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 2019

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

2019                                                                             2019

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


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 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