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Special Rate For New Graduates

The special rate for New Graduates is only extended to those who have graduated within the past 12 months. The graduation certificate needs to be uploaded with this application.

Registration Form

First name

Last name

DCR Number or State Registration / License number

Clinic Address

Clinic Phone No

Email address

Contact Number

Year of Graduation

Address

Purchase Confirmation

Description	Subtotal
Special Rate For New Graduates × 1	$50.00
Subtotal	$50.00
Total	$50.00

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Special Rate For New Graduates

Registration Form

Purchase Confirmation

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Contact Info

Address