If you do not have a printer, just print clearly on a sheet of paper and mail with payment. You are allowed to combine payments into one money order or certified bank check. I do NOT accept personal checks, the ones out of your checkbook. View "Registering / Class Fees" to find out your payment options. Thank you. 704-496-2618
NAME: __________________________________________________________________________________
Mailing Address: This is where you want your books and receipt mailed.
__________________________________________________________________________________________
___________________________________________________________________________________________
Email Address: ____________________________________________________________________________
Phone number (either home and / or cell): _______________________________________________________
Class Date Requested: ___________________________________________________________________
Second Choice on Class Date: _____________________________________________________________
Location: Circle: Monroe, Concord, Greensboro, Durham, Winston-Salem, NCSU, Morganton, Lumberton
~ Registering for: READ "explanation of classes" Circle: CNA full training class ~ CNA full training class with skills DVD ~ CNA full training class with clinical class ~ CNA skills only class ~ CNA home study and skills DVD ~ Pharmacy Tech home study ~ Medication Aide class only ~ CNA skills DVD only ~ CPR class ~ First Aide class ~ CNA practice tests and skills DVD ~ CNA clinical class ~ CNA practice tests only ~ CNA pin (circle pin) ~ Private Tutoring ~ CEU inservice class ~ Re-scheduling Fee ~ CNA/Med Aide certified dual program ~ Med Aide emblem pin ~ Pharmacy emblem pin ~
Fee Enclosed: $_______________________________________
Mailing address for payment and registration form:
Danielle Hossler PO Box 1762 Indian Trail, NC 28079-1762
~ You are CONFIRMED for your first choice class date, UNLESS you hear differently from me. If your class is full, I will call or email you. There are no refunds on deposits or full payments. You must attend the class date that you have chosen. If you do not show up, you forfeit all fees paid. If you do NOT have your books within four business days, call or email me. I have tracking numbers on all packages. Thank you.