Saco River Education PDF Details

The Saco River Education Form is an online form designed to help educators learn more about the Saco River Watershed. The form asks a series of questions about the educator's experience with the Saco River and their interests in learning more about it. Educators can then use the information they provide to find relevant resources and connect with other educators who are interested in the Saco River. The form is easy to use and provides a wealth of information for educators who want to learn more about this wonderful watershed.

We have gathered some general details about the saco river education. You may want to look at it before writing the gaps.

Form NameSaco River Education
Form Length7 pages
Fillable fields0
Avg. time to fill out1 min 45 sec
Other namescom sacorivereducation, education river saco, education sacorivereducation com, saco river education login

Form Preview Example

Saco River Education

P.O. Box 69

Waterboro, ME. 04087

(207)247-9000 option 5


Dear Student,

Thank you for your interest in Saco River Education. Our online training course for Personal Support Specialist is an innovative way for you to learn. The majority of the Course is taken online, through SRE’s website, and consists of the virtual classroom, handouts, quizzes, homework questions and onsite re-demonstrations/final exam.

Included in this packet are the Payment Guidelines, a Registration Form, the Student Enrollment Contract a Payment Information Form, a Release of Information Form and the Course Policies and Procedures.

Saco River Education has an open enrollment policy; a student can enroll at anytime! Simply fill out and return pages 3 thru 6 to Saco River Education and retain pages 2 and 7 for your records. Once Saco River Education has received all necessary forms and payment, a confirmation email is sent with all necessary information to access the web site. If there is a third party involved with funding the cost of the Course, the student will need to sign and return the Permission to Release Information Form as well. Saco River Education does have payment plan options, for more information and to set up a payment plan, please call Saco River Education or reference the Payment Information Page.

Should you have any questions regarding this material, or questions about the Course, please feel free to contact Saco River Education by phone or e-mail.

Once again thank you for your interest in Saco River Education and we look forward to working with you soon!

Saco River Education

P.O. Box 69

Waterboro, ME. 04087

(207)247-9000 option 5



Payment Policies: Payment in full, or the first installment in a payment plan ($100), is due upon registration. Access to the website will be granted for a period of six months. Saco River Education reserves the right to suspend access to any student who has not complied with a payment plan. Certificates are not issued for those who have not paid in full.

Level I: Individual

Cost: $200.00/Individual

Level II: Agency

Cost varies depending on Agency. Please refer to your contracted price. Agency must pay for the course, not the student.

**If a student does not complete the Course a refund may be available. Please see our Refund Policy in the Student Enrollment Contract. Email a request for refund to

Rev. 4/2011

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802 Main Street, P.O. Box 69 Waterboro, Maine 04087 Phone: (207) 247-9000 opt 5 Fax: (207) 247-6109


Registration Form

Name: ___________________________ Mailing Address: ____________________________________

City: _________________________________ State: __________________ Zip: __________________

Phone Number: _______________________________ Cell Phone: _____________________________

E-Mail Address: (mandatory, you MUST have an E-mail address for routine correspondence):

__________________________________________________________________ (please write clearly)

Last 4 Social Security #: ________________________ Date of Birth: ___________________________

Employer Name:_______________________________ Phone Number: _________________________

Contact Person at Agency (if applicable): __________________________________________________

Current Position: ______________________________ Highest Grade Completed: _________________

Computer Experience: [ ] None


] Minimal


] Average


] Above Average

Do you have experience with E-mail? [

] None


] Minimal


] Average

Do you have experience working with: [

] Internet


] Microsoft Word



Internet Access Type: [ ] Dial up (not recommended)

[ ] Cable / DSL



In planning for the re-demonstration and final exam, which site is closest to you?

(These are offered on a regular basis and you will see upcoming dates and times in the Student Update)

[ ] Presque Isle [ ] Waterville [ ] Saco (Portland Area) [ ] Bangor

What date does the Agency require you to have your final exam by? ____________________________

A letter of class confirmation and all materials needed to access the web site is sent as soon as all forms necessary have been filled out and payment received. Please allow 7 to 10 business days from receipt to process registration.


