Veterinary Assistant Program Registration

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Vet Assistant Program Registration

P.O. Box 1307 Mt. Pleasant, TX 75456-1307
Office 903-434-8134 | Fax 903-434-4408
continuinged@ntcc.edu

Student Information:

First Name:

Middle Initial:

Last Name:

Address:

City:

State:

Zip Code:

Social Security Number:

Date of Birth:

Primary Phone:

Email Address:

Are you in high school?

Please note that students under 18 years old (or who have not graduated high school) are not eligible for financial assistance.

Demographic Information:

Gender:

Ethnicity:

Optional Externship?:

This information I have provided is complete and correct to the best of my knowledge. I authorize the college to verify the information I have provided.

Agree

Disagree

Note: Payment for Continuing Education courses is due at the time of registration. Our office will contact you regarding payment when we receive your form and register you for the course. Please see our website for additional registration policies: CE Registration and Policies

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