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IV Therapy/Blood Withdrawal Group Course Registration 

Step One: Complete Course Registration Form and Submit Form.

Step Two: Select Course Payment Option, Click Cart, and Submit Payment.

(Note: For Payment Plan Option, you will receive an invoice for balance due after initial deposit payment is processed.) 

First and Last Name*


Email Address*

Mailing Address*



Zip Code*

School Institution*

Expected Graduation Date*

Please Select Course Date

Course Payment Options

*Please complete the registration form above and submit the form before making payment.  Then select Payment Option and click on Shopping Cart to submit payment. 

Payment Option 1
(Pay In Full)


 Course Fee

No product

Payment Option 2
(Deposit w/4 monthly payments)


Course Deposit Fee due by July 15th to reserve seat. 

$225.00 remaining split into 4 monthly payments of $56.25 

(You will receive an invoice for balance due)

No product

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