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ApplicationCT (Howard Community College)

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Howard Community College CT Program
Application for Admission
Note. All CT applicants MUST have at least a valid ARRT registration in either Radiography, Nuclear
Medicine Technology, or Radiation Therapy
First Name
_________________________
Last Name
______________________________
Mailing Address
____________________________
Apt #
_____
__________________
City
______________________________
Zip Code
_____________
State
__________________
Record your ARRT score for
Radiography
__________
Nuclear Medicine Technology
__________
Radiation Therapy
___________
What year did you first earn ARRT certification in either Radiography, Nuclear Medicine Technology, or
Radiation Therapy? _____________________
What program did you attend for your Radiography degree or certificate? _______________________
How many years of experience do you have in either Radiography, Nuclear Medicine Technology, or
Radiation Therapy _____________________ (round to the nearest year)
Have you worked or currently working as MRI / CT technologist / Neither (circle one or both, if
applicable, neither if you have not)
I prefer to be enrolled as single or dual certification (choose one)
A. CT only
B. CT and MRI – one at a time (Check preferred certification)
C. CT and MRI – simultaneously
Can you provide the following list of documents (Yes/No)
A. Copy of ARRT certification ___________
B. Copy of ARRT certification exam score ________________
C. Supervisor or professor’s referral ________________ (separate form)
Please Return to Adrienne Summers. Email: asummers@howardcc.edu or Fax: 443-518-4332
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ApplicationCT (Howard Community College)

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Completed 25 July 2020

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