Morris Hunter Arrowhead Regional Medical Center School of Radiologic Technology 400 North Pepper Avenue Colton, CA
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1 Arrowhead Regional Medical Center School of Radiologic Technology 400 North Pepper Avenue Colton, CA (909) Web: Dear Prospective Student, In reply to your request, we are enclosing an application to Arrowhead Regional Medical Center School of Radiologic Technology. This program is affiliated with Crafton Hills College. We must receive your completed Application, General Education Requirement form (attached), High School Diploma or GED (copy), and OFFICIAL sealed transcripts from all colleges attended; no later than April 1, Applicants who do not complete the application process by the April 1st deadline will not be considered for the program. Include all documents in one envelope. Mail applications documents and transcripts to: Morris Hunter Arrowhead Regional Medical Center School of Radiologic Technology 400 North Pepper Avenue Colton, CA The application fee is $50.00 payable to: A.R.M.C. School of Radiologic Technology. Please enclose a money order or cashier s check with your application. Do not submit cash or personal checks. The application fee is non-refundable. Factors considered in selection: Personal Interview, Professional attire, academic success, volunteer and/or job experience in a patient care environment, knowledge of the Medical Imaging Profession, Re-applicant, and previous alternate status. Note: If you do not have a college degree, the attached General Education Requirement Form (Crafton Hills College AS/AS Degree Requirements) should be completed and signed by a college counselor. Sincerely, Morris Hunter Morris Hunter, MA. RT(R), CRT Program Director Revised 10/1/2014 1
2 APPLICATION FOR ADMISSION Print Name: Maiden name: Last 4 digits of SSN: XXX-XX- Home phone: Cell phone: Other contact number: address: Mailing address: Have you ever applied to this radiography program? If yes, what year? How did you learn about this Program? EDUCATION HighSchool: Name Location Year Graduated College: Name Location Degree (yes/no) College: Name Location Degree (yes/no) Other: Revised 10/1/2014 2
3 EXPERIENCE: Give your employment history for the last three years, including relevant volunteer experience. If additional space is needed, add an attachment. Institution: Phone: Address: Position Held: Supervisor: How Long at this Job? Duties Institution: Phone: Address: Position Held: Supervisor: How Long at this Job? Duties Institution: Phone: Address: Position Held: Supervisor: How Long at this Job? Duties REFERENCES: List three personal references (other than relatives) who have known you for at least two years. Name: Occupation: Address: Phone: Name: Occupation: Address: Phone: Name: Occupation: Address: Phone: Please update your contact information if there are any changes prior to the interview. any updates to: Note: You may include a resume or personal reference letter(s) With this application, however they are not required. Revised 10/1/2014 3
4 Professional Course Checklist Please fill out this section completely or the selection committee will not accept this application. Transcript Course Year Letter Name of College where course(s) Units Included Completed Grade were completed Yes / No English Composition Computer Literacy Intermediate Algebra Anatomy Physiology Medical Terminology AH 090 -Survey of Radiologic Technology Note: To be considered for a personal interview, the applicant shall: 1) Submit a completed application package and $50.00 fee 2) Provide official College Transcripts 3) Complete the college courses listed above with minimum 2.5 GPA plus complete all General Education Courses for AA or AS degree prior to the April 1 st deadline. 4) Submit a completed general education form titled: Crafton Hills College AA/AS Degree Have a college counselor complete and sign this form. Note: GE education form is not required if you have a degree. A photograph is preferred, but not required. Please attach below with tape, do not staple. Revised 10/1/2014 4
5 Autobiographical Sketch Submit, on the page provided, an autobiography of yourself. Include your interests, hobbies; how you became interested in Radiologic Technology; what are your future professional aspirations; what you believe to be your responsibility to the community as a professional person. Revised 10/1/2014 5
6 Revised 10/1/2014 6
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