Ophthalmic Medical Assisting Application for Admission
Applications are validated by completing an information session September 11, 2019 to February 25, 2019.

Deadline for submission of the Health Science application is March 15, 2020.

Do not submit this application after March 15, 2020.
First Name *
Your answer
Last Name *
Your answer
Student ID Number *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Personal Email Address *
Your answer
MYEDGE Email Address
The MYEDGE email account is created upon application to the school. This is the address all faculty and staff will use to contact you once your application to the college has been submitted. Example: First Initial, Last Name, Date of Birth (jdoe0612@myedge.cc)
Your answer
Have you completed an admissions application to Edgecombe Community College? *
Educational Experience *
High school or GED completion date *
MM
/
DD
/
YYYY
College/Training Previously Attended *
Include all (1) colleges attended, (2) degrees/diplomas/certificates awarded, and (3) years attended.
Your answer
Official Transcripts *
Required
Do you have work experience related to the medical field? *
If you answered yes to the question above, list (1) Employer (2) Modality (3) Date/s you worked
Your answer
Do you have any active certifications (excluding CPR)? *
If you answered yes to the question above, list (1) Certifying agency (2) Certificate earned (3) Date earned
Your answer
Edgecombe Community College serves the public without regard to race, creed, color, religion, national origin, or sex.
When did you attend an information session? *
ECC Health Sciences Admission Policies and Requirements *
Required
*All required fields must be completed for successful submission of this application.
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