Medical Assistant - Evening Session

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1 Medical Assistant - Evening Session Information and Application 3300 Century Avenue North White Bear Lake, Minnesota century.edu Century College is a Member of the Minnesota State Colleges and Universities system. We are an affirmative action, equal opportunity employer and educator. This document can be available in alternate formats to individuals with disabilities by calling or x3354.

2 Medical Assistant Program Spring 2015 Evening Program century.edu last updated: 8/13/ Century Avenue North, White Bear Lake, MN 55110

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5 Admissions Office 3300 Century Ave N White Bear Lake, MN This application is for: Medical Assistant Application Form Evening Program Name (Last, First, Middle, Maiden) Century Student ID number Permanent Address City State Zip Code Home Phone address Cell Phone Educational Record: Names of secondary schools, colleges and technical schools attended: High School attended or GED City State Graduation Month Year All applicants must have an official high school transcript or GED transcript on file to be eligible for admission. Applicants who have graduated from high school outside of the United States must submit a WES evaluated high school transcript Have you ever attended any college? Yes No Have you ever attended Century College? Yes No Colleges, technical or Dates Certificate, degree or City State other post secondary schools From To diploma received Please contact each college and request an official transcript be sent directly to the DARS/Transfer Office at Century College. Applicant Signature I hereby certify that the information provided on this application form and in all other admission application materials is complete, accurate, and true to the best of my knowledge. Signature Date NOTICE Admission is granted without regard to race, creed, color, sex, age, national origin or handicap. This institution abides by the provisions of Title IX, federal legislation forbidding discrimination on the basis of sex and by all other federal laws regarding equal opportunity. Note: Federal and state legislation requires that the contents of student files be open to review by the student. Application forms, high school transcripts, test date, letters, and recommendations that are sent as part of any application for admission will be open to the student's review upon request. Century College is a Member of the Minnesota State Colleges and Universities system. We are an affirmative action, equal opportunity employer and educator. This document can be available in alternative formats to indivdiuals with disablilities by calling or x3354.

6 MEDICAL ASSISTANT PROGRAM APPLICANT CHECKLIST Please complete the following checklist. All items under the "Application Requirements" must be completed or inprogress prior to the August 31 application deadline or your application will be denied. PLAN AHEAD. ALL DOCMENTATION MUST BE RECEIVED BEFORE THE APPLICATON DEADLINE APPLICATION REQUIREMENTS: All items must be completed and documented before the application deadline. All courses completed or in progress must be reflected on official transcripts. YES NO Have you ever attended Century College? If no: Have you submitted the required Century College Application with the $20 application fee? (Note: a college application must be on file before your Medical Assistant application can be processed. The Medical Assistant application is not a substitute for the Century College Application form.) Have you taken the Century College assessment test for placement in Reading, and Math or submitted Accuplacer scores from another institution? Assessment scores are requried to determine program readiness. Placement requirements are: Reading 1000 and Math 0030 (Century College courses). You must submit a copy of your test results to the Assessment Office if you have taken your test at an institution OTHER than Century College. If you retake your assessment test at Century College there is a $10 retest fee required. (Exemption to the Reading and Math assessment will be given in accordance with college policy. Please contact the Assessment Office at 651/ for details). Have you requested official transcripts verifying successful completion of high school or GED? Transcripts must be received prior to the application deadline or your application not be considered. Students who graduated from an international high school msut submit a WES verified high school transcript. You are responsible for providing official proof of graduation prior to the application deadline. Have you requested official transcripts from ALL post-secondary institutions attended? Transcripts must be current with grades posted for all terms completed prior to the deadline and must be received in a sealed envelope from the originating institution. Transcripts must be received prior to the application deadline or your application not be considered. Will you have completed all developmental coursework for Reading and/or Math indicated by assessments before the application deadline? All developmental coursework must be completed with a grade of C or better to qualifiy to apply. Have your completed all required courses as outlined under step 3 in the information/application booklet? We will only consider applicants with coursework inprogress if we are unable to fill the program with fully-eligible applicants by the application deadline. Coursework in-progress must be comleted prior to the program start date. Are you in good Academic and Financial standing at Century College? If you are on Academic Suspension, your suspension must be cleared prior to the application deadline or your application not be considered. This applies to both Century College and all MnSCU institutions previously attended. It is strongly recommended you meet with an advisor or counselor to discuss your general education credits to ensure you are on track with the liberal arts requirements.

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