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Request for Course Progress

First Name*

Last Name*

Email Address*

Are you enrolled in automatic debit?*

Select an option

Which course are you currently enrolled in?*

Which module did you just complete?

If you are not enrolled in automatic payments, How much have you paid as of now?*

Please fill out this form after meeting your financial obligations.


once received, give one business day  to have the next course access.

You must have paid $800 to have the next access

You must have paid $1300 to have the next access

You must have paid $1800 to proceed to have the next access

You must have paid in full to proceed to the  Surgical Tech



If you have NOT paid enough to proceed to the next module, 

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