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 Application Form  

 
  Providence Sacred Heart Medical Center & Children's Hospital School of Phlebotomy - Spokane, WA

Please complete ALL information; at the end of the application, you will be directed to a secure website where you can pay the $25 application fee with a credit card.

Your application is not complete until payment is received.
   
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Enter none if not applicable.
 
   
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If none, mark as NA.
 
   
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Format should be (999) 999-9999
 
   
 
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