2018 Radiologic Technology Application
Online and Paper Applications will only be accepted from February 1, 2018- March 31, 2018. (NO EXCEPTIONS)
Please make sure to submit the paper applications with all your supporting documents to the LACC Mailroom located in the Administration Building (AD) Room 101. Please make sure to write attention to "Israel Fonseca" and leave the documents either in the LACC Mail slot or with the Jorge Cabrera (Ext. 2096).

Mr. Cabrera only accepts the documents. The Rad Tech department processes the applications and shall contact you directly via your LACCD student email.

For the students submitting transcripts for in progress classes complete your online application then submit your paper application along with the supporting documents before the March 31, 2018 deadline to the LACC mailroom (AD 101). The official transcripts for in progress students will need to be submitted to the LACC RT mailroom by the June 15, 2018 3:00pm deadline. No late or postmarked transcripts will be accepted.

Last Name *
As it appears on your Social Security Card
Your answer
First Name *
As it appears on your Social Security Card
Your answer
Gender *
Mailing Address *
(Full Address, City, State, Zipcode)
Your answer
Birthdate *
Format: 01/01/2001
Your answer
Contact Phone Number *
Format: (123)-456-7890
Your answer
LACCD Student ID # *
Format:: 88-111-1234
Your answer
LACCD Email Address *
A valid email address is required. All official communication from the RT department is sent via email to the LACCD Email Address. It is the applicants responsibility to provide a valid email address.
Your answer
Personal Email Address *
A valid email address is required. All communication from the RT department is sent via email. It is the applicants responsibility to provide a valid email address.
Your answer
Overall GPA for Seven RT Prerequisite Courses *
Please indicate your overall GPA for RT 200, RT 201, RT 202, Math 125, English 101, Human Anatomy, Human Physiology If you are unsure on how to calculate your GPA please use this website: http://gpacalculator.net/how-to-calculate-gpa/
Your answer
Do you have an AA or AS Degree? *
Please make sure to follow the guidelines in the LACC RT Information packet and submit the proper documentation with your paper RT application.
Do you have an BA, BS, or Higher Degree? *
Please make sure to follow the guidelines in the LACC RT Information packet and submit the proper documentation with your paper RT application.
Please indicate the years you have applied and have been eligible for entry into the LACC RT Program. *
This is the year(s) you finished all the prerequisites for the LACC RT Program.
Are you a Veteran? *
Please make sure to follow the guidelines in the LACC RT Information packet and submit the proper documentation with your paper RT application.
Do you possess a valid social security number? *
Please list the last four numbers of your Social Security # *
As it appears on your Social Security Card
Your answer
Do you have legal authorization to work in the United States? *
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms