Certifications - Certified Phlebotomy Technician "*" indicates required fields Select certification*Certified Phlebotomy Technician (CPT)Certified Medical Laboratory Assistant (CMLA)Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* School AttendedGraduation Date Employer,Employer's PhoneEmergency Contact Name* First Last Emergency Contact Phone*CPT/CMLA Exam* Price: Payment Method*PayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Payment Terms* I agree to the terms below. PLEASE NOTE: Payment is to be made via Credit Card; once you submit your application, you can select the drop down for PayPal or Credit Card. If you prefer to pay by no credit-check financing, you are welcome to do so. Simply submit your application and contact our office to arrange payment.Consent By checking this box, you agree to receive text messages from American Association of Phlebotomy Technicians related to customer care at the phone number provided above. You may reply STOP to opt out at any time. Reply HELP for assistance. Message and data rates may apply. Message frequency will vary. Learn more on our Privacy Policy and Terms & Conditions.