TECHNI-PRO INSTITUTE

414 NW 35th Street, Boca Raton, FL 33431

P: (561) 395-1444, F: (561) 395-1485

www.techniproedu.com

EVERGLADES TRAINING PROGRAM APPLICATION FORM

Last 4 Digits of SS# *
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Attended High School or GED? *

Attended College? *

Attained Degree?? *
Any prior Medical Training? *
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I verify that all information contained in this application is true and correct. I understand any falsification or omission of information may result in my rejection or dismissal by Techni-Pro Institute. I further authorize Techni Pro Institute to contact former employers and educational institutes listed on this application and authorize these employers and institutions to release information to Techni Pro Institute. *
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The following items are required in order to be considered for admission to the program:

  1. Proof of a high school diploma, GED, or validated foreign equivalent
  2. Copies of any postsecondary certificates of health related course taken (CORE, PCT, PCA, HHA, Medical Terminology, CNA, and MA).
  3. Official transcripts of college degrees no later than 1 week of start date.
  4. A copy of your FL driver license
  5. A copy of your Social Security card
  6. FDLE-Level 2 Background screening

Note: If you have taken the TEAS/KAPLAN/ATI or HESI Test at an approved school within the past two years, you should request the school to send a copy of your scores to Techni Pro Institute.