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To reserve your seat and to began the enrollment process please submit the registration fee with your submission. If you receive state benefits and your course is being sponsored please include the name of the Agency that is sponsoring it.

Registration Application

Title

First name *

Last name *

Birthday *

Street Address*

Apt/Suite

City*

State*

Postal Code *

Phone Number *

Email Address *

Highest Level of Education *

Year Highest Education Level Completed *

Program of Interest*

Preferred Course Code/ Start date *

PLEASE COMPLETE IF YOU ARE REGISTERING FOR PHLEBOTOMY BASICS TO ADVANCED OR EKG BASICS

Scrub Size (runs big) *

Agency*

If other, please enter agency name

Case Manager's/Career Navigators Name

Case Manager's Email Address

Case Manager's Telephone Number

How did you find us? *

Thank you for pre-registering with Trinity. We look forward to assisting you reach your health career goals. Your pre-registration application has been submitted to one of our student service experts. We will contact you shortly regarding your application. In the meantime, if you have any questions please call our office at (414)998-0958 or send an email to register@trinityedu.net.

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