REGISTRATION FORM

1.        See up-coming dates below.

2.        Class begins promptly at 8:00am.  Students are asked to arrive, at least, 15 minutes early.

3.        There is a $100.00 nonrefundable registration fee that is a part of the tuition.

4.        Tuition of $850, or $1700 can be paid with cashier's check or money order.  
      NO PERSONAL CHECKS ARE ACCEPTED.      

5.        Registration forms with tuition should be returned, at least,  two weeks prior to class
to ensure seating or you may have to be scheduled for the following month.

6.        
Phlebotomy classes are held in the city of Long Beach at:

ALLIED PROFESSIONAL INSTITUTE
5199 E PACIFIC COAST HWY, STE 300N
LONG BEACH, CA 90804

(562)808-2152

EMAIL: mildredcasper@att.net
WEBSITE: www.apiedu.net

CLASS SCHEDULE FOR 2018

CLASSES ARE HELD ONCE A MONTH.  LECTURES ARE ON THE WEEKEND ONLY AND THE
EXTERNSHIP IS MONDAY THRU FRIDAY FOR ONE OR TWO WEEKS.

BASIC COURSE                                                               ADVANCE COURSE

    2018                                                                             2018


JANUARY 6, 7, 13, 14 AND 20                                     JANUARY 13, 14 AND 20
FEBRUARY 3, 4, 10, 11 AND 17                                   FEBRUARY 10, 11 AND 17
MARCH 3, 4, 10, 11 AND 17                                          MARCH 10, 11 AND 17
APRIL 7, 8, 14, 15 AND 21                                             APRIL 14, 15,  AND 21
MAY 5, 6, 12, 13 AND 19                                                MAY 12, 13, AND 19           
JUNE 2, 3, 9, 10, AND 16                                              JUNE 9, 10 AND 16
JULY 7, 8, 14, 15 AND 21                                              JULY 14, 15 AND 21
AUGUST 4, 5, 11, 12 AND 18                                       AUGUST 11, 12 AND 18
SEPTEMBER 9, 9, 15, 16 AND 22                              SEPTEMBER 15, 16 AND 22
OCTOBER 6, 7, 13, 14 AND 20                                    OCTOBER 13, 14 AND 20
NOVEMBER 3, 4, 10, 11 AND 17                                 NOVEMBER 10, 11 AND 17
DECEMBER 1, 2, 8, 9 AND 15                                      DECEMBER 8, 9 AND 15


STUDENTS MUST ENROLL AT LEAST 2 WEEKS PRIOR TO THE CLASS THEY WANT TO TAKE.
     



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Enclosed is my $850 (Advance course only), or $1700 (Basic course only) tuition to
reserve my space in the class and a copy of my High School Diploma or GED.

Name
                                                                                                                                    
                        Print name
Address
                                                                                                                                

City                                                                                                                                        

State                                            Zip Code                                                    

Phone                                                                                                                                   

Mess Phone                                                                                                                         

Signature                                                                                                                              

Class Date                                                                                                                            

EMAIL ADDRESS:                                                                                                                

How Did You Learn About The Class?                                                                   
                                                                                                    

EMAIL ADDRESS OR FAX NUMBER IF YOU WOULD LIKE CONFIRMATION BY ONE OF THESE
METHODS OR IT WILL BE MAILED TO YOU:
                                                                                                   


PLEASE MAIL REGISTRATION AND PAYMENT TO:

Allied Professional Institute
5199 E Pacific Coast Hwy, Ste 300N
Long Beach, CA 90804
Allied Professional Institute, First Aid Instruction, Long Beach, CA