________________________ Student ID #
Fall 2019 Cardiovascular Technician Course
Candidate Review Form
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INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED!
NAME ____________________
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hold the job classification indicated. Please check the appropriate box and list the complete name of the organization
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Minimum Admissions Requirements Check Sheet
DO NOT FILL OUT THIS PAGE!
To be completed by the Admissions Staff in the Whitcomb Student Center.
Notes
(Staff Use Only)
Item
Verification
(Staff Use Only)
Placement test scores or waiver on file
___ Credit for DRE 098 or higher
___ Credit for RISE Tier 1
___ TABE results (21/25)
Official High School Transcript or equivalent on file
____Verified by Admissions Staff
____Verified by Admissions Staff
Copy of Driver’s License or Government issued ID on file
Your signature on this document indicates that the information on this
Candidate Review Form is correct to the best of your knowledge.
Student Signature: _______________________________________________________ Date: ________________
Signature of Admissions Staff completing form: ________________________________ Date: ________________
Important Dates, Deadlines, and Payment Information
Application Deadline
Paym
ent Deadline
Thursday, August 22 @ 5pm
Friday, August 23 @ 3pm
*Total cost of course is $190, plus textbook*
*Contact Admissions at (336) 342-4261 ext. 2333 for more information*
____Verified by Admissions Staff
Current RCC Application on file
Dates & Times
aAugust 27 - November 21, 2019
Tuesday/Thursday 5:30pm-9:30pm