Phlebotomy

Current: Phlebotomy -> Billing -> Review -> Finish

Personal Information

First Name Required Field

Last Name

Maiden Name (if applicable):

Date of Birth: Required Field

Country of Birth: Required Field

In what country do you hold citizenship? Required Field

Street Address: Required Field

City:

State:

Zip:

Home Phone #: Required Field

Cell Phone #: Required Field

Email:

Name as it should appear on your certificate: Required Field

Statistical Information

Gender?

What do you consider your ethnic origin? Required Field

What do you consider your ethnic origin? Hispanic or Latino
Not Hispanic or Latino

Please indicate your race: Required Field

Have you ever attended any college/university or other post-secondary school? Required Field

Enrollment Plans

I would like to begin classes: Required Field

Please indicate the year you wish to begin classes: Required Field

I am aware of the COVID-19 vaccine requirement in order to be officially registered. Required Field

You must upload proof of COVID-19 vaccination before starting class. Complete this form to be eligible to register. For student ID number, please enter P123456789. Your official student ID number will be assigned after registration is complete.

Additional Information

I would like to enroll in this program for the following reason(s): Required Field

I, the undersigned, understand the policies outlined in Harcum College's catalog (harcum.edu/catalog) and supportive documents and agree to abide by them. I also understand that supplying misleading or false information will disqualify this application and may result in dismissal from the College. By signing this document, I give permission to Harcum College to request and receive transcripts from other institutions for the purpose of admission evaluation. I also understand that all the documents submitted in support of this application become the property of the College and are not returnable. Also, harcum.edu/consumerinfo provides important consumer information about Harcum College, as required by the Higher Education Opportunity Act of 2008.

Applicant Signature Required Field

Date

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Payment Information

Course Fees, Registration, Billing/Payment, and Cancellation Policy:
There is a non-refundable $100 deposit required prior to being registered and considered enrolled. The deposit will be applied to the overall cost of the course. Once registered, students will receive log-in information for Power Campus. This self-service portal is where students can view bills and make payments. Tuition bills for summer are posted to Power Campus in April, bills for fall are posted in July, and bills for spring are posted in November. Payment is due in-full prior to class start. Students with outstanding balances by the due date indicated on their tuition bill will forfeit their registration and deposit.

Drop Policy:
Courses can be dropped until the end of the Add/Drop period for the term. In order to drop a class, students must complete an Add/Drop form and give the form to their academic advisor who will return the form to the Office of Student Records. Courses dropped are subject to the College’s Tuition Refund Policy listed below. If a student drops from the program the $100 deposit will be held on the student’s tuition account for one year. The deposit is forfeited if the student does not re-enroll within a year from the date the deposit was paid.

Tuition Refund Policy:
Prior to the end of add/drop - 100% refund
Within one week after add/drop - 80% refund
Within two weeks after add/drop - 40% refund
After two weeks - No refund

By checking the box below, I understand that I am making the $100 deposit as required by this program. I further understand that this deposit is non-refundable. Should I decide to drop from the program and enroll at a later time, I agree that the deposit will be held on my account for one year from the payment date. I also agree, that should I not enroll in the program within a years’ time my deposit will be forfeited.

I understand the Course Fees, Registration, Billing/Payment, and Cancellation Policy. Required Field

Tuition Deposit: Required Field

Quantity:
$100.00

*Please enter a "1" in the quantity box to pay the tuition deposit.

How did you hear about Harcum? Required Field

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