SECTION 1 TO BE COMPLETED BY STUDENT
Request waiver of the program admission requirement(s) indicated: (Health Sciences Program)
TEAS-V or SAT or ACT ASSET
Other Please Specify
If this waiver is approved, request that I be admitted to the Pre-Health Care Certificate (PTH6 for Physical Therapist Assistant
program. I understand that program changes may aect my financial aid and financial aid counseling is available at the
Financial Aid Oce on either Beltline or Airport campus.
Please Print Name
Signature
Date Social Security Number
A F
SECTION 2 TO BE COMPLETED BY PROGRAM DIRECTOR
o
Approved
o
Disapproved
Comments:
Signature Date
SECTION 3 TO BE COMPLETED BY AHNAC
To: MTC Records Oce
Please add the following program codes to this student’s record. (This action is not intended to delete or change any previous
program codes.)
Major Minor
AHNAC Signature Dates
midlandstech.edu
i
PO Box 2408
i
Columbia, SC 29202
i
803.738.8324
OFFICE OF ADMISSIONS
HEALTH SCIENCES WAIVER
REQUEST PROGRAM DECLARATION
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
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