How To Apply

Supplemental Application
for Paramedic Programs

The application, all transcripts, and any applicable test scores must be received by the November 1st deadline to be eligible for the program.

CHECK ALL THAT APPLY	PROGRAM	DEADLINE	CLASSES BEGIN
	Associates Degree in Paramedic Emergency Services (AAS.PES)	November 1	January
	Certificate in Paramedic Emergency Services (CER.PES)	November 1	January

I am interested in the following year for admission:

Name:
	(last)	(first)	(middle initial)

Email Address:

Student ID Number: Former Name:

Address:

City: State: Zip:

County: Telephone:

Is this a new address? Yes No

Which of the following do you have? High school diploma GED

Have you completed or do you plan to complete coursework at another college?	Yes (If so, please make sure that all official transcripts have been sent to HCC)	No

*Which, if any of these courses have you completed?*	EMT Basic (PES 101) Introduction to EMS (PES 102) Practicum I (PES 103)

Any healthcare experience?	Yes # Years	No

I understand that I will be considered for the indicated program during the year specified on this application. If I wish to defer consideration to a later year, it is my responsibility to submit a new application to the Office of Admissions and Registration.

I understand that the program that I am applying for is selective, and that acceptance is not guaranteed. I also understand that preference may be given to students residing in Washington County.

I have met individually with an academic advisor or program coordinator concerning the requirements of the program I am applying for.

I understand that it is my responsibility to ensure all application materials are received by HCC by the published deadline, and to inform HCC of any address or name changes immediately.

Supplemental Application for Paramedic Programs

Supplemental Application
for Paramedic Programs