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-9pmMonday November 27, 2023 - Wednesday January 10, 2024 No Class 12/25, 12/27 and 1/1 , 1/3Clinical Medical Assistant Monday 6pm-10pm/ Wednesday 6pm-9pmMonday November 27, 2023 - Wednesday February 14, 2024 - No Class 12/25, 12/27 and 1/1 , 1/3Phlebotomy Technician Wednesday 12pm-4pm/ Friday 12pm-3pmWednesday November 29, 2023 - Friday December 29, 2023Clinical Medical Assistant Wednesday 12pm-4pm/ Friday 12pm-3pmWednesday November 29, 2023- Friday February 2, 2024Phlebotomy Technician Saturday 8am-12pm/Sunday 8am-11amSaturday November 25, 2023 - Sunday December 31, 2023 No Class 12/23, 12/24Clinical Medical Assistant Saturday 8am-12pm/ Sunday 8am-11amSaturday November 25, 2023- Sunday February 4, 2024- No Class 12/23, 12/24Once you have completed the registration form you must click the red SUBMIT REGISTRATION bar below.
