I have:

On This Date:

Completed the WCTC Admissions process on

 

Requested my high school/college transcripts be sent on

 

Completed the admissions testing on

 

Attended an informational meeting on

 

Completed all my program readiness course(s) in the Learning Place (if needed) on

 

Completed the program prerequisites (ie. chemistry, biology, etc.) (if needed) on

 

Passed the typing test (only for Medical Assistant, Medical Transcription, and Phlebotomy programs) (six months from the date of application) on

 

Read the Allied Health Handbook containing the program’s essential functions on

 

Filled out the Background Information Disclosure BID (HFS-64) (only for Dental Hygienist, Medical Assistant, Surgical Technology, Phlebotomy, & Radiography)

 

Filled out the Medical Coding Specialist & Phlebotomy program computer skills evalution/assessment (required for all Medical Coding students) (waived only for Phlebotomy) (download Adobe Acrobat)

 

Have read and are able to meet the Medical Assistant Program Technical Standards and have signed the receipt form. (download Adobe Acrobat)  
Filled out the Criminal History Request CHR (DJ-LE-250) (only for Dental Hygienist(at clinical orientation meeting), Medical Assistant, Surgical Technology, Phlebotomy, & Radiography)

 

Read the Program Information Contract on

 

Filled out the Health Requirement Forms

 

Student Name
SS # or ID #
Name of Program
Address                                                                     City / Zip

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