| REGISTRATION FORM Please print to fill out & mail in along with registration fee, you may also bring it in or fax it to us at 740 205-0097. You can also copy and paste, fill it out then email it to debraziadeh@yahoo.com. You will not be registered for the class until we receive your registration fee. This application is for admission to a program of study at TTC. Upon submitting this form you are acknowledging complete responsibility for all Fees and pre-requisites . NSF checks are charged $45. Please call the school if you have any questions. |
Name______________________________________________________________________________________
Address_______________________________________________________________Apt.__________________
City___________________________________________State_______________Zip Code__________________
Phone__________________________ E-Mail_____________________________________________________
Program Applying For
****Please call office for availability of class dates, all classes are on a first come bases****
STNA - Date of class registering for ___________________________________________________
Phlebotomy - Date of class registering for ______________________________________________________
EKG - Date of class registering for ________________________ day______________evening_____________
Paramedical Ins. Examiner- Date of class registering for____________________________________________
Tuition Fee Included - $_______________
Education- High school diploma________________ GED__________________ N/A________________
How did you hear about us: Website_________ Friend___________________ Student_________________
Sign (where)____________________ Job Fair_________________ Job & Family Services______________
Opportunity Links_______________________ School (name)_______________________________________
Other____________________________________________________________________________________
Signature_______________________________________________ Date____________________________
Address_______________________________________________________________Apt.__________________
City___________________________________________State_______________Zip Code__________________
Phone__________________________ E-Mail_____________________________________________________
Program Applying For
****Please call office for availability of class dates, all classes are on a first come bases****
STNA - Date of class registering for ___________________________________________________
Phlebotomy - Date of class registering for ______________________________________________________
EKG - Date of class registering for ________________________ day______________evening_____________
Paramedical Ins. Examiner- Date of class registering for____________________________________________
Tuition Fee Included - $_______________
Education- High school diploma________________ GED__________________ N/A________________
How did you hear about us: Website_________ Friend___________________ Student_________________
Sign (where)____________________ Job Fair_________________ Job & Family Services______________
Opportunity Links_______________________ School (name)_______________________________________
Other____________________________________________________________________________________
Signature_______________________________________________ Date____________________________
TTC
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| SEATS ARE STILL AVAILABLE FOR OUR MAY 6TH STNA & PHLEBOTOMY CLASSES |