

Advanced Horseshoeing & Blacksmithing Course - 12 Weeks (648 hours)

Tuition: $5,000.00
Choice of class dates: 1st: 2nd:
I am submitting my $150 tuition deposit. I will pay the balance of tuition of $4,850.00 on the first day of class.

Advanced Horseshoeing, Blacksmithing and Applied Horsemanship Program - 15 Weeks (738 hours)

Tuition: $6,000.00
Choice of class dates: 1st: 2nd:
I am submitting my $150 tuition deposit. I will pay the balance of tuition of $5,850.00 on the first day of class.

Horse Owner's Practical Horse Training - 2 Weeks (60 hours)

Tuition: $1,300.00
Choice of class dates: 1st: 2nd:
I am submitting my $150 tuition deposit. I will pay the balance of tuition of $1,150.00 on the first day of class.

Continuing Education for OHS Grads - 1 Week blocks (54 hours per week)

I graduated from the course on (date) .
I wish to continue my education in this same field for (# of weeks) .
Choice of class dates: 1st: 2nd:
Tuition: $400.00 per week
I am submitting my $50 tuition deposit. I will pay the balance of tuition of $350.00 for the first week, and tuition of $400.00 per week for the following weeks on the first day of class.
We only accept payment by use of credit card. You must complete the following information:

I am using a: Visa MasterCard American Express Discover

Name on the Card (please print):

Card number:

Expiration Date:

Your signature:

ATTENTION - VERY IMPORTANT INFORMATION BELOW. PLEASE READ ALL OF IT NOW, BEFORE COMPLETING THE REST OF THIS FORM.

THESE CONDITIONS ARE PART OF THIS AGREEMENT

Deposit: I understand that my deposit is non refundable if, due to my actions, I fail to attend school. The school will notify me within one week of the receipt of my deposit as to my class date. If a satisfactory date cannot be arranged, my deposit shall be refunded.

Continuation of All Horseshoeing Courses and Programs: It is understood that should I choose to enroll in a longer horseshoeing program, I will be automatically be credited for the time and tuition already spent.

Continuation of All Courses: If, for any reason the student wishes to attend class at the end of his/her course, he/she is entitled to stay at the school at the rate of $400.00 per week.

Release: I understand that horseshoeing, horse training, equine dental technology and horseback riding are dangerous. I fully assume all responsibility for any accident or injury which I may suffer during the period of enrollment, as well as any compensation time allowed by the school for any reason. I further release and discharge the school, its owners and operators, horse owners, and owners of land upon which any classes or training is taking place, in all manners from suits, actions and causes of action under the terms as herein above set forth.

I understand that this application is personal to me and that if I desire to assign same, I must get the written consent of the school.

Cause for dismissal:

Lack of satisfactory progress
Breach of attendance or conduct policy
Termination Refund Policy

1) Termination date for refund computation purposes shall be the last date of class attendance by the student. The school requests notice of cancellation or withdrawal to be given to the school in writing.

2) Any applicant rejected by the school (not accepted for enrollment) shall be refunded all tuition and enrollment fees paid.

3) Any applicant who wishes to cancel his/her enrollment within three days of signing an enrollment contract and making an initial payment shall be entitled to a full refund of all tuition and enrollment fees paid to the school. Any applicant who wishes to cancel his/her enrollment after three days of signing an enrollment contract, but before beginning classes, shall be entitled to a refund of all monies paid minus the enrollment deposit fee of $150.00.

4) Any two week student requesting termination of enrollment within the first 1/4 of the course shall be refunded all monies paid minus the ($150.00 deposit plus 1/4 the total tuition paid). Any two week student requesting termination of his/her studies after the initial 1/4 of the course but within the first ½ of the course shall be refunded all monies paid minus the ($150.00 tuition deposit plus ½ the total tuition paid). Any two week student requesting termination of enrollment after having attended more than 1/2 of the course shall not be entitled to any refund.

5) Any student of a course longer than two weeks who requests termination of enrollment shall be refunded as follows:
Any student requesting termination of enrollment within the first week of study shall be refunded all monies paid minus 10% of the contract price of the course plus the $150.00 enrollment fee (not to exceed $350.00).
Any student requesting termination of enrollment after the first week but within the first 25% of the course shall be refunded all monies paid minus 25% of the cost of the course plus the $150.00 enrollment fee.
Any student requesting termination of enrollment after the first 25% of the course but within the first 50% of the course shall be refunded all monies paid minus 50% of the cost of the course plus the $150.00 enrollment fee.
Any student requesting termination of enrollment after more than the first 50% of the course shall not be entitled to any refund.

6) Any student using Veteran’s Benefits and requesting termination of enrollment shall be refunded on a pro rata basis according to the amount of time he/she has been enrolled in school.

7) In the case of prolonged illness or accident, death in the immediate family, or other circumstances which make it impractical for the student to complete the program, the school shall make a settlement which is fair and reasonable to both parties.

8) Any refund due the applicant shall be made within 30 days of cancellation or termination.

9) In the case that any course in which a student or prospective student is enrolled shall be cancelled, the student shall be refunded all tuition and enrollment deposit fees.

10) Books and tools received by the student are non-refundable.

11) Any holder of this consumer credit contract is subject to all claims and defenses which the debtor could assert against the seller of goods and services obtained pursuant or with the proceeds hereof. Recovery shall not exceed the amounts paid by the debtor.

Student Name:

Address:

Phone number:

Fax number:

E-mail address:

Age:

Sex:

Height:

Weight:

Handicaps (please explain):

Previous experience:

I want a room: Yes No

International Students must complete these:

Date of birth:

Country of birth:

Country of citizenship:

I have fully read and understand this Agreement: Yes

Signature of Applicant:

I will print out and retain a copy of this application: Yes

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If you are not a minor, you may skip this section, but
IF THE STUDENT IS A MINOR, both parents must sign this application.
Both parents of the minor should sign and date in this box:

Remember to print out two copies of this completed application, and retain one for your records.