Athens Technical College

Computed Tomography Specialist Intent Form

Seeking acceptance to the Computed Tomography Specialist Program beginning
Today's Date:
First Name:

Last Name:

ATC Student ID:

Mailing Address:

City:

State:

Zip Code:

Cell Phone:

Home Phone:

Email Address:

Have you attended another college/colleges? No
Yes

Please List:

Applicants must submit all required documentation to the Admissions Office by July 1 to receive consideration in the selection process. Applicants who are on academic probation or are academically dismissed from the college as of the application deadline will not be considered for admission. Applicants not selected for the program may reapply during subsequent admission intake periods. There is no waiting list between intake periods; applicants must complete the application process for each attempt for entry into the Radiography program. Applicants must complete the following steps by the June 1 application deadline:

Submit a completed and signed application for admission and a $25 nonrefundable application fee.
Provide proof of legal presence in the United States.Submit official transcripts showing that applicants earned a minimum grade point average of 2.0 on a 4.0 scale in high school and on all college work attempted. Students transferring from other colleges will not be required to submit high school transcripts if they complete a minimum of 30 semester or 45 quarter credit hours of study at one or more colleges.
Electronically submit the CT Intent form.

For acceptance to the online Computed Tomography (CT) Specialist Certificate program, you must meet one of the following requirements:

Be a registered radiologic technologist or registry eligible. Applicants with nuclear medicine and radiation therapy certification will be reviewed on a case-by-case basis.
or
Be a second-year radiography student attending an accredited radiography program and hold a radiography GPA of 2.75 or above.

Before enrolling in RADT 2250 Computed Tomography Clinical Education I and RADT 2265 Computed Tomography Clinical Education II, students in the Computed Tomography (CT) Specialist Certificate program must complete the following steps:

Complete RADT 2201 Introduction to Computed Tomography, RADT 2210 CT Physics & Instrumentation,RADT 2220 Computed Tomography Procedures I, and RADT 2230 Computed Tomography Procedures II.
Provide documentation that student has passed the ARRT examination for radiography and be in good standing. Applicants with nuclear medicine and radiation therapy certification will be reviewed on case-by-case basis.
Show proof of current certification in CPR at the healthcare provider level.
Provide documentation of immunizations.
Undergo a criminal background check.
Undergo and pass a drug screen.

Individual CT Coursework Admissions

Registered radiographers, nuclear medicine technologists, and radiation therapists will be eligible to enroll in individual CT specialist courses to meet the requirements to sit for the ARRT examination at the discretion of the radiography program chair.

Students must be enrolled in the Computed Tomography (CT) Specialist Certificate program to be eligible to enroll in RADT 2250 Computed Tomography Clinical Education I and RADT 2265 Computed Tomography Clinical Education II. Only in the event that the program slots cannot be filled with Georgia residents who meet the minimum admissions criteria can out-of-state students be admitted.

I certify that the above information is true and correct. I understand that misrepresentation or omission of information will be sufficient cause for rejection or dismissal. No
Yes

Is the picture on the right an image of books,pencils,pens,or notebooks?(type your response)