900_______________
Please initial next to each statement, signifying that you have read and understand the
following information, then sign and date below.
I understand that all courses marked by an asterisk (*) in the list above must have been completed within 5
years. If you are applying for the Spring Cohort, the ALHS/BIOL classes must be completed by the
end of the Fall semester 2015.
I understand this application, along with an unofficial transcript from my Banner account and I have
confirmed that all courses and grades listed above are accurately reflected therein.
I have attached an unofficial copy of my Gwinnett Technical College transcript, which I have printed from gtc
web.org.,a picture of my driver’s license and if you are not a U.S. Citizen you will need to attach a picture of your
Permanent Resident Card. You can schedule an appointment on QLess to submit your application in person on the
Lawrenceville or Alpharetta-North Fulton campus or you can email your application to healthapp@gwinnetttech.edu
by the program application deadline of October 10th. I also understand incomplete packets will not be considered.
I understand FYES 1000 (unless exempt) must be completed with a “C” or higher. Students are encouraged
to complete this course prior to program start or will be required to enroll the first semester of the
Respiratory Care program.
I also understand that completion of prerequisite courses and meeting other minimum requirements does
not guarantee selection to the Repiratory Care Degree program, as there are a limited number of seats
available in the occupational and clinical courses. I understand that candidate selection is based on a
competitive selection process.
Student Signature _______________________________________________ Date ___________________
For staff use only
Student has an active admissions file.
All previous transcripts received and
prerequisites are transferred in accurately in
SHATERM
Student is in good academic standing
Student has a 2.75 GPA or higher in
most recent attempt of required
prerequisite courses
All BIOL classes were taken Fall 2015 or
later for Spring start.
Permanent Resident card is attached and has
not expired.
Check to see if student has taken FYES 1000
or exempt.
Driver’s license is attached and has not
expired.
Gwinnett Technical College does not discriminate on the basis of race, color, national origin, sex, age,
or disability. Lisa Richardson, Section 504/ADA, Title IX and Equity Coordinator, Building 100, Room
708, 678.226.6691, LRichardson@GwinnettTech.edu.
JH 8/2020