Surgical Technician Program Registration

Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date of Birth

Social Security #

Phone Number

Format: (000) 000-0000.

Email

example@example.com

This program is $3,500. Deposit is $500 which can be split into two payments of $250.

After applying please reach out to director, Melissa Evans or program assistant, Nakierra Brister for further information.

Ms. Melissa Evans, (769) 217-8468.

Payment Plan Option

T/TH Night Class 5:00pm-9:00pm