Registration

If you are serious about attending Mount Eagle Institute, please fill out the application below. Your application will be reviewed, and you will receive a call to setup an interview at the school. Please note that there is a non-refundable registration fee of $25.00 due at the submission. Thank you for your interest in Mount Eagle!

 

First Name
Last Name
Email Address
Address
Address 2
City
State
Zip
Primary Phone
Secondary Phone
Emergency Contact Full Name
Emergency Phone
Education Level	High School DiplomaSome College No Degree2 Year College4 Year CollegeMaster and Above
GED	Yes No
No GED	Yes No
Program of Study	Clinical Medical AssistingPhlebotomy (Day)Phlebotomy (Evening)CNA-I (Day)CNA-I (Evening) Life Science Certificate PCA (Day)PCA (Evening)EKG Technician (Day)Medical Billing and Coding (Day)Medical Billing and Coding (Evening)Certicied Pharmacy Technician (Day)Certified Nurse Aide-II (Day)Certified Nurse Aide-II (Evening)Medical Administration Day
Start Date
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Comments
Image Verification Please enter the text from the image: [ Refresh Image ] [ What's This? ]   I understand and agree that my application and registration form will NOT be processed or considered if I do not complete the registration fee of $25.00. Application that are not accompanied by the fee are deleted at the end of the day. By clicking the button below, I agree to these terms.