Please
provide information about yourself.
*Please
note that course MC03 (Introduction
to Healthcare) is nontransferable.
Fees:
$35.00 per course(s) being transferred (4hr or 8 hr)
$25.00 application fee
Complete this form,
print it, and forward the
completed application with
enclosed check or money order
made
payable to PAT/TABI:
PAT/TABI Records Department
P.O. Box 243
Amherst, OH 44001-0243
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