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?*WebsiteTVRadioFacebookFriendotherProgram SelectionPlease choose the course you would like to register for below.Phlebotomy Technician Monday 6pm-10pm/Wednesday 6pm-9pmMonday September 12, 2022 to Wednesday October 12, 2022Monday November 21, 2022 to Wednesday December 21, 2022Clinical Medical Assistant Monday 6pm-10pm/ Wednesday 6pm-9pmMonday September 12, 2022 to Wednesday November 16, 2022Monday November 21, 2022 to Wednesday January 25, 2023Phlebotomy Technician Wednesday 12pm-4pm/ Friday 12pm-3pmWednesday September 14, 2022 to Friday October 14, 2022Wednesday November 23, 2022 to Friday December 23, 2022Clinical Medical Assistant Wednesday 12pm-4pm/ Friday 12pm-3pmWednesday September 14, 2022 to Friday November 18, 2022Wednesday November 23, 2022 to Friday January 27, 2022Phlebotomy Technician Saturday 8am-12pm/Sunday 8am-11amSaturday September 10, 2022 to Sunday October 9, 2022Saturday November 19, 2022 to Sunday December 18, 2023Clinical Medical Assistant Saturday 8am-12pm/ Sunday 8am-11amSaturday September 10, 2022 to Sunday November 13, 2022Saturday November 19, 2022 to Sunday Feb 5, 2023Once you have completed the registration form you must click the red SUBMIT REGISTRATION bar below.
