Please Initial next to each statement, signifying that you have read and understand the following
information, then sign and date below.
⎯ I understand that all courses marked by an asterisk (*) in the list above must have been completed within 5
years of the application deadline. BIOL classes completed before the Fall Semester of 2015 will be considered
expired and must be re-taken or an exemption exam must be passed. Exemption exam information:
⎯ I have attached an unofficial copy of my Gwinnett Technical College transcript which I have downloaded from
gtc-web.org and I have confirmed all courses and grades listed above are accurately reflected therein.
⎯ I understand this application, along with all course information and supporting documents (driver’s license,
Permanent Resident card, if not a US Citizen, Kaplan Score report, and LPN/Paramedic/Surgical Technologist
license) must be received by the Enrollment Support Center on the Lawrenceville or Alpharetta-North Fulton
campus or emailed to the email@example.com by the application deadline. If you would like to
submit your application in person you may do so by scheduling a QLess appointment with a Healthcare
Enrollment Advisor on the Lawrenceville or Alpharetta-North Fulton campus. I understand that incomplete
packets will not be considered.
⎯ In addition to the courses listed above, I understand that ENGL 1102, FYES 1000 (if not eligible for an
exemption from this course), PSYC 2103, and the Humanities Elective must be completed prior to the start of
Spring C-Term 2021 to continue in the Nursing (LPN/Paramedic/Surgical Technologist) Bridge program.
⎯ I understand completion of prerequisite courses and meeting other minimum requirements does not
guarantee selection to the Nursing LPN/Paramedic/Surgical Technologist Bridge program, as there are a
limited number of seats available in the occupational and clinical courses. I understand candidate selection is
based on a competitive selection process.
Student Signature _______________________________________________ Date ___________________
Gwinnett Technical College does not discriminate on the basis of race, color, national origin, sex, age, or
disability. Lisa Richardson, Section 504/ADA, Title IX and Equity Coordinator, Building 100, Room 708,