Professional Development Program Registration

1. Please provide the following contact information:

   First Name
   Last Name
   Street Address
   Address (cont.)
   City
   State/Province
   Zip/Postal Code
   Country
   Work Phone
   Home Phone
   FAX
   E-mail
   Social Security or other nine digit #	Do not use 123456789

Phlebotomy, Polysomnography, Computed Tomography and Magnetic Resonance Imaging  require additional documentation.  Please call the Office of Professional Development for specific information.

1.  Click on one of the following options:

Pharmacy Tech Phlebotomy Polysomnography Certification CT: Computed Tomography MRI: Magnetic Resonance Imaging

2.   Select Cost:  

Pharmacy Tech $300 Pharmacy Tech Late Registration $400 Phlebotomy $550 Polysomnography Deposit $500 Polysomnography Payment $1450 Polysomnography $4,350 CT: Computed Tomography $1,800 MRI: Magnetic Resonance Imaging $3,200.00

3.   Choose one of the following payment options: 

  Mail registration with check made payable to East Tennessee State University Charge to MasterCard Charge to VISA Charge to Discover

Charge Card Number  Expiration date: Name on credit card

Be sure to print your confirmation for your records. 

Cancellation/Refund Policy

To cancel a registration, notify us at 1-800-222-3878 at least TWO WEEKS PRIOR to the first day of class. Failure to attend does not constitute withdrawal or cancellation.  Substitutions permitted with adequate notice. Each cancellation will incur a cancellation fee of $50.00.  No refunds will be given after the first session.