Registration Personal InformationName* First Last Address* Street Address City State Zip Phone*Email* Date of Birth* MM slash DD slash YYYY Gender*FemaleMaleTransgenderOtherHigh School InformationDiploma Type*High School DiplomaGEDYear Issued* Place Issued* How did you hear about us?*WebsiteTVRadioFacebookFriendotherMedical Assistant and Phlebotomy Technician CoursesPlease choose the course you would like to register for below.Phlebotomy Technician Monday 6pm-10pm/Wednesday 6pm-9pmClass Full- Waitlist Only- Monday June 5, 2023 Wednesday July 12, 2023- No Class 7/3 & 7/5Monday September 11 , 2023 - Wednesday October 11, 2023Monday November 20, 2023 - Wednesday December 20, 2023Clinical Medical Assistant Monday 6pm-10pm/ Wednesday 6pm-9pmClass Full-Waitlist Only-Monday June 5, 2023 - Wednesday August 16, 2023 - No Class 7/3, 7/5Monday September 11, 2023 Wednesday November 15, 2023Monday November 20, 2023 - Wednesday February 7, 2024 - No Class 12/25, 12/27 and 1/1 , 1/3Phlebotomy Technician Wednesday 12pm-4pm/ Friday 12pm-3pmWednesday June 7, 2023 -Friday July 14, 2023 - No Class 7/5 & 7/7Wednesday September 13, 2023 - Friday October 13, 2023Wednesday November 22, 2023 - Friday December 22, 2023Clinical Medical Assistant Wednesday 12pm-4pm/ Friday 12pm-3pmWednesday June 7, 2023- Friday August 18, 2023 - No Class 7/5, 7/7Wednesday September 13, 2023- Friday November 17, 2023Wednesday November 22, 2023- Friday January 26, 2024Phlebotomy Technician Saturday 8am-12pm/Sunday 8am-11amClass Full- Waitlist only- Saturday June 3, 2023 - Sunday July 9, 2023 - No Class 7/1 & 7/2Saturday September 9, 2023 - Sunday October 8, 2023Saturday November 18, 2023 - Sunday December 17, 2023Clinical Medical Assistant Saturday 8am-12pm/ Sunday 8am-11amClass Full-Waitlist Only-Saturday June 3, 2023- Sunday August 13, 2023 - No Class 7/1, 7/2Saturday September 9, 2023 - Sunday November 12, 2023Saturday November 18, 2023- Sunday January 28, 2024- No Class 12/23, 12/24Once you have completed the registration form you must click the red SUBMIT REGISTRATION bar below.