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EIEI Enrollment Agreement
The Education Institute for Early Intervention (EIEI), Inc Enrollment Agreement Form for ALL Programs
(Effective 8/5/2020)
252 Melrose Ave
Lansdowne, PA 19050
267-415-6724

STUDENT INFORMATION

STUDENT NAME

ADDRESS

CITY/STATE/ZIP

PHONE NUMBERS:

E-MAIL ADDRESS

LAST FOUR DIGITS OF YOUR SOCIAL SECURITY NUMBER

TELEPHONE NUMBER

NAME OF CHILD CARE PROGRAM

PROGRAM ZIP CODE

STAR LEVEL

PROGRAM ROLE (POSITION)

AGE GROUP

CCW: Y / N (SUBSIDY)

PROJECTED DAY OF ADMISSION

Child Development Associate (CDA) (9 CREDITS)

Early Childhood Education Inclusion Associate (ECEIA) (35.7 credits, 11 MONTHS)

School Age Inclusion Associate (SAIA) (33.7 credits, 11 Months)

LEARNING MODE

DAYS/EVENINGS CLASS MEETS: (check)

TIME CLASS BEGINS

TIME CLASS ENDS

CONSUMER INFORMATION

All schools are required to make available, at a minimum, the following disclosure information clearly and conspicuously on their 1) internet website, 2) school catalog, and 3) as an addendum to their Enrollment Agreement:
The number of students who were admitted in the program as of July 1 of that reporting period.
The number of additional students who were admitted in the program during the next 12 months and classified in one of the following categories: new starts, re-enrollments, and transfers into the program from other programs at the school.
The total number of students admitted in the program during the 12-month reporting period.
The number of students enrolled in the program during the 12-month reporting period who: transferred out of the program and into another program at the school, completed or graduated from a program, withdrew from the school, and are still enrolled.
The number of students enrolled in the program who were: placed in their field of study, placed in a related field, placed out of the field, not available for placement due to personal reasons, and not employed.
The number of students who took a State licensing exam or professional certification exam, if any, during the reporting period, as well as the number who passed.
The number of graduates who obtained employment in the field who did not use the school’s placement assistance during the reporting period (pending reasonable efforts to obtain this information from graduates).
The average starting salary for all school graduates employed during the reporting period (pending reasonable efforts to obtain this information from graduates).

NOTICE TO STUDENT

Do not sign this agreement before you have read it or if it contains any blank spaces.
This agreement is a legally binding instrument and is only binding when the agreement is accepted, signed, and dated by the authorized official of the school or the admissions officer at the school’s principal place of business. Read all pages of this contract before signing.
You are entitled to an exact copy of the agreement and any disclosure pages you sign.
This agreement and the school catalog constitute the entire agreement between the student and the school.
Any changes in this agreement must be made in writing and shall not be binding on either the student or the school unless such changes have been approved in writing by the authorized official of the school and by the student. All terms and conditions of this agreement are not subject to amendment or modification by oral agreement.
The school does not guarantee the transferability of hours to another school, college, or university. Coursework is not likely to transfer.

STUDENT ACKNOWLEDGMENTS

I hereby acknowledge receipt of the school’s catalog, which contains information describing programs offered, and equipment or supplies provided. The school catalog is included as part of this enrollment agreement and I acknowledge that I have received a copy of this catalog.
I have carefully read and received an exact copy of this enrollment agreement.
I understand that the school may terminate/withdrawal my enrollment if I fail to comply with attendance, academic, and financial requirements or if I fail to abide by established standards of conduct, as outlined in the school catalog. While enrolled in the school, I understand that I must maintain satisfactory academic progress as described in the school catalog and that my financial obligation to the school must be paid in full before a certificate or credential may be awarded.
To graduate, students must pass all required courses and have a cumulative average of a C (GPA 2.00) or better for all their courses.
I hereby acknowledge that the school has made available to me all required disclosure information listed under the Consumer Information section of this Enrollment Agreement.
Students are required to have a computer and/or access to a computer to complete assignments, be fully engaged in coursework, and research evidence based strategies to improve the practice. Computers are available at the school during non-instructional hours on designated days as outlined in the school’s operational hours.
I understand that the school does not guarantee transferability of hours and that in most cases, hours or coursework are not likely to transfer to another institution.
I understand that the school does not guarantee job placement to graduates upon program completion.
I understand that complaints, which cannot be resolved by direct negotiation with the school in accordance to its written grievance policy, may be filed with the State Board of Private License Schools, Pennsylvania Department of Education, 333 Market Street, 12th Floor, Harrisburg, PA 17126-0333 For questions, call 717.783.8228 or e-mail ra-pls@pa.gov.
The student acknowledges receiving a copy of this completed agreement, the school catalog, and written confirmation of acceptance prior to signing this contract. The student by signing this contract acknowledges that he/she has read this contract, understands the terms and conditions, and agrees to the conditions outlined in this contract. Any questions, comments, and concerns should be addressed to the Chief Executive Officer (CEO) Dr. Essence Allen-Presley at eallen7@gmail.com. It is further understood that this agreement supersedes all prior or contemporaneous verbal or written agreements and may not be modified without the written agreement of the student and the School Official. The student and the school will retain a copy of this agreement.

CONSENT

The Institute does not collect personal information for commercial marketing or distribution to any private organizations.

Student’s Names and Initials

Date




Admission Requirements

Candidates for admission are considered without discrimination from age, gender, race, ethnicity, national origin, religion, disabling condition or sexual orientation.

  • All applicants must submit a completed The Education Institute for Early Intervention (EIEI) Inc, application.
  • Applicants must submit an official high school transcript from an accredited high school or an equivalency diploma (GED) score report.
  • Background Checks Requirement:
  • Federal Criminal History Record
  • Pennsylvania State Police Request for Criminal Records Check
  • Department of Human Services Child Abuse History Clearance
  • Tuberculosis (TB) negative test result
  • Externship Fieldwork Informed Consent Form
  • Mandated Reporting Certificate
  • Employer Background Checks Verification Form (PA187)
  • Arrest/Conviction Report and Certification Form (PDE form-6004)

 

  • Applicants who have previously been convicted of a felony or misdemeanor may not be eligible to work in certain fields upon completion of the diploma. For more specific details and advice, the applicant should discuss his/her situation with the Chief Executive Officer.
  • Two letters of recommendation
  • A personal email address for correspondence
  • Personal interviews are not usually required however; the institute may require an interview with individual applicants for clarification on documents submitted.
  • The student is notified of their admission decision through written correspondence.