Application for Admission

*I would like to begin classes in:
JanuaryAprilJulyOctober

*Of the year:

*Highest level of education achieved:
—Please choose an option—GEDHigh SchoolSome CollegeCollege Graduate

Are you able to meet the applicant requirements listed below:

• be 18 years of age or older when the program begins

• fluent in speaking and writing in English

• pass a drug screen and background check

• current or willing to become current in the vaccinations detailed in the catalog

• able to walk and stand for extended periods of time

• able to lift forty pounds (40 lbs)

• certified or willing to become certified in Basic Life Support for Healthcare Providers by the American Heart Association or Red Cross*

Do you currently work in a health care facility?*

If you answered YES to the last question, specify where:

What is your position?

Will you need assistance finding a clinical site?*

Have you completed a job shadow with an EEG Technologist?*

Are you currently performing the job of an EEG Technologist, EEG Technician, or EEG Monitoring Technician?*

I acknowledge that the information provided above is accurate and complete. I understand that any false or misleading information may result in the rejection of my application.

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