STEP 1.5

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STEP 2

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Enter your information to register

Member Type -- University Medical Center Public Health Police Department West Texas Pain Institute Imaging and Interventional Specialists Vista Hills Family Dental Anthony ISD Centro De Salud Familiar La Fe

First Name

Last Name

SSN (No special characters only 9 digits number)

DOB

Program Program Master of Health Administration Master of Business Administration Master of Science in Nursing Assisting Master of Science in Healthcare Leadership and Management AAS in of Business Management in Healthcare Support Systems Bachelor of Science in Nursing Bachelor of Science in Radiological Sciences Bachelor of Science in Health Administration Bachelor of Science in Business Management Associate of Applied Science in Radiological Sciences Associate of Applied Science in Computer Information Technology Systems Associates of Applied Science in Ophthalmic Technology Program Associate of Applied Science in Medical Coding and Billing Associate of Applied Science in Surgical Technology Associate of Applied Science in Dental Assisting

Gender Gender -- Female Male

Ethnicity Ethnicity Hispanic/Latino American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Non-Resident Alien Other\Unknown

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Street Address

City

State --Select a state-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

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Email

Phone

Mobile Phone

Highest Level of Education Highest Level of Education --- High School Diploma GED Some College Enrolled in High School Other

Citizenship Citizenship US RESIDENT US CITIZEN Foreigner

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Done!

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