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Career Certification Program Interest Form - Lompoc Adult School
After you complete this form, you will be invited to a Zoom information session.
First Name
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required
Last Name
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required
Email Address
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Street Address
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City
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Phone Number
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Text Field
I understand that clinical medical experience is required for the Phlebotomy Program, and I possess this experience.*
Yes
If you do not have clinical medical experience, you may not apply for this program.
Please select the program that interests you: You will be invited to a Zoom meeting for further information:*
CompTIA A+
Clinical Medical Assistant
Dental Assistant
Medical Billing and Coding
Patient Care Technician
Pharmacy Technician
Phlebotomy Technician I
I understand that students must be 18 or older and have a high school diploma or equivalent*
Yes
No
I understand that all course fees are due by the first day of school.*
Yes
No
I understand that there is no scholarship or payment plan available for these courses.*
Yes
No
I understand that these programs offer state and/or industry certifications that are accepted in the workplace.*
Yes
No
Are there any questions that you would like answered by email at this time?
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required