Student Admission Application

Student Information
Course Selection & Enrollment Information
Course Fee Payment

Section 2 of 3: Course Selection & Enrollment Information

Upcoming - Section 3 of 3: Course Fee Payment

Which courses would you like to Register for?

Nursing Assistant

EKG Technician

Pharmacy Technician

Phlebotomy Technician

Medical Billing and Coding

Trained Medication Aide

Nursing Assistant Admissions Application

Nursing Assistant Admissions Application - Nursing Assistant

EKG Technician Admissions Application

EKG Technician Admissions Application - EKG Technician

Phlebotomy Technician Admissions Application

Phlebotomy Technician Admissions Application - Phlebotomy Technician

Medical Billing and Coding Admissions Application

Pharmacy Technician Admissions Application

Pharmacy Technician Admissions Application - Nursing Assistant

Trained Medication Aide Admissions Application

Nursing Assistant Admissions Application - Nursing Assistant

Are you at least 16 years of age? You must be at least 16 years old to enroll Nursing Assistant program requires you to be at least 16 years of age, other program require you to be 18+

Are you willing to consent to a background check? * Background checks are required prior to going into the clinical /externship setting

Which cohort are you applying for? * This time frame only applies to when you come in for face to face time in skills lab and not clinical hours. Clinical is 8 hours long with a total of 16 hours during your last week of class.

When would you like to start? *

Is English your first language? Are you willing to complete our basic English test? Students must be proficient in the English language in order to be successful in the program.

Do you have a current AHA Basic Life Support CPR card? We offer this class as well. Certification must be through American Heart Association (AHA)

Tell us why you want to pursue a career in the course you selected? *

Uniform Selection

Uniform will be ordered based on the uniform color assigned to the program you are applying to

Scrub Top Uniform Size This information will be used to order your school uniform. Our program uniform is a red scrub top with black scrub bottoms.

Scrub Bottom Size This information will be used to order your school uniform. Our program uniform is a red scrub top with black scrub bottoms.

Section 3 of 3: Course Fee Payment

Important Information

Tuition Cost:

Tuition includes course fees, textbook/workbook and and initial state exam.

Fee Paid by 3rd Party:

If a third party entity is paying the tuition on behalf of the student, please check the "other" box and provide 3rd party payee name and contact number. Please keep in mind that our program is WIOA certified to receive funding from county programs. Please send us an email to nursing@primetimemedtraining.com to request tuition assistance options.

Payment Plan / Paying in Installments:

These terms are not final, if choosing a payment plan, you will receive a payment invoice and be contacted to enroll in auto payment drafting to pay your invoice as scheduled per your payment arrangement. All payment arrangements must be paid in full before the start of any supervised lab (clinical) hours.

Who is the Fee Payer? *

I will Pay in Full or Installments

3rd Party Fee Payer

3rd Party Fee Payer: Full Name

3rd Party Fee Payer: Phone Number

Payment Method: *

Credit Card

Mail a Check

In-person at school

Other

Please Add the Courses you Selected earlier to your Cart.

Nursing Assistant Tuition Payment Option
Cost includes nursing assistant course tuition & fees, uniform, program materials/supplies, Basic Life Support CPR training & initial NATO state written and skills exam that is required to get on the nursing assistant registry. Installment plans (non-pay in full payments) will incur a service fee. This fee has already been added in the cost shown. Pay in full payments do not have this fee incurred. Payment plan fees are subject to change at any time. All payment arrangements must be paid in full before any clinical/supervised lab hours. By selecting a payment plan, you are authorizing Prime Time Medical Training to process payments according to the selected installments selected in this application using the card information you are submitting. Payments will be deducted weekly on the Tuesday of each

How I Want to Pay?

Basic Life Support CPR training (OPT OUT) - Save $55
If you are already certified, you may opt out of Basic Life Support CPR training.

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How did you find out about us? * If referred by someone, please provide full name of referring individual. Referring persons may be eligible for a referral reward of up to $50 per referee.

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By signing below, you are acknowledging that you agree to have read the information in this application in its entirety. You also acknowledge that you are the student enrolling or delegated designee to complete this application and are agreeing and acknowledging understanding of the terms and agreements set forth in this document and take full responsibility for the payment of the tuition and fees for the program you are applying to. If you are younger than 18, your parent or guardian is required to sign this application on your behalf.