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Email (Preferred Contact Email):
Why are you interested in this program?
Do you have a Bachelor's Degree?
- Select - Yes No If yes, please list your full degree, major, institution, and date awarded:
Do you have healthcare experience?
- Select - Yes No If Yes, please provide the length of your healthcare experience and explain the type of experience.
Do you have information technology experience?
- Select - Yes No If Yes, please provide the length of your information technology experience and explain the type of experience:
Are you a licensed professional?
If yes, please include your Healthcare and/or IT Industry certifications:
By selecting this option, I certify that the preceding answers are true, correct, and complete. I understand that any falsification or intentional misrepresentation of information on this application may be cause of dismissal from the Healthcare Technology Systems Program and from the college.