For Office Use Only

User Name: ________________ Password: _________________ Tested: [

] Invoice # ____________

Control # _________ Expiration Date: ______________ Pay Plan: [ ] no [

] 2 ______ By: ________

Rev. 4/2011

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802 Main Street, P.O. Box 69 Waterboro, Maine 04087 Phone: (207) 247-9000 opt 5 Fax: (207) 247-6109


Student Enrollment Contract

The Personal Support Specialist Course is a 50-hour online (computer-based) Certificate Course. Tuition: $200.00 or otherwise negotiated

Instructors: Joyce S. Segee, RN, MSN, & Elizabeth S. Sjulander, RN, BSN

Student Expectations: Each student must have a valid email address that they will check regularly for correspondence. Our students are responsible for keeping SRE updated as to their contact information while they are enrolled in the course. Please provide us with your email address below. This is mandatory:


Refund Policy: All refund requests must be made in writing, utilize the refund request form available online, within six months of enrollment and sent to SRE.

100% refund available for requests received within three business days of enrollment.

$50 registration fee and a prorated charge for each class taken will be issued after three business days up to a period of six months.

No refund requests will be honored after six months of enrollment. Refunds are issued to the person that made the payments.

Please allow 4-6 weeks for your refund to process.

Payment Expectations: Full payment is expected upon registration, prior to starting the PSS Course. Saco River Education will accept payment in the form of cash or check, Visa, MasterCard or Discover. Checks should be made payable to Saco River Education. Access to the course will not be granted until full payment is received, UNLESS a payment plan has been established and agreed upon by the billing department of Saco River Education. A confirmation of registration and all materials necessary to access the web site classroom will be sent within 7- 10 business days after receipt of all completed registration forms and payment. All billing inquires, including refunds, should be directed to our billing department at Expiration/Reinstatement: There will be a six (6) month expiration date on all user names and passwords. This may be extended to one year upon request. There is a one year inactivation policy, and, if after one year of enrollment, a student would like to continue with the course there will be a $50.00 re-activation fee. Complaints: All concerns or complaints related to the PSS Course should be directed to Elizabeth Sjulander via email ( or sent to Saco River Education, at P.O. Box 69 Waterboro, ME 04087. Payment Plan: If the student has elected the payment plan option, a $100.00 payment is due at the time of registration which will grant access to the website for a six month time frame, a second payment of $50 is due within 30 days, and the remainder of the balance is due within 60 or prior to re-demonstration, whichever comes first. SRE reserves the right to suspend the password at anytime for NON-payment. Certificates of completion will be held until verification of all funds has occurred and no student will be allowed to attend a final exam until full payment is received.

Tech Support: Is available by emailing or by phone during regular business hours of Monday thru Friday 9:00am to 3:00pm, or by appointment. As this is a very limited time frame you are encouraged to fully read the Welcome Packet as most technical support issues can be easily solved by following the simple instructions. Before calling, the student should be connected to the internet and on the SRE Website. It is essential that the student be able to work on the computer and speak with technical support at the same time in order for SRE to provide the best possible customer service. After hours technical support is available upon request, by appointment.

Student Signature __________________________________ Date __________________

Rev. 4/2011

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802 Main Street, P.O. Box 69 Waterboro, Maine 04087 Phone: (207) 247-9000 opt 5 Fax: (207) 247-6109


Payment Information

Reminder: For all payment methods Tuition is due upon registration. Acceptable payment methods are cash, checks, Visa, Mastercard and Discover. No student will be allowed to attend a final exam prior to full tuition being received.

Payment Plan Options: $100 down then [ ] $50 (2 pay option) [ ] Please invoice my remaining balance.

[] I am paying by CHECK or MONEY ORDER.

Please make payable to Saco River Education and mail to:

P.O. Box 69

Waterboro, Maine 04087

[] I am paying by CREDIT CARD. (please fill out the information below)

I authorize Saco River Education to charge my credit card for the full tuition payment of

$__________. Or

[ ] I would like a payment plan and authorize the initial tuition payment of (minimum of $100.00) $___________. And subsequent payments of: [ ] $50 (2 pay option)




(account number)


(exp. date)


(card security code)









Billing Address: ________________________________

(name on card)







[] I am paying by CASH. (Please, do NOT mail cash)

If you wish to pay by cash, please come to our location at: 802 Main Street

Waterboro, Maine.

This is the Saco River Health Services office and you may pay by cash and get a receipt for payment.

[ ] Please BILL MY PROVIDER. Provider’s Signature: ________________________________

Rev. 4/2011

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802 Main Street, P.O. Box 69 Waterboro, Maine 04087 Phone: (207) 247-9000 opt 5 Fax: (207) 247-6109



As a student who is participating in this class, funded by an agency / facility, you MUST give permission for Saco River Education to release information to that agency / facility.

