AH CT Program Application

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Computed Tomography
Program Application

Galveston College Computed Tomography (CT) Program has a selective admissions process. This process is nondiscriminatory on the basis of race, color, national origin, gender, age, qualified disability, marital status, veteran's status, or sexual orientation in admissions to the program. Note: It is the student's responsibility to provide the program director written notification of any changes in contact information.

First Name:

Middle Name:

Last Name:

Student ID:

Cell Phone Number:

Email:

Date of Birth:

SSN:

Address:

City:

State:

Zip:

Program & Education

CT - Online with Clinic

CT - Online without Clinic

Applying for:

Semester:

Fall

Spring

Summer

Year:

2023

2024

2025

School & Employer Information

Please provide the name of schools you have attended as well as your current employment information and position. Please send all official transcripts from all schools attended to the admissions office. These can be sent upon acceptance to Galveston College.

Institution:

Graduating from school/program:

GPA:

Current Employer

Current Position:

Clinic Rotation Information

Are you planning to do your clinical rotation at your current employer?

I understand that if I choose to participate in the Clinical portion, the Background Check and Drug Screen are my responsibility to complete prior to the start of the program at my own expense.

Yes, I understand

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