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Application for Charter CT School
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Mailing Address
*
Your answer
Phone Number
*
Your answer
I can provide documentation which verifies that I am currently an ARRT certified and registered radiologic technologist in good standing.
*
Yes
No
Required
I can provide documentation which verifies that I currently hold a valid radiographer license that is issued by the Maryland Board of Physicians.
*
Yes
No
Required
I understand that I must purchase CT Basics: The Series from the ASRT.
*
Yes
No
Required
Which term are you applying for?
*
Choose
Term 1 (Jan-Apr)
Term 2 (May-Aug)
Term 3 (Sept-Dec)
My preferred clinical rotation is:
*
Choose
Columbia Location, (M, W, F), Day Shift
Columbia Location, (M, W, F), Evening Shift
Columbia Location, (T, Th, Sa), Day Shift
Columbia Location, (T, Th, Sa), Evening Shift
Reisterstown Location, (M, W), Day Shift
Reisterstown Location, (T, Th), Day Shift
I have reviewed the Charter CT School Student Handbook and understand all policies and procedures listed. If selected as a student I shall abide by all program and clinical affiliate policies and procedures.
*
Yes
No
Required
If accepted into the Charter CT School, I elect my payment method option to be:
*
Tuition paid in full ($3,500)
Monthly Payment Plan (four payments of $875)
Required
Today's Date is:
*
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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