Register for Open House

Yes, I would like to attend the Open House and learn more about an education at Great Lakes.

Please complete all sections of this form and hit submit.

First Name:

Middle Initial:

Last Name:

Maiden Name:

Address:

City:

State:

   Zip:  

Home Phone:

Work Phone:

May we contact you at work?

Yes No

Email Address*:

Date of Open House

Please check the date you will attend: April 27 June 17 August 19 October 14 December 16 <\SELECT>

Programs of Interest

Medical Programs:

Continuing Education
Dental Assistant
Diagnostic Medical Sonographer
Medical Assistant with Computer Operating
Medical Secretary with Computer Operating
Massage Therapy
Pharmacy Technician
Surgical Technologist
Veterinary Assistant