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 $150.00 nonrefundable registration fee that is a part of the tuition.

4.        Tuition of $900, or $1800 can be paid with cashier's check or money order.  
    NO PERSONAL CHECKS ARE ACCEPTED.   WE ACCEPT ALL MAJOR CREDIT CARDS.

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 2021

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

BASIC COURSE                                                               ADVANCE COURSE

                                                                                     
2021                                                                                                  2021

JANUARY 9, 10, 16, 17 AND 23                                  JANUARY 16, 17 AND 23
FEBRUARY 6, 7, 13, 14 AND 20                                   FEBRUARY 13, 14 AND 20
MARCH 6, 7, 13, 14 AND 20                                          MARCH 13, 14 AND 20
APRIL 10, 11, 17, 18 AND 24                                          APRIL 17, 18,  AND 24
MAY 1, 2, 8, 9 AND 15                                                     MAY 8, 9, AND 15           
JUNE 5, 6, 12, 13, AND 19                                             JUNE 12, 13 AND 19
JULY 10, 11, 17, 18 AND 24                                           JULY 17, 18 AND 24
AUGUST 7, 8, 14, 15 AND 21                                         AUGUST 14, 15 AND 21
SEPTEMBER 11,  12, 18, 19 AND 25                           SEPTEMBER 18, 19 AND 25
OCTOBER 9, 10, 16, 17 AND 23                                   OCTOBER 16, 17 AND 23
NOVEMBER 6, 7, 13, 14 AND 20                                   NOVEMBER 13, 14 AND 20
DECEMBER 4, 5, 11, 12 AND 18                                   DECEMBER 11. 12, AND 18

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


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Enclosed is my $900 (Advance course only), or $1800 (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?                                                                                  
                                                                                

EMERGENCY CONTACT INFORMATION:
                                                                                                                                                 
         
                                                                                                                                                 



PLEASE MAIL REGISTRATION FORM AND PAYMENT THROUGH REGULAR
MAIL TO THE ADDRESS BELOW OR CALL FOR AN APPOINTMENT TO COME
IN TO REGISTER:

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