Apply Online

Congratulations on taking your first step toward furthering your education and ultimately your career.

There's no application fee and no obligation, just another way we show our commitment to your education and your future.

Peak Medical Academy's campus is conveniently located in Worcester, Massachusetts. We created this online application to make it easy for you. Once your application has been submitted, you will be entered into our database, and an admissions representative will contact you to assist you in completing the enrollment process so you can begin your career training journey.

Application for Admissions

First Name

Last Name

Address 1

Address 2

City

State

---STATE--- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip

E-Mail

Primary Phone

Alternative Phone

Indicate Which Program You Desire

---PROGRAM--- Nursing Assistant Technician/Home Health Aide Clinical Medical Assistant Phlebotomy Technician

Male/Female

---GENDER--- Male Female

Race/Ethnicity

---RACE/ETHNICITY--- Hispanic/Latino American Indian/Alaska Native Asian Black/African American Native Hawaiian/Pacific Islander White Two or More Races Race/Ethnicity Unknown

Date of Birth

Highest Level of Education

---EDUCATION--- GED Highschool Some College Associate Degree Bachelors' Degree Masters/Graduate Degree Doctorate Degree (Ph.D) Professional Certification Other

Emergency Contact Name

Emergency Contact Address/City/State/Zip

Emergency Phone

Relationship

Enter the code

Denotes required information.

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