Student Information
Student Name (First and Last)

Phone Number

Email

Address

City

State

Zip

Last 4 Digits of SSN

Were you referred to us by a former student?
YesNo

Who referred you? (Please provide their first and last name)



Course Option
Choose Which Location You Wish to Attend:
MariettaBuckhead

Choose a Class Day and Time
Choose a Class Day and Time



Scrub Sizing

Size XXS XS S M L XL
Numeric 0-2 2-4 6-8 10-12 14-16 18-20
Bust 33-35 35-36 37-39 40-43 44-47 48-50
Waist 24-26 26-27 28-31 32-34 35-38 39-41
Hip 35-37 37-38 39-41 42-45 46-48 49-52

So that we may order the correct scrub uniform for you, WE NEED TO KNOW YOUR SIZE.

Selection
XXSXSSMLXL


Expected Payment Method

Payment Confirmation



Online Credit Card Processing Currently Down

Online payment processing is currently down for maintenance.

If you are ready to submit or make payment, please call our office:

(770) 973-0496