Health Information Technology Application HIT Registration Form If you are human, leave this field blank. If you have not applied to and received your acceptance to Craven Community College, please go to Craven Community College Application. Once you have received your acceptance to Craven CC, please come back and complete this application for the Health Information Technology Program. If you have any questions, please contact Admissions or contact Health Programs. • As an applicant to the Health Information Technology Program at Craven Community College, I have applied to Craven Community College and been accepted. * Enter Initials Date * Student ID # * Enter 7 digit ID Number Legal First Name: * Middle Initial: Legal Last Name: * Additional Last Names: Craven Student Email Address * You must include your Craven Community College Email Address. Example: pantherID@my.cravencc.edu. Using an email other than your official College Student Email may delay your application. Mailing Address * City * State * Zipcode * Phone Number * Alternate Phone Number Alternate Email Address High School Attended/GED Earned * High School Graduation / Date GED Earned * List all post-secondary institutions attended Military Experience * Active Duty Reserve Veteran None How did you learn about the Health Information Technology Program? What city do you currently reside in? * What state do you currently reside in? * Do you have an Associate's Degree? * Yes No Do you have a Bachelor's degree? * Yes No Associate Degree Information Institute * Date of Degree * Name of Degree * GPA * Bachelor Degree Information Institute * Date of Degree * Name of Degree * GPA * Have you completed all developmental requirements to be eligible to enroll in ENG 111? * Yes No Have you completed all developmental requirements to be eligible to enroll in MAT 110? * Yes No Have you completed all development requirements to be eligible to enroll in BIO 168? * Yes No Have you completed, with a C or above, or are currently taking the following classes: ACA 111 (College Student Success) * Yes No ACA 122 (College Transfer Success) * Yes No BIO 168 (Anatomy and Physiology I) * Yes No BIO 169 (Anatomy and Physiology II) * Yes No ENG 111 or compatible (Writing and Inquiry) * Yes No ENG 114 (Professional Research and Reporting) * Yes No MAT 110 or higher (Math Measurement and Lit) * Yes No MED 121 (Medical Terminology I) * Yes No MED 122 (Medical Terminology II) * Yes No CIS 110 (Introduction to Computers) * Yes No DBA 110 (Database Concepts) * Yes No HSC 110 (Orientation to Health Services) * Yes No ART 111 (Art Appreciation) * Yes No ART 114 ( Art History Survey I) * Yes No ART 115 (Art History Survey II) * Yes No HUM 110 (Technology and Society) * Yes No HUM 115 (Critical Thinking) * Yes No HUM 211 (Humanities I) * Yes No HUM 212 (Humanities II) * Yes No MUS 110 (Music Appreciation) * Yes No MUS 112 (Introduction to Jazz) * Yes No MUS 113 (American Music) * Yes No PHI 215 (Philosophical Issues) * Yes No PHI 240 (Introduction to Ethics) * Yes No REL 110 (World Religions) * Yes No ECO 251 (Principles of Macroeconomics) * Yes No PSY 150 (General Psychology) * Yes No View the Health Information Technology Plan of Study (opens in a new tab) I understand that it is my responsibility to send all official transcripts to the Registrar at Craven Community College so that my application can be processed. Please initial below. * Submit
