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 2017

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

         2017                                                                            2017
JANUARY 7, 8, 14, 15 AND 21                                     JANUARY 14, 15 AND 21
FEBRUARY 4, 5, 11, 12 AND 18                                   FEBRUARY 11, 12 AND 18
MARCH 4, 5, 11, 12 AND 18                                          MARCH 11, 12 AND 18
APRIL 1, 2, 8, 9 AND 15                                                 APRIL 8, 9,  AND 15
APRIL 29, APRIL 30, MAY 6, 7 AND 13                        MAY 6, 7, AND 13           
JUNE 3, 4, 10, 11 AND 17                                             JUNE 10, 11 AND 17
JULY 8, 9, 14, 15 AND 22                                              JULY 14, 15 AND 22
AUGUST 5, 6, 12, 13 AND 19                                       AUGUST 12, 13 AND 19
SEPTEMBER 9, 10, 16, 17 AND 23                             SEPTEMBER 16, 17 AND 23
OCTOBER 7, 8, 16, 17 AND 21                                    OCTOBER 16, 17 AND 21
NOVEMBER 4, 5, 11, 12 AND 18                                 NOVEMBER 11, 12 AND 18
DECEMBER 2, 3, 9, 10 AND 16                                   DECEMBER 9, 10  AND 16


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
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