You must have JavaScript enabled to use this form. Required fields are marked with an asterisk '*'. As an applicant to the Medical Assisting 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 * Enter your seven digit Student ID number with leading zeros. Craven Student Email Address? * Mailing Address * Address * Address 2 City/Town * State * ZIP/Postal Code * Phone Number? * Alternate Email Address Alternate Phone Number What city are your currently living in? * What state are you currently living in? * Do you prefer day or night classes? * Day Night My schedule is flexible Do you have a Bachelor Degree? * Yes No Name of Institution Date degree earned Name of Degree GPA Do you have an Associate Degree? * Yes No Associate Degree Institution Associate Degree Date Earned Name of Associate Degree earned 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 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? ACA-111 (College Student Success) * Yes No In Progress ACA-122 (College Transfer Success) * Yes No In Progress BIO-163 (Basic Anatomy and Physiology) * Yes No In Progress ENG-111 (Writing and Inquiry) * Yes No In Progress ENG-112 (Argument-Based Research) or ENG-114 * Yes No In Progress MAT-110 (Math Measurement & Literacy) or higher * Yes No In Progress MED-121 (Medical Terminology I) * Yes No In Progress MED-122 (Medical Terminology II) * Yes No In Progress PSY-150 (General Psychology) * Yes No In Progress CIS-110 (Introduction to Computers) * Yes No In Progress ART-111 (Art Appreciation) * Yes No In Progress ART-114 (Art History Survey I) * Yes No In Progress ART-115 (Art History Survey II) * Yes No In Progress ENG-231 (American Literature I) * Yes No In Progress ENG-232 (American Literature II) * Yes No In Progress ENG-243 (Major British Writers) * Yes No In Progress HUM-110 (Technology and Society) * Yes No In Progress HUM-115 (Critical Thinking) * Yes No In Progress HUM-211 (Humanities I) * Yes No In Progress HUM-212 (Humanities II) * Yes No In Progress MUS-110 (Music Appreciation) * Yes No In Progress MUS-112 (Introduction to Jazz) * Yes No In Progress MUS-113 (American Music) * Yes No In Progress PHI-215 (Philosophical Issues) * Yes No In Progress PHI-240 (Introduction to Ethics) * Yes No In Progress REL-110 (World Religions) * Yes No In Progress Do you have any of the following active certifications?? * EMT-Basic EMT-Intermediate Paramedic Certified Nurse Aide I Certified Nurse Aide II Phlebotomy Other None Certification Number High School Attended/GED Earned * High School Graduation/Date GED Earned * List all post-secondary institutions attended I understand that it is my responsibility to send all official transcripts to the Registrar at Craven Community so that my application can be processed. *