This form is for the admission into the next cohort. All applications must be submitted by May 1.
Please note that you will need to fill out this application in one sitting. There is no option to save your progress and come back to finish it.
Please fill in every form field below. If the item is not applicable to you, please write “n/a.”
Please do not submit more than one application. Subsequent submissions will not be considered.
Thank you.

Questions? Please contact [email protected].

Surgical Technology Application
Name
Name
First
Last
Address
Address
County
City
State/Province
Zip/Postal

Letters

Maximum file size: 52.43MB

Maximum file size: 52.43MB

Maximum file size: 52.43MB

Pre-Requisite and General Education Courses

English

Math

Arts/Humanities

Psychology

Sociology

Medical Terminology 106

Biology 103

Biology 211 Anatomy & Physiology I

Biology 212 Anatomy & Physiology II

Biology 202 Microbiology

Signature

I certify that the information on this application is true and accurate to the best of my knowledge. I am aware that falsification or misrepresentation may result in being denied admission, or if enrolled, dismissed from this program. I understand that final acceptance into the Surgical Technology program shall be contingent upon satisfactory completion of a criminal background check and satisfactory completion of a health examination record. Typing out your name and the date is your signature to this petition for admission to the Surgical Technology program.