Phlebotomy Technician Program Application

* Denotes required fields
* Please choose the class you would like to attend:

Personal Information

* Gender

Optional: What do you consider your ethnic origin?

This information will not be used in the admissions process and is for reporting purposes only.

* Are you a United States Citizen?
Non-US citizens: Are you a permanent US resident?

Statement of Understanding

I have reviewed the "Essential Job Functions" (on the website) and have had an opportunity to ask questions about them, and, now, to the best of my ability, understand and can meet those technical abilities and competencies with or without reasona-ble accommodation.

The school reserves the right to deny admission or readmission or to revoke admission to any applicant if, in the opinion of the School, his/her admission is not in the best interest of the student or School.

RHSHS operates without distinction to age, race, color, religion, gender, disability, sexual orientation, national origin, or economic means.


Payment Type

* How do you wish to pay for your $30 application fee?