| REGISTRATION FORM Please print to fill out & mail in along with registration fee or you may pay now by using paypal, visa, mastercard or discover card & choosing the appropriate buy now button below then fill out form & bring it in, mail 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. 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 . |
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 ________________day_____evening_____
Phlebotomy - Date of class registering for _____________________________
Registration/ Tuition Fee Included $________ Paid on web site $__________
Education- High school diploma________ GED_______ Neither_______
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 ________________day_____evening_____
Phlebotomy - Date of class registering for _____________________________
Registration/ Tuition Fee Included $________ Paid on web site $__________
Education- High school diploma________ GED_______ Neither_______
How did you hear about us: Website_____ Friend________ Student_______
Sign (where)_____________ Job Fair_______ Job & Family Services______
Opportunity Links_______ School (name)______________________________
Other___________________________________________________________
Signature_______________________________ Date___________________
 |
 |
 |
 |
 |
 |
 |
 |
TTC
| Phlebotomy full tuition $700 |
| STNA full tuition $750 |
| STNA registration fee $150 |
| Phlebotomy registration fee $100 |