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Nursing Guaranteed Admission Program Form
1.
First name *
2.
Last Name
3.
Address
4.
E mail
5.
Telephone
6.
Fax
7.
Previous Studies
8.
Anticipated starting date of the studies
9.
Your Personal Budget (Includes Tuition-Lodging and meal)
Less than $ 8 000
from $ 8 000 to $ 15 000
Over $15 000
10.
I prefer a:
Small Campus (up to 1000 Student)
Medium Size Campus (1000 to 5000 Students)
Large Campus (Over 5000 students)
11.
Preferred location:
New England (Northeast)
Atlantic States
South
South West
West Coast
North west
Midwest
Alaska
Hawaî
Guam
Puerto Rico
No preference
12.
I'd like to order from AUAP
Nursing Guaranteed Admission Program $500
Extra university $ 500
13.
Payment Amount
$ 500
$ 100
$ 1500
$ 2000
14.
Credit Card Number
15.
Expiration date:
16.
CSS Number ( 3 Digits on the back at the card close to the Signature, on the front with American Express)
17.
Name of the Card Holder
18.
I prefer to pay by:
Bank transfer (ask AUAP the routing instruction)
US Check on American Bank. AUAP Suite 19 5053 Ocean Blvd Sarasota FL 34242 USA
19.
Additional Comments
* = Input is required
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