Medical Assisting Technology (MAT) Application

The application for the Medical Assisting Technology (MAT) is included below. Please click on and follow the instructions for completing the application. Currently, the only way an application for the program is accepted is on-line. If you have any questions, please contact Miranda Amrich, at mamrich@cscc.edu.

Deadline for Autumn Semester Enrollment: August 10, 2020

Medical Assisting Technology (MAT) Application

Prefered Starting Semester

Please choose a starting semster

Student Information

First Name

Mid Initial

Last Name

Email Address

Please use your CSCC email address if you are a student.

Phone Number

Cougar ID Number

Home Address

City

State

Zip Code

County

Credentials / Student Status

Are you a current student?

* if you are NOT a current student at Columbus State, please apply here.

If you have transcripts from other institutions, have they been sent over to Records and Registration from your other school(s):

What other colleges have you attended?

School 1 School 2 School 3

What degrees have you earned (if applicable)?

Degree 1 Degree 2 Degree 3

In your own words, please write a few sentences regarding why you are interested in the Medical Assisting field and what it is that you want to do with your certificate, once earned:

Your additional notes/comments for us:

By accepting below you agree that:

I understand that this is a sequential program, and that once I am accepted into the MAT program, I will take all courses on the Plan of Study as listed. I also understand that this program is only offered during the daytime hours:

I accept

I attest that everything on this application is true and correct to my knowledge. I have read and understand all statements regarding policies and procedures on this form.

I do

Academics Department

(614) 287-0000

academics@cscc.edu

Medical Assisting Technology (MAT) Application

Medical Assisting Technology (MAT) Application

Department Contact