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APPLICATION INFORMATION
APPLICATION STATEMENT

ExPO Signature Training Institute (a Katrix LLC company, hereinafter called “the Company”) does not discriminate on the basis of race, creed or color, religion, national origin, citizenship, age, gender, sexual orientation, disability, marital status, veteran status or any other status protected by law. The Company reserves the right to solicit information relative to your suitability for the training for which you are being considered.

To be in compliance with the New Jersey State Law regulations regarding criminal history background check, the Company requires that all students enrolled in the Certified Home Health Aide training course obtain a Fingerprint/ Criminal Background Check.

Please note that New Jersey State law provides that a person shall be disqualified from certification if that person’s criminal history record background check has not been cleared. This confirms that the Company reserves the right to drop such student(s) from the class with no tuition funds refunded.

This application is for training and does not constitute an offer of employment. Eligibility for employment will be determined after an employment application is filed, an interview is performed, references are verified and the interview process is successfully completed.

By signing below I understand and accept the above requirements.

I understand that omissions and/or misrepresentations made on the application form may be cause for my removal from training. I therefore certify that the information contained therein is true and complete to the best of my knowledge.

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CONSENT FORM

In consideration for being allowed to participate in the training programs provided by ExPO Signature Training Institute (a Katrix LLC company, hereinafter “the Company”) and/or in the use of its facilities and equipment where applicable, I do hereby waive, release and forever discharge the Company and all its directors, officers, agents, employees, representatives, successors and assigns, and all others from any and all responsibilities or liability for injuries or damages resulting from my participation in any training activities. I do also hereby release all of those mentioned above, from any responsibility or liability for any damages or injury to myself, including those caused by the negligent act or omission of any one of those mentioned or others acting on behalf, or in any way arising out of or connected with my participation in any of the contemplated activities or in the use of equipment through the Company or otherwise.

In witness whereof, the participant has executed the Express Assumption of Risk/ Prospective Waiver of Liability and Release Agreement as of the date below, which shall be binding upon them and their respective heirs, executors, administrators and assigns. They also hereby further agree to indemnify and hold the Company and all those named or identified herein absolutely harmless, in the event that anyone claiming any cause of action as a result of injury to participant, attempt at any time to institute any claim or suit against the Company arising out of any of the activities or programs herein or in use of any equipment.

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PAYMENT OPERATION

The cost for the training is $600.00 that must be paid in full by check, cash or credit/debit card before the class session begins. There will be a $25.00 charge for returned checks.

Please submit applications to admin@katrixhomecare.com. Payment arrangements can be made through the same email address. We appreciate your review and any feedback you may have.

PLEASE NOTE: Classes that do not meet the minimum number of students may be canceled. Students already enrolled will be notified immediately and will have the choice of deferring to the next scheduled class or receiving a full refund.

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