If you need more information call (800) 720-2125 or email us at Name: * Address: City: *  State:  * Zip: Phone:  * Cell Phone: Email: * 1. What is your previous level of education?* Non High School Grad High School Diploma/GED Some College College Graduate Other, please specify: 2. What is your current employment status? Full-time Part-Time Unemployed Other, please specify: 3. What do you want from an education? More money Better employment opportunities Greater self-confidence More interesting/rewarding career 4. Which of our services interest you? Federal Financial Aid for those who qualify VA eligible Job Placement Assistance 5. Which of the following career areas interest you? Please check the program areas that are of interest to you.* Medical Assistant Medical Billing / Coding / Front Office Computerized Acct / Office Admin Information Systems Technology, including Computer Networking, Electronics, and Fiber Optics. 6. I would like someone to help me decide what area of study would best fit my strengths and talents: * Yes! I would like a representative to give me a call. No, I already know what area I am interested in. 7. My friend or relative might be interested in attending Advanced Training.