You must have JavaScript enabled to use this form. Required fields are marked with an asterisk '*'. As an applicant to the Health Information Technology Program at Craven Community College, I have applied to Craven Community College and been accepted. * Legal First Name * Middle Initial Legal Last Name * Additional Last Names Craven Student ID Number? * Craven Student Email Address? * Mailing Address * Address * Address 2 City/Town * State * ZIP/Postal Code * Phone Number? * Alternate Email Address Alternate Phone Number? Military Service * Active Duty Reserve Veteran None Do you have a Bachelor Degree? * Yes No Institution? 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-152? * Yes No Have you completed all developmental 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: ENG-111 (Writing and Inquiry) or compatible * Yes No In Progress MAT-152 Statistical Methods * Yes No In Progress BIO-163 (Basic Anatomy & Physiology) * Yes No In Progress MED-121 (Medical Terminology I) * Yes No In Progress MED-122 (Medical Terminology II) * Yes No In Progress CIS-110 (Introduction to Computers) * Yes No In Progress Humanities Elective (See Plan of Study) * Yes No In Progress Social Science Elective (See Plan of Study) * Yes No In Progress High School Attended/GED Earned? * List all post-secondary institutions attended How did you learn about the Health Information Technology Program? 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. * Leave this field blank