734-251-2848
Receive your certificate and take your exam to become licensed or certified within your state. WE ACCEPT OUT OF STATE STUDENTS. PLEASE ANSWER ALL QUESTION IF IT DONT APPLY TO YOU PLEASE INPUT N/A DO NOT LEAVE ANYTHING BLANK. PLEASE UPLOAD ALL YOUR STATE ID , SSN AND HIGH SCHOOL DIPLOMA IF YOU REFUSE TO DO SO YOUR APPLICATION WILL BE DENIED . IF APPROVED YOUR ACCEPTANCE LETTER WILL BE SENT WITHIN 24/72 HOURS
Student Name
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First Name
Last Name
Email
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Phone Number
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Format: (000) 000-0000.
SSN#
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DOB
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SIZE SHIRT YOU WEAR ?
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Gender
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Female
Male
Other
Location
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State of MI Student
Out of State Student
Other
Have you been approved by Michigan works ?
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Yes
NO
Other
Michigan Works Career Advisor
First Name
Last Name
Michigan Works Career Advisor #
Please enter a valid phone number.
Format: (000) 000-0000.
Michigan Works Career Advisor Email #
Student Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you ever been convicted of a crime? If yes please explain
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Are you a veteran?
*
How are you paying for your tuition? Financial Information
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Self Pay & Affirm
Family/ Friends
Employer
Michigan Work
Military families are 20% off.
Payment plan 50% down plus monthly payments
Apply for Loan
Michigan Achievement Skills Scholarship
Other
Education Background
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High School Diploma
GED
Some College Credits
Associate Degree
Bachelor Degree
Master Degree
Doctorates Degree
Other
What year did you graduate from high school or GED ?
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Date you graduated from high school ?
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What’s the name of the high school or GED program you graduate from?
*
Address of the high school diploma or GED program you graduated from
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone number of the high school or GED program you graduated from ?
Please enter a valid phone number.
Format: (000) 000-0000.
Referred by
*
Myles The Prince Scholarship
Alexis Scholarship
Innovative Scholars
Driven With Purpose Scholars
Future Stars Scholarship
K & R Scholars
Other
Occupation
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Years of Experience in the medical field?
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Tell us about yourself ? and the reason you want to join the medical field?
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Do you need help finding employment after you graduate?
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Emergency Contact Name
*
First Name
Last Name
Emeregency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
State ID or Driver's License or Passport
*
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SSN Card Photo (optional)
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High School Diploma or GED . if you have it please upload !
*
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Expired Certifications ( Optional )
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Any transcripts (optional)
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Certifications or Licenses you may have (Optional )
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Do you have anyone you want to refer? Please leave their full name and phone number.
*
Do you have any learning disabilities ?
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Select Welcome Call for Zoom
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Monday - Wednesday (8.00 am - 8.00 pm)
Other
What classes are you interested in?
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Pharmacy Technician -10 Weeks Course (Online )
Physical Therapy Technician /Aide -10 Weeks (Online )
Medical Assistant - 10 Weeks (Online )
Dental Assistant - 8 Weeks (Online )
Medical Office Assistant - 4 Weeks Course (online)
Medical Billing and Coding Specialist - 8 Weeks Course (Online )
Medical Administrative Assistant - 8 Weeks Course (Online )
Dental Support Technician -10 Weeks Course (Online )
Dental Office Assistant -8 Week Course (Online )
EKG Technician - 7 Day Course (Online )
Mental Health Technician -8 Weeks Course (Online )
Home Health Aide - 5 Weeks Course (online )
Pharmacology 16 WEEKS - CNA TO LVN PATHWAY for California only
Do you want to take your Exam?
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Online at Home
Online at School
At School Pencil & Paper Exam
If you are private pay client and courses are non-refundable. You will receive an email with your username and password to start your course online. All classes include nationally accredited, and you will receive your certificate of completion. Graduations are held every 90 days if you would like to attend ceremony . All your information is confidential at all times. If you need a payment plan, please give us a call.
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Type your Full name
Today, Date
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2 digit month, 2 digit day, 4 digit year
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