Registration Form / Matricularse


Registration form / Matricularse

 Name / Nombre:
 Address / Dicreccion:
 City / Ciudad:
 State / Estado:
 Zipcode / Zona Postal:  
 Telephone / Telefono:  
 E-mail / Correo Electronico:  
Referred by / Quien te refirió:
Preferred communication / Métodos de comunicación:
 Course / Curso:
Learning experience of the workshop is dependent on students' participation.
Workshop Matierial will not be given to the student to take home.
IMPORTANT: Once the registration form is submitted one of our representative will be contacting you soon.
A $300.00 deposit is required once is fully registered. / Un deposito de $ 300.00 es requerido una vez sea matriculado.
There will be no reimbursement after 2nd class***Any books provided to the student will need to be returned if the student drops class, then all classes taken must be paid by the student.
Course includes: Chapter Book, CPT, ICD-10-CM, HCPCS, & Final Review.
Online classes in English and Spanish from 6PM to 9PM. / Clases online en ingles y español de 6PM a 9PM.
Monday - Thursday on campus from 6pm to 9pm and Saturday from 8:30am to 12:30pm.
Clases de Lunes a Jueves presenciales de 6pm a 9pm, y los Sábados de 8:30 am a 12:30 PM.

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