Dr. Ramiro R. Casso
Nursing/Allied Health Campus
APPLICATION TO MEDICAL ASSISTANT TECHNOLOGY PROGRAM
Name______________________________________________________________________________Date________________________________
Print or Type (Last)
(First)
(Middle)
(Maiden Name)
Residence Address____________________________________________________________________________________________________
(No. and Street)
(Cit y)
(State)
(Zip Code)
Mailing Address_______________________________________________________________________________________________________
(No. and Street)
Phone Number (
(City)
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(Home)
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SID# A____________________________
(Work/Message/Pager/Mobile)
E-Mail Address________________________________________________________________________________________________________
Directions:
1. Mark an “X” in all the circles below that apply to you. If you answer “No” to questions 1-5 below, your
application may not be considered.
2. Sign and date the application.
3. Attach a copy of all transcripts for all classes taken outside of STC (i.e. UTPA, UTB, etc.)
4. Mail or bring application to:
MAIL:
or
BRING:
South Texas College
South Texas College
Nursing/Allied Health Division
Dr. Ramiro R. Casso NAHC
P.O. Box 9701
1101 E. Vermont Street
McAllen, TX 78502-9701
McAllen, TX 78503
5. The application and all verification documents must be on file in the Nursing/Allied Health Division office
prior to registration. Qualifying applicants are admitted on a first come first serve basis until the class
reaches maximum capacity.
ADMISSION REQUIREMENTS:
1. Meet general admission requirements to South Texas College.
2. Have a High School diploma or GED.
3. Earn a minimum cumulative GPA of 2.5 on a 4.0 scale for all courses completed through STC.
4. Satisfy program specific requirements for clinical practice.
5. Submit a completed Medical Assistant Technology program application.
6. Participate in individual student advisement with Medical Assistant Technology faculty prior to
application.
7. Degree option: Be TSI Complete or TSI Exempt via State approved exam scores.
Level 2 Certificate option: Pass college placement test with minimum scores or complete
developmental classes with a grade of “C” or better for course placement as follows;
Completion of READ 0200 or INRW 0304 or equivalent.
Completion of ENGL 0200 or INRW 0304 or equivalent.
Completion of MATH 0200 or equivalent.
YES
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NO
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I have read the contents of this information packet and am responsible both for my application’s completeness and for the
information contained within it. I certify that the information provided within this application is true and realize that reporting
untrue information will result in my disqualification from the applicant pool and program and I will not be eligible to reapply.
SIGNED__________________________________________________________________________DATE________________________________________________
Applicant’s Signature
STATEMENT OF EQUAL OPPORTUNITY
No person shall be excluded from participation in, denied the benefits of, or be subject to discrimination under any program or activity sponsored or conducted by South Texas
College on the basis of race, color, national origin, religion, sex, age, veteran status, or disability.
Revised 5/2015