Continuing Education Health Classes Registration |

CLASS LIST

Dialysis Technician - TBA
Nurse Assistant I/II
Medication Aide
Medical Assistant - TBA
Pharmacy Technician
Phlebotomy Technology
Fast Forward Class In Pharmacy Technician - TBA
Emergency Medical Technician (EMT) - TBA
Anatomy & Physiology for EMS Providers (EMS 3000)
BLS for HealthCare Providers (CPR) - TBA

Dialysis Technician

TBA

Nurse Assistant I/II

NUR-3240 Nurse Assistant I 9:00 am-1:00 pm M,T,W,TH 1/27/20 - 4/22/20 $216.50
NUR-3240 Nurse Assistant I 9:00 am-1:00 pm M,T,W,TH 5/13/20 - 8/13/20 $216.50
NUR-3241 Nurse Assistant II 1:30 pm-5:30 pm T,TH 1/7/20 - 5/18/20 $216.50

Medication Aide

PHM-4100 Medication Aide for Skilled Living 6:00 pm-10:00 pm T 6/16/20 - 7/28/20 $126.50
PHM-4100 Medication Aide for Assisted Living 9:00 am-1:00 pm TH 4/2/20 - 5/14/20 $126.50
PHM-4100 Medication Aide for Assisted Living 6:00 pm - 10:00 pm TH 7/9/20 - 8/20/20 $126.50

Medical Assistant

TBA

Pharmacy Technician

PHM-3250 Pharmacy Tech 6:00 pm-10:00 pm M,W 5/14/20 - 9/29/20 $181.50
PHM-3250 Pharmacy Tech-hybrid 7:00 pm-10:00 pm Class will meet on 1/28, 3/31, 6/9 1/28/20 - 6/9/20 $181.50

Phlebotomy Technology

MLA-PHLE Phlebotomy Tech hybrid 6:00 pm-10:00 pm W 1/15/20 - 7/29/20 $181.50

Fast Forward Class In Pharmacy Technician

TBA

Emergency Medical Technician (EMT)

TBA

Anatomy & Physiology for EMS Providers (EMS 3000)

Jan 6 – March 15, 2020 - $125 registration

BLS for HealthCare Providers (CPR)

TBA

SSN OR STUDENT ID NUMBER:*

FULL NAME:*

First Middle Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

EMAIL ADDRESS:*

HOME PHONE:*

BIRTH DATE: Month:*

ARE YOU HISPANIC/LATINO?

NO (NHS)
YES (HIS)

RACE (Check one)

White
Black/African American
Native American/Alaska Native
Asian
Hawaiian/Pacific Islander

SEX (Check one):

Male
Female

EMPLOYMENT STATUS (Check one):

Retired
Unemployed-Not Seeking
Unemployed-Seeking
Full time
Part-Time--Number of Hours Per Week

No. of hours

EDUCATION LEVEL (Check only one):

Completed High School
Adult High School Diploma
GED Diploma
One-Year Vocational Diploma
Associate Degree
Bachelor's Degree
Master's Degree
OR -Highest Grade Completed

Grade

CITIZENSHIP (Check one):

U.S Citizen
Permanent Resident Alien
Non-Immigrant Alien
Other

Name of Employer

STUDENT SIGNATURE:

Date

Certification of Accuracy*

By this check, I certify that the information I have given is true and complete to the best of my knowledge. I further understand that falsification or failure to supply the correct information may be considered grounds for rejection or dismissal. Further, I understand that by submitting this information via electronic transmission that I acknowledge the above statement of certification in lieu of a signature.
Please check:

Yes

Continuing Education Health Classes Registration

SHARE THIS PAGE