Payment

West Coast Medical Assistant Training Program Deposit

Please fill out the form below for your $300 deposit payment. The $300 deposit is nonrefundable and is deducted from the $2500 enrollment fee.

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Class Type(Required)

Online

In person

Choose Your Course Date - 2026 & 2027 Classes Available(Required)

Choose Deposit Amount(Required)

Total

Credit Card

Card Details

Cardholder Name