Applicant Name:

Address:

City, State, Zip:

Phone:

Date of Birth: _____________ Soc. Sec. #:

E-mail address:

________ Medical Terminology (MEDTRM100) (60 Hours) - $975 includes all books materials

________ Human Anatomy (MEDANA200)  (60 Hours) - $975 includes all books materials

________ Medical Secretary/Receptionist (MEDSEC300)  (72 Hours) - $1295 Includes all books and materials

________ Medical Billing/Coding (MEDBILCOD400)  (60 Hours) - $1295 Include all books and materials

________ Medical Transcription (MEDTRN500)  (60 Hours) - $975 Includes all books and materials

________ A+ Operation Systems (TECA+OS)  (48 Hours)- $780 Includes all books and materials

________ A+ Hardware Systems (TECA+HS)  (48 Hours) - $780 Includes all books and materials

________ Basic Computer Maintenance (TECCMU)  (40 Hours)- $650 Includes all books and materials

________ 6-Hour Software Classroom Program - $150 Includes all books and materials Software Name:                          

________ 12-Hour Software Classroom Program - $300 Includes all books and materials

CHECK or MONEY ORDER ENCLOSED:

CREDIT CARD NUMBER                                                                                      EXPIRATION DATE:

PLEASE MAIL TO:

CAREER ACADEMY
321 S Front Street
MARQUETTE MI 49855