I, ____________________________________, hereby give permission for Saco River Education to

disclose information to______________________________________(please fill in the name of the

agency / facility) about any of the following:

1.All Attendance

2.General Progress Reports with detail available upon request

3.All correspondence between Student and SRE

The above information will be released with my full consent. I understand that this authorization remains in effect until a written request is sent to revoke this authorization.


Signature of Student Allowing Release of InformationDate


TO PROVIDER, please provide SRE with an email address that is checked frequently so SRE can send you progress Updates and any other necessary information.

Email Address: ______________________________________

Contact Name: _______________________________________

Saco River Education – 802 Main Street - P.O. Box 69 - Waterboro, Me.04087

Phone 207-247-9000 option 5 Fax 207-247-6109


Rev. 4/2011

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802 Main Street, P.O. Box 69 Waterboro, Maine 04087 Phone: (207) 247-9000 opt 5 Fax: (207) 247-6109



Student Attendance: Each student is responsible for their own progress. Each student must have an email address to which we may send progress reports. Progress reports (with a signed Permission to Release) will also be sent to any Agency that is funding the training.

Length of Course: The Course is accessed through a 24-hour website therefore class length is the amount of time it takes the student to complete the required materials. Saco River Education (SRE) sets no time limit on the completion of the course, yet we reserve the right to discharge students due to inactivity. An expiration date of 6 months is given for completion. An extension is easily obtained by contacting Saco River Education via phone or email.

Independent Study: Each student who is enrolled in SRE’s online training is an independent study student. We expect that our students will take responsibility for initiating activity on our learning website. We are available via email and through our website contacts, and will respond to your questions as soon as we can. We will provide details regarding how to contact your Instructor upon registration.

Student Learning Expectations: Each student is expected to independently complete all of the required classes including viewing/listening to the class, reading any associated handouts, completing homework questions on the syllabus via the link in the classroom, and submitting an accepted quiz. Our Instructors will contact students if homework is not complete/accepted. Students may contact their Instructor for further clarification if needed. Students may call our administrative office during business hours and we will assist them over the phone. The student will also be required to attend an onsite re-demonstration and final exam.

Partial Completion: Any student who completes the initial “core” curriculum (classes 1-6) can receive a partial certificate of completion. This may be credited towards the Certified Nursing Assistant Curriculum in Maine for a period of two years.

Educational Materials: The online program is the primary text, and the handouts printable. We will provide printed handouts for the entire class for a charge of $35.00. Students are NOT required to purchase any text for this Course. The classroom/curriculum material however, is ONLY available online and not available to be printed, for any fee.

Testing: Students complete homework questions (found on the syllabus and via the homework questions link at the bottom of the classroom. These are NOT the “discussion questions” located at the end of the slides in the virtual classroom). Quizzes are taken at the end of each class and may be taken up to 3 times if a score of 80% is not achieved. Once a quiz is taken more than once, a maximum grade of 80% is assigned. The student must achieve an average of 80% on all testing to successfully complete the course. If you need a quiz reset, please email A re-demonstration of skills onsite is required after all classes have been completed. A secured final exam is given on the re-demonstration day. A score of 75% must be achieved on the Final Exam. After successful completion of all classes, re-demonstration skills and the final exam, certificates are requested from the State of Maine. You may print your certificate from in approximately six weeks from completion of final exam.

Required Materials: A windows based computer in which you are the administrator (i.e. not a “guest”), a working email address that you check regularly (i.e. at least 5 times a week) and access to the internet (preferably high speed).

Rev. 4/2011

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Provide the requested particulars in the section Do you have experience working, Microsoft Word, Internet Access Type Dial up not, Cable DSL, In planning for the, Presque Isle Waterville Saco, What date does the Agency require, and Control Expiration Date Pay.

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Indicate the essential information in The Personal Support Specialist, Refund Policy All refund requests, cid cid, cid cid, refund available for requests, and Please allow weeks for your segment.

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Within the box Please allow weeks for your, Student Signature Date, and Rev, specify the rights and responsibilities of the sides.

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Look at the areas Payment Plan Options down then, I am paying by CHECK or MONEY, Please make payable to Saco River, I am paying by CREDIT CARD, I authorize Saco River Education, account number, exp date, card security code, signature, and date and then complete them.

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