Biotechnology Program - Application
First Name Middle Name Last Name
_____________________________________________________________________________________
Address Phone
_____________________________________________________________________________________
Email
Tell us about your science background (i.e. what science classes have you taken, if any recently):
Are you currently seeking a degree? If yes, what will be your degree?
Which one of the following Biotechnology credentials are you interested in:
1. Basic Biotechnician Certificate
2. Advanced Biotechnician Certificate
3. Environmental Biotechnician Certificate
4. AAS in Biotechnology
When do you anticipate beginning coursework with the Biotechnology program?
Please submit your completed application to: Keith Allen, Biotechnology Coordinator
470 Cooper Drive, 332-A Oswald Building
Lexington, KY 40506, Phone: 859-246-6767
bl_biotechnology@kctcs.edu
Indicate the appropriate responses below:
1. Gender: ___Male ___Female
2. Ethnicity: _________________________
3. Student Status: ___Full-Time ___Part-time
Biotechnology Program – Application for Fall 2014
