Online Enrollment Agreement

Davis University

433 N. Summit St.
Suite 202
Toledo, OH 43604

419-473-2700
www.davisuniversity.edu

Davis University Online Enrollment Agreement

First Name *

Last Name *

Preferred Name (Nickname)

Maiden Name:

Birth Date *

Email Address *

Social Security Number *

Street Address *

City *

State *

ZIP Code *

Phone Number *

Race or Ethnicity (U.S. Department of Education Disclosure Information) *

Gender Assigned at Birth (U.S. Department of Education Disclosure Information) *

Female

Male

Marital Status (U.S. Department of Education Disclosure Information) *

Married

Single

Have you made an application to Davis University before? *

Yes

No

Year

I will be attending *

Day

Evening

Unsure

Anticipated Course Load *

Full-time (12+ credit hours)

3/4-time (9–11 credit hours)

Part-time (6–8 credit hours)

Unsure

Program (Select program in which you are enrolling.) *

Start Date *

Fall Quarter (August)

Winter Quarter (November)

Spring Quarter (February)

Summer (May)

Program Length (Select program in which you are enrolling.) Program length is based on the student taking 12 credit hours. "Weeks" means weeks of instruction. Actual time to complete this program depends on the number of credit hours taken per quarter. *

High School *

High School Diploma or GED *

High School Diploma

GED

Street Address

City

State

ZIP Code

Graduation Date

Have you attended another college or university? *

Yes

No

Colleges and Universities Attended

College or University

Last Date of Attendance

College or University

Last Date of Attendance

College or University

Last Date of Attendance

Are you seeking transfer of credits? *

Yes

No

Are you a U.S. citizen? *

Yes

No

Do you plan to apply for Financial Aid? *

Yes

No

Are you eligible for Veteran’s Benefits? *

Yes

No

Are you Agency or Company Sponsored? *

Yes

No

If sponsored, provide name and phone number of sponsor or company.

Sponsor/Company Name

Phone Number

Emergency Contacts

Emergency Contact 1

First Name *

Last Name *

Phone Number *

Relationship to Student *

Emergency Contact 2

First Name

Last Name

Phone Number

Relationship to Student

TUITION & FEES I agree to pay quarterly tuition and fees as follows: (Please select all items below.) *

$20 Application Fee

$350 per Credit Hour Tuition

$25 Computer/Clinical Lab Fee (per Lab Hour) if applicable.

$350 General Fee (Resource Center, Help Center, Tutoring Service, Student Activities, Student Planner, Parking)

Projected Tuition Cost of Program (Select program in which you are enrolling.) *

These are the estimated costs for the first quarter. Books and fees are not included.

Tuition and fee amounts are based on the fee structure in place at the time of enrollment. Davis University reserves the right to change policies, procedures, requirements, courses, textbooks, tuition, and fees without prior notice.

TUITION REFUND POLICY

Refunds on tuition and fees are as follows:

Withdrawal	Refund
Before 1^st calendar week	FULL REFUND
1^st calendar week	75%
2^nd calendar week	50%
3^rd calendar week	25%
4^th calendar week	NO REFUND

By signing this Application for Admission and enrolling in Davis University, the undersigned agrees to be bound and governed, during his/her enrollment at Davis University, by the rules, regulations and procedures as established and set forth in the Academic Catalog, Catalog Supplement, and Student Handbook as revised or supplemented by Davis University from time to time.

This application may be cancelled, and all fees paid to the school refunded within five calendar days after the date of signing provided Davis University is notified of the cancellation in writing.

In compliance with the State Board of Career Colleges and Schools rules, I certify that I have been made aware of and understand that: “All problems or complaints that I have about Davis University, whether or not the problems or complaints have been resolved to my satisfaction by the school, may at my option be directed to the Executive Director, State Board of Career Colleges and Schools, 30 East Broad Street, Suite 2481, Columbus, Ohio 43215 (877) 275-4219, email: bpsr@scr.state.oh.us.”

Student Signature *

clear

Signature of parent, guardian, or sponsor (if minor)

clear

Signature of Admissions Representative

clear

Date *

The Davis University Campus Security Report

Publication Date: August 2020

Revised Date: November 2023