PHCT SCHOOL
Certified to Operate by SCHEV
ONLINE PAYMENT FORM
Student Name
*
First Name
Last Name
Student Code
(Optional)
Phone Number
*
Email
*
Course/Program
*
Please Select
BLS SKILLS $70 (COMPLETE ONLINE FIRST)
BLS PROVIDER/RENEWAL $ 90
FA/CPR $125
CLINICAL MEDICAL ASSISTANT (CCMA) $3600
PHLEBOTOMY TECH (CPT) $1900
PERSONAL CARE AIDE (PCA) $675
EKG TECH (CET) $1600
NURSE AIDE (CNA) $1300
32 HR MEDICATION MANAGEMENT (MM) $675
68 HR MEDICATION AIDE (RMA) $975
Date
*
-
Month
-
Day
Year
Payment Date
Amount ($)
*
prev
next
( X )
USD
Next Payment Date
*
-
Month
-
Day
Year
12072024
Student Signature
*
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
Submit
Should be Empty: