Request A Seat for Orientation
Please fill out this form to request a seat at the next orientation for CNA, CCMA, Phlebotomy and Pharmacy Technician. Once this form is completed you will be contacted with more information. 
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E-posta *
First Name: *
Last Name: *
Student ID: C0# *
Ivy Tech Email: *
Primary Phone Number *
Important Information
Certificate programs are offered on a first-come, first-serve basis. Certificate programs are offered throughout the academic year. 
  • CNA is offered every eight weeks in all semesters including Summer

  • CCMA is offered every eight weeks in all semesters including Summer

  • Phlebotomy is offered every eight weeks in all semesters including Summer.

  • Pharmacy Technician is offered every eight weeks in all semesters including Summer. 
**Certificate program courses can be canceled if there is low enrollment.

Please select the certificate program for which you are applying. *
Please select the semester you want to attend. *
Gerekli
Please pick the orientation date you would like to attend. *
Please pick the program/time/location you would like to attend. *
Please enter today's date. *
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Please sign your first and last name. *
Additional Comments:
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