OFFICE OF ADMISSIONS
ALLIED HEALTH SCIENCES
DEGREE GRADUATE NOTIFICATION
Last Name First Name Middle
Street Address (include apt. #) City State Zip Code
Home Phone Number Alternate Phone Number
Student ID Number Email Address
I have completed the degree at Midlands Technical College, term ending .
In addition to the above, I am tracking:
Nursing Degree Health Sciences Degree
I also wish to be considered to attend an orientation/interview/information session for that program of study.
Student Signature Date
Return this form to:
Admissions Office
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Attn: Nursing/Health Scinces
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Midlands Technical College
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PO Box 2408
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Columbia, SC 29202