Medical Assisting Application Medical Assisting Application If you are human, leave this field blank. As an applicant to the Medical Assisting Program at Craven Community College, I have applied to Craven Community College and been accepted. * Initial 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 Medical Assisting Program. If you have any questions, please contact Admissions or contact Health Programs. 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 * 999-999-9999 Alternate Phone Number 999-999-9999 Alternate Email Address High School Attended/GED Earned * High School Graduation / Date GED Earned * List all post-secondary institutions attended Do you prefer day or night classes? * Day Night Do you have a Associate's Degree? * Yes No Do you have a Bachelor's Degree? * Yes No Associate Degree Information Institution * Date of Degree * Name of Degree * GPA * Bachelor Degree Information Institution * Date of Degree * Name of Degree * GPA * Have you completed all development requirements to be eligible to enroll in ENG 111? * Yes No Have you completed all development requirements to be eligible to enroll in MAT 110? * Yes No Have you completed all development requirements to be eligible to enroll in BIO 163? * Yes No Have you completed, with a C or above, or are you currently taking the following classes? ACA 111/122 (College Student Success) * Yes No CIS 110 (Introduction to Computers) * Yes No ENG 111 (Writing and Inquiry) * Yes No ENG 112 (Argument-Based Research) * Yes No MAT 110 or higher (Math Measurement and Lit * Yes No BIO 163 (Basic Anatomy and Physiology * Yes No PSY 150 (General Psychology) * Yes No MED 121 (Medical Terminology I) * Yes No MED 122 (Medical Terminology II) * Yes No ART 111 (Art Appreciation) * Yes No ART 114 (Art History Survey I) * Yes No ART 115 (Art History Survey II) * Yes No ENG 231 (American Literature I) * Yes No ENG 232 (American Literature II) * Yes No ENG 243 (Major British Writers) * 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 Do you have any of the following active certifications? * EMT - Basic EMT - Intermediate EMT - Advanced Intermediate Paramedic Certified Nurse Aide I Certified Nurse Aide II Phlebotomy Other None of the Above Enter Certification Number 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. * Initial Submit
