Application for Group Enrollments » Maples Center for Forensic Medicine » College of Medicine

Interested in enrolling multiple students?

If your shelter wants to enroll multiple people on one invoice or purchase order, please fill out this form or contact maples-center@ahc.ufl.edu

What is the name of your organization?(Required)

Which course would you like to enroll in? (Select all that apply)(Required)

Euthanasia by Injection, Full Course ($400)

Euthanasia by Injection, Part One ($200)

Euthanasia by Injection, Part Two ($200)

Preferred method of payment? (Select all that apply)(Required)

Credit card

Purchase order

Check

Billing contact name:(Required)

Billing contact email:(Required)

Billing contact phone number:(Required)

How many students do you want to enroll?(Required)

List each student's name and email address:(Required)

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