LearnXray.com - Enrollment Form

NOTE: The Texas Department of Health reserves the right to issue a MRTNC Permit based on passing a criminal background review. Only PAID enrollments assure your class seat. Job placement not included.

Yes, I have read and accept the following Refund Policy before enrolling;
Refund Policy: 100% refund available if we receive your written cancellation
notice 72 hrs before your first class starts. No other refunds.
Refunds paid within 21 days.

No, I am not ready to enroll.

Select your Class Location and Date:
Please enroll early as class size is limited.

Classes
Classes enrolling NOW in Arlington, Houston and Garland! Call for days and times. Please call for exact class locations for onsite training at area doctors offices and clinics.
Select		Times
	Nights - Enrolling now!! Call for Start Date.	6:00 p.m. to 9:00 p.m.
	Days - Enrolling now!! Call for Start Date.	9:00 a.m. to 3:30 p.m.

Payment Please select from the following payment options:
$1895 paid in full two weeks before the class starts

$947 down with your enrollment form, $947 billed and charged to your account at midpoint of class.

$85 CE 6 Hour Class
Please select the type of payment: *
Check
Money Order
My employer will pay for my training:
Business Name	Business phone number
Contact:	Business fax number
Address:
City State Zip
How did you find out about us? Internet Advertisement Drive by Word of mouth Other: Who did you talk to at LearnXray? Michelle Phil Other:
When we receive your enrollment form and payment we will mail or email you a confirmation letter. Refund Policy: 100% refund available if we receive a written cancellation notice 72 hrs before the first class starts. Refunds will be issued within 21 days. Thank you for your interest in our X-Ray training program.

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