Your form message has been successfully sent.

REGISTRATION FORM

Please correct your input in the following fields:

Error while sending the form. Please try again later.

First Name: *

Last Name: *

Address: *

E-mail address: *

City: *

State: *

Zip Code: * (#####)

Date of Birth: * (MM-DD-YYYY)

Social Security #: * (###-##-####)

Cell #: * ((###) ###-####)

Alternate Phone #: * ((###) ###-####)

I hereby digitally Signing Business, Insurance, Investigator and Security enrollment form, understand that I can only attend the Approved classes scheduled by BIS, I understand that I must submit a formal absentee request or Doctor note to skip classes or extend study, I understand that I must Complete the time allotted courses set by Government for the Pre-Licensing and be attentive at all times, furthermore I understand that during the entire time as Student I am bound by all other provisions or rules given to me by an instructor during the course of my studies, I understand that accordance to the Laws BIS enforces Equal opportunity treatment of fellow students, and has zero tolerance for offensive comments on (Race, Nationality’s, Accent, Religion, Age, and most importantly appearances), particularly offensive comments or jokes, Sexual gestures, advancements, comments that may construe as Sexual Harassment, and any action of sort will be cause for immediate suspensions and termination, If such determination is proven with “factual evidence” it may possibly result ban from obtaining my Government Licenses. I understand IF you are victim of such treatment You must IMMEDIATELY inform School’s Admission Department otherwise it will be hard to properly investigate and corroborate your issue.
If a student withdraws and does Not reschedule his or her classes, the following will apply:

Students who fail to attend have the option to re-schedule within 3 MONTHS from the original enrollment Date, at NO extra charge. - Minimum standards and study time for the program are set by the in charge Department of the State Government you reside.
I understand that if I do NOT complete my Online course within 60 days period and my absence was NOT APPROVED for break or sick time, I will be occupying access to the online classroom and therefore I authorize BIS to Charge my Credit Card For extension.

I Agree to comply with all terms and attendance Rules set forth by Business Insurance School on behalf of my License provider.

Refund or Cancellation POLICY for out of pocket clients:

I Agree that I can NOT dispute the charge that I authorized to pay for my Class by my credit or Debit card to BIS with my Bank and must go through Business and Insurance School Admission Department for Cancellation or Refund if any applies according to my enforcement provisions. I understand that if I violate this provision & Agreement I will be charged a Fee of $490.00

I Agree to comply with all terms set forth by Business and Insurance School. I understand because upon submission of payment I immediately receive access to the Course that I purchased, Business and Insurance School has NO refund policy and this transaction is final.

IMPORTANT: It is the State Government that will ultimately issues “A” “License” that you apply directly from the Government, Business and Insurance School has NO role or decision making power in that process, so be advised that the Government Department can revoke or deny “A” “License” at its own discretion. IF you believe that your Record is tainted because of minor offenses seek guidance from BIS Admission to Assist you to have it corrected, please make sure to communicate directly with the Dept. that you are seeking it’s License, Business and Insurance School Instructor, or Staff are prohibited to provide you with any advice or suggestions other than directing you to the Dept. for all your question with regard to your personal matters.

I Agree to all of the CA Dept of Insurance Rules and Regulations. That under CA penalty laws that my personal information and address is accurate.

How did you hear about Cyber Insurance School. Please be specific and provide the name or source:*

Company Affiliation. Please be specific and provide the name of your employer's Agency and Recruiter, phone number and address: *

SSL Privacy Policy NOTICE:

We understand how important your privacy is to you, so we are committed to assuring your privacy. We use SSL-encryption technology when transferring and receiving consumer data on our and our affiliates' websites to protect your personal information. Additional information on how your personal information is used and disclosed is contained in our complete Private Policy (View Cyber Insurance School entire Privacy Policy). I understand that by submitting my Registration form I am agreeing to the terms of Cyber Insurance School Privacy Policy Agreement.

Note: Fields marked with * are required

If you intend to pay with American Express please contact admission toll free 1-877-800-2822