Date:

NameDOB/Age

AddressStateZip

CityEmail

Home PhoneAlt #

Area of Interest (Mark one)

Medical Assisting                            Automated Office System
                                                              

How did you learn about CET

Please note that all information session are on Tuesday, 11:00am and Friday, 2:00pm.

Select the day that will best suit your schedule.

Tuesday, 11:00 am                            Friday, 2:00 pm
                                                         

Please submit any questions or comments.