Class Registration - Medical Career Training | Medical Assistant & Phlebotomy Training

Course Title

Course Date / Time

Name *

First

Last Name *

Last

Address

City

State/Province

Zip/Postal

Phone

Student Account Email

Student Account Username

Only lower case letters (a-z) and numbers (0-9) are allowed.

Student Account Password

Enter Password

Choose Payment Option

Pay in Full

Payment Plan

Total Due Today

Payment

Please complete the following documents then upload to your student profile before class begins or on the first day of class:

Student Enrollment Agreement

Maximum file size: 134.22MB

Payment Plan / Tour Form

Maximum file size: 134.22MB

Receipt of Enrollment Form

Maximum file size: 134.22MB

Previous Education Form

Maximum file size: 134.22MB

High School Diploma or GED

Maximum file size: 134.22MB

Transcript

Maximum file size: 134.22MB

Certificate of Completion

Maximum file size: 134.22MB

Employer

Work Phone

Work Address

City

State/Province

Zip/Postal