Medical Assistant Technology Program Application

MEDICAL ASSISTANT PROGRAM APPLICATION
Notice: Admission requirements and procedures may change without prior notice. A new application must be submitted by the applicant for each admission cycle.
Name*

First NameMiddle or Maiden NameLast Name
List any previous last names on transcripts:
SUSCC Student ID Number *
EX: A12345678
SUSCC Email*
SUSCC email preferred
Phone Number*
Please enter a valid phone number.
PROGRAM OVERVIEW
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Which program are you applying for?*
Which semester are you applying for?
Which semester are you applying for?
Which semester are you applying for?
Which semester are you applying for?
ADMISSION REQUIREMENTS

Meeting minimal requirements does not guarantee acceptance. Applicants who do not meet all minimal requirements will not be considered for program admission.
MINIMUM ADMISSION REQUIREMENTS
1. Unconditional admission to the college. (See College Catalog)
2. Minimum 2.0 GPA at Southern Union. Transfer students must enter the College on clear status with minimum 2.0 GPA.
3. Official transcripts in Records Office from all postsecondary institutions attended, along with high school transcript.
4. Meet eligibility for English Composition I and Intermediate College Algebra (Mth 100).
5. In good standing with the college.
GPA REQUIREMENTS

CUMULATIVE GPA: A minimum college cumulative GPA of 2.0 is required.
Which of the following best applies to you?*

I am a SUSCC student (current or previous)I am a SUSCC student (current or previous) and I have attended another college.I have attended another college, but plan to enter SUSCC as a new student with a clear academic status.I have never attended college and my GPA is from my 12th grade coursework.I completed the GED.
Name of graduating High School or GED location:
Year of high school graduation or GED completion:

RECORDS & TRANSCRIPTS
List all colleges attended (including Southern Union):
Official transcripts form EACH college attended must be received (via mail or electronically) by the Registrar's office in Wadley before the application deadline. Send to: SUSCC Records Office, P.O. Box 1000, Wadley, AL 36276 OR electronically.

PRIOR ACADEMIC CREDIT

A minimum grade of "C" or higher is required on any completed program academic core courses. All academic core courses that are required for the Medical Assistant Technology program may be completed either prior to OR concurrently while in the program.

Please select the final grade posted on your transcripts for each of the following courses. For courses not taken, please leave field set to 'please select'.
ENG 101: English Composition I
MAT 100: Intermediate Algebra or higher level math
BIO 201: Anatomy & Physiology I
BIO 202: Anatomy & Physiology II
SPH 107: Public Speaking or SPH 106: Oral Communications
PSY 200: General Psychology
IDS 102: Ethics
Elective: NAS 100 (Nursing Assistant) or OAD 101 (Keyboarding) or CIS 146 (Microcomputer Applications) or PSY 210

TRANSFER CREDIT
Do you have credits from another college that you would like to have considered for transfer credit?*

YesNo
TRANSFER CREDIT: Course descriptions must be uploaded for TRANSFER courses required for the Medical Assistant Technology program. Contact your previous college for the course descriptions from the year the course was taken. Upload your course descriptions here if applicable. Credits from colleges in Alabama do not require an upload.

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ESSENTIAL FUNCTIONS

Students admitted into the MAT Program must maintain the ability to meet all physical and mental essential functions with or without reasonable accommodations. After admission into the program, students will be required to obtain medical verification of their ability to meet all essential functions in order to participate in the program.

NON-DISCRIMINATION POLICY

It is the official policy of the Alabama State Board of Education and Southern Union State Community College that no person shall, on the grounds of race, color, disability, gender, religion, creed, national origin, marital status, or age, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program, activity, or employment. Persons requiring reasonable accommodations under the Americans with Disabilities Act (ADA) should contact the Southern Union State Community College ADA Coordinator at (334) 745-6437 extension 5351.
E-Signature*
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MEDICAL ASSISTANT PROGRAM APPLICATION