Student Interest Form

The Associate in Applied Science (AAS) in Nutrition and Dietetic Technology is a degree that emphasizes medical nutrition therapy, community nutrition and food service management. Students acquire the knowledge and skills foundation to work in dietetics through the integration of classroom learning and supervised practice. Take a moment to fill out the student interest form below for more information.

First Name

Last Name

Address

City/Town

State/Province

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E-mail

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I have reviewed the Dietetic Technology Consortium Program Curriculum and I plan on completing the full certificate program.

I am considering completing the Dietetic Technology Consortium Program at PVCC.

The number of classes per term I am interested in taking is

I am interested in taking summer courses.

I am willing to take a class at another MCCCD college if a class is not available at a time that meets my needs (classes are offered at CGCC, SCC, GCC, and MCC).

My schedule allows me to take: (please enter the number of classes)

Day Classes:

Evening Classes:

Weekend Classes:

On-line Classes

I am interested in courses offered in

Distance learning format (on-line or flex)

Traditional classroom format (face-to-face)

I would like to transfer into a 4-year degree program and pursue the Registered Dietitician (R.D.) credential.

Please check other certifications that you would be interested in

Dietary Managerial Certification

ACSM Health and Fitness Instructor Certification (American College of Sports Medicine)

ACSM Personal Trainer Certification

NASM Personal Trainer Certification (National Academy of Sports Medicine)

NSCA Personal Trainer Certification (National Strength and Conditioning Association)

ACE Personal Trainer Certification (American Council on Exercise)

ACE Group Fitness Instructor Certification

Food Service (e.g. School Nutrition Association (SNA) Certification)

Other Allied Health degree / certifications: (please specify)

Other (not listed above):

I would be interested in taking additional courses to help me specialize in:

Nutrition for Seniors (60+)

Sports Nutrition

Diabetes

Obesity / Weight Management

Lifestyle Coaching

Operating my own business

What past professional or personal experience do you have in the field of health and fitness that has contributed to your interest in this program?

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Nutrition Info