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NOTE: You must have a minimum of a high school diploma or GED in order to inquire.



First Name: * Last Name: *
Address: * Address 2:  
City: * State/Province: *
ZIP Code: * Country: *
E-mail: * Confirm E-mail: *
Work Phone (valid
number required): *
Home Phone (valid
number required): *
Additional Information
Expected Start Date: *
What is the highest academic credential you possess? *
Mobile Phone: *
Do you have any credits to transfer? * Yes No
Are you or your spouse Active or a Reservist in the U.S. Military? * Yes No
Are you a U.S. citizen or a national or permanent resident of the U.S.? * Yes No
For the Master of Health Care Administration or Master of Public Health programs: Do you possess a bachelor's degree from a regionally accredited institution or an institution accredited by an agency recognized by the Department of Education? * Yes No
For the Medical Assisting program: Are you comfortable dealing with blood and other bodily fluids? *
For the Medical Assisting program: Are you comfortable working with needles? *
For the Medical Assisting program: Would you be comfortable assisting a physician with patient preparation, examinations, and patient relations?
*
* By submitting this form, I agree that Kaplan, including its affiliates, may contact me via email, telephone, text, or prerecorded message regarding its programs and offers, as well as those of a third-party institution. If I reside outside the United States, I consent to the transfer of my data to the United States.