Enrollment Agreement with Form

Enrollment Agreement Form

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We are currently working on our Electronic Enrollment Forms, please follow below instructions to proceed with the Enrollment using our Downloadable Forms.

Instruction:

1. Fill out the form below, select the desired course and download the

Enrollment Agreement Form.

2. Complete the Enrollment Agreement Form and sign.

3. Upload the signed form.

4. Proceed to payment.

5. Click Submit.
E-mail*
Name*

First NameLast Name
Select Course*
Download Enrollment Agreement - Advanced Dialysis Technician

View PBVS Disclosure Reporting Chart

View Jethro Healthcare School, LLC School Catalog and Student Handbook
Download Enrollment Agreement - Restorative Nurse Aide

View PBVS Disclosure Reporting Chart

View Jethro Healthcare School, LLC School Catalog and Student Handbook
Download Enrollment Agreement - Phlebotomy Technician

View PBVS Disclosure Reporting Chart

View Jethro Healthcare School, LLC School Catalog and Student Handbook
Download Enrollment Agreement - Physical/Occupational Therapy Aide

View PBVS Disclosure Reporting Chart

View Jethro Healthcare School, LLC School Catalog and Student Handbook
Download Enrollment Agreement - Pharmacy Technician

View PBVS Disclosure Reporting Chart

View Jethro Healthcare School, LLC School Catalog and Student Handbook
Download Enrollment Agreement - EKG Technician

View PBVS Disclosure Reporting Chart

View Jethro Healthcare School, LLC School Catalog and Student Handbook
Download Enrollment Agreement - Basic Nurse Assistant

View PBVS Disclosure Reporting Chart

View Jethro Healthcare School, LLC School Catalog and Student Handbook

Upload Signed Enrollment Agreement*

Upload a File

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Have you submitted the Basic School Requirements

YesNo, I'd like to submit them now.No, I will submit the requirements later
Click here to submit the Basic Requirements online.
Have you submitted the Course Requirements?

YesNo, I will submit the requirements later

Payment*
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Basic Nurse Assistant$950.00

Payment Terms
Item subtotal:$0.00

Dialysis Technician$1,800.00

Payment Terms
Item subtotal:$0.00

Physical/Occupational Therapy Aide$1,800.00

Payment Terms
Item subtotal:$0.00

Pharmacy Technician$990.00

Payment Terms
Item subtotal:$0.00

Restorative Nurse Aide$600.00

Payment Terms
Item subtotal:$0.00

Phlebotomy Technician$990.00

Payment Terms
Item subtotal:$0.00

EKG Technician$990.00

Payment Terms
Item subtotal:$0.00

Total $0.00
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Enrollment Agreement Form