STUDENT # : Section I : STUDENT INFORMATION Last Name: First Name: Terms: Address: City: Province: Country: Email: Telephone: Gender: Date of birth: Tuition: Admissions fees : File fees : Balance of : Administration Fees: Total Due: Terms of payment : X X TERMS OF PAYMENT The registration fee and File Fee (if applicable) of $250 is non-refundable regardless of the circumstances. The parties accept the payment terms described above: Student's initial Initials for college ADDENDUM VISA STUDENT Permanent Code: Postal code : 5290372 Ayeni Adesanmi Folorunso 3331 Av Maréchal Montreal CA lapaixsy@protonmail.com 4389237522 June 03, 1997 Student VISA QC H3T1M8 M $19,400 $19,150 $200 $50 + $1000 administration fees = $5,191 + $1000 administration fees = $4,384 + $1000 administration fees = $3000 + $2,250 administration fees = $11,825 09 / 19 / 2022 10 / 19 / 2022 11 / 19 / 2022 05 / 19 / 2023 $4,191 $3,384 $2000 $9,575 $5,250 $24,400 Document Ref: JSSLP-65XMH-BZ7CK-ERT2U Page 1 of 6 All parties are in agreement that the following annexes are an integral part of this contract. Annex A: International Student Obligations and obligations Annex B: Additional charges Annex C: Validity of immigration documents Annex D: Affidavit Annex E: Disclosure Form In witness whereof, all parties have executed this contract in Montreal on : Signatures : For Herzing College: For Student: X Document Ref: JSSLP-65XMH-BZ7CK-ERT2U Page 2 of 6 International students are required to: Signed in Montreal, this: X ANNEX A International Student Information: 1. Completion of your program of choice does NOT guarantee a Post Graduate Work Permit. All programs at Herzing College Montreal qualify for the PGWP, but every student’s situation is looked at individually. Information about the Post Graduate Work Permit can be found at the Citizenship and Immigration Canada website. https://www.canada.ca/en/immigration-refugees- citizenship/services/study-canada/work/after-graduation.html 2. Overall employment rates do not guarantee employment in Canada or anywhere else. They are based on statistics from the Montreal campuses but are not intended to guarantee employment. 1. Ensure that they are able to communicate adequately in one of the two official languages, otherwise their internship must be held at the college. 2. Make an appointment with our Internship Coordinator twenty (20) weeks prior to the start of their internship; To confirm the status of their co-op work permit that is required before starting the internship. 3. Make an appointment with their Admissions Advisor 16 weeks before the expiry of their documents (CAQ, Study Permit). 4. Provide documents (CAQ, study permit, health insurance), as otherwise the student will be put on the waiting list. 5. Obtain health insurance valid for the duration of their studies through Herzing College health insurance providor. Student Signature 09 / 07 / 2022 Document Ref: JSSLP-65XMH-BZ7CK-ERT2U Page 3 of 6 The services covered by these fees include, but are not limited to: X Here is a list of additional fees based on Program duration. Fees shown are for general administrative expenses as well as student services' fees. Health insurance by GuardMe and Morneau Shepell (International Student Support Program) are also included for the duration of the program. ANNEXE B ADDITIONAL ADMINISTRATIVE FEES International Advisor Program Duration Additional Fees Program duration less than 2 Years Program duration greater than 2 Years Name Signature I understand that the fees mentioned above are additional administrative fees to tuition fees and that I have to pay these administrative fees. These fees are 100% refundable up to the first day of class. If you do not start class at Herzing College, you pay NO Administrative fees. They are even up to 100% refundable within the first 2 weeks of class (depending on insurance claims). If you decide to withdraw after 2 weeks of class, these fees are 50% refundable. After one month of studies, the fees have been earned. All of these services are paid up front by Herzing College and are accessible to you whether you withdraw from the college or not. Health insurance is NOT cancelled if you withdraw after having paid your Administrative fees. At Herzing College, we do our best to equip you to succeed in college, but it is a fact that it does not work out that way for all students. Please keep in mind that the door at Herzing College is always open if you withdraw from the college. It is always possible for you to return to the college and pick up where you left off. The Administrative fees paid would still be honoured and applied to your studies upon return. 1. Health insurance for the duration of the student’s studies (up to 26 months, through GuardMe) 2. 24/7 counseling through the Keep Me Safe program for the duration of the student studies (up to 26 months, administered by Morneau Sheppell) 3. Online language training through Berlitz (up to 2 years) 4. Financial Awareness Training with Enrichment Academy (for the duration of the program, with no expiration) Adesanmi Folorunso Ayeni $5,250.00 $6,000.00 Document Ref: JSSLP-65XMH-BZ7CK-ERT2U Page 4 of 6 X ANNEX C RECOGNITION OF IMMIGRATION DOCUMENTS FOR INTERNATIONAL STUDENTS THAT EXPIRE BEFORE THE END OF THE HERZING COLLEGE STUDY PROGRAM. The Canadian and Québec governments have strict regulations regarding the documentation necessary for foreign students to study in Canada, and specifically in Québec. Some or all of your documentation expires before the completion of the program youhave enrolled in at Herzing College. Although you have provided the necessary documentation to begin the program, without the corrected end dates for your documentation, you will not be able to remain a student after the expiration of your documents (CAQ or Study Permit or both) I, , acknowledge that I have read the above notice and understand how this may pertain to my status as a student at Herzing College. I understand that I have thirty (30) days from the date this document is signed to present in writing, proof to the college that I have requested the necessary corrected documentation Student Adesanmi Folorunso Ayeni AEC LEA.3V : MICROCOMPUTERS AND NETWORKING SYSTEMS Document Ref: JSSLP-65XMH-BZ7CK-ERT2U Page 5 of 6 Family Name: First Name: Gender: Date and place of birth: Father Family Name: First Name: Mother Family Name: First Name: Signed on at Herzing College of Montreal. Advisor (Witness) Admissions Department 514-935-7494 ANNEX D Affidavit I______________________________ student residing at: ___________________________________________ state that the information listed below is accurate and true. Country Zena Kejjo Commissaire à l’Assermentation 514-935-7494 poste 114 Date X Student Signature Date of Birth City, province Adesanmi Folorunso Ayeni 3331 Av Maréchal June 03, 1997 Ila Orangun, Osun State Ayeni Adetona Ayeni Temitayo 09 / 07 / 2022 M Nigeria Montreal QC H3T1M8 Ayeni Adesanmi Folorunso Document Ref: JSSLP-65XMH-BZ7CK-ERT2U Page 6 of 6 Signature Certificate Reference number: JSSLP-65XMH-BZ7CK-ERT2U Document completed by all parties on: 07 Sep 2022 19:00:46 UTC Page 1 of 1 Signer Timestamp Signature Negar Pouladian Email: npouladian@mtl.herzing.ca Recipient Verification: Sent: 07 Sep 2022 14:19:54 UTC Viewed: 07 Sep 2022 14:20:32 UTC Signed: 07 Sep 2022 18:34:06 UTC ✔ Email verified 07 Sep 2022 14:20:32 UTC IP address: 199.167.106.250 Location: Verdun, Canada Adesanmi Folorunso Ayeni Email: lapaixsy@protonmail.com Recipient Verification: Sent: 07 Sep 2022 14:19:54 UTC Viewed: 07 Sep 2022 18:59:49 UTC Signed: 07 Sep 2022 19:00:46 UTC ✔ Email verified 07 Sep 2022 18:59:49 UTC IP address: 89.36.78.215 Location: Montreal, Canada Signed with PandaDoc PandaDoc is a document workflow and certified eSignature solution trusted by 30,000+ companies worldwide.