PCI HEALTH TRAINING CENTER RICHARDSON & DALLAS, TEXAS
Request Program Information Form
HOME WHATS NEW PROGRAMS GRADUATE SERVICES REQUEST INFO FINANCIAL AID ACCREDITATIONS LINKS RESOURCES
NAME: First * Last *
Address *
Apartment #
City *
State *
ZIP Code *
Home Number *
Cell Number *
Email Address *
Alternative E-mail address
What is the Best Time of Day to Contact You? Mornings Afternoon
Why are you interested in the medical field?
Which Medical Training Programs Are You Interested in? (Click All That May Apply)
Medical Assistant
Medical Office Assistant
Patient Care Technician
How soon are you planning to start your training? I'm Ready to Start Now! Next month Just Started Planning Not Sure
What is your current education level?
Did not complete High School
Need GED Tutoring Information? No problem PCI offers free GED classes
High School Graduate Please Enter Year of Graduation
Some College
College Graduate Please Enter Year of Graduation
How Did You Hear About PCI Health Training Center .
Google_Search Dart Dallas_Morning_News Sign Employment_guide Greensheet High_School 104.5 105.7 106.1 107.5 107.9 93.3 97.9 99.1 99.5 Referal WIA_Agency TV11 TV21 TV27 TV33 TV4 MTV3 Yellow_pages
ADDITIONAL COMMENTS OR QUESTIONS
Have you ever enrolled or attended PCI? NO YES