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Name:
SID:
Email:
Mailing Address:
Day Phone #:
Evening/Other Phone #:
Which clinical sequence quarter do you expect to be eligible for? Winter:
2015
2016
2017
Please check required college courses listed below that you have completed with a 2.0 or better grade. If any of the required
courses were taken at a college other than Clark, official college transcripts must be submitted and course equivalencies
evaluated and approved. The most recent educational experience will be used to meet these criteria. Course credit hours
and equivalency will be determined by Clark College. Further information about the Medical Assistant program and related
requirements can be accessed online via the Clark College Catalog: http://www.clark.edu/catalog
APPLICATION REQUIREMENTS
To be eligible for the selection into Medical Assistant program all students must complete the following:

TASKS
Complete the Clark College Admission Application and the Medical Assistant Application. Return
them to the Clark College Welcome Center with the $50.00 non-refundable program application fee
by October 1. Students who are new to Clark College must also pay a one-time non-refundable
$25.00 admission fee. Date of Medical Assistant (fee paid date) will be considered in selecting
students for entry into the program.
Submit official high school transcript in sealed envelope or GED scores. Due to Washington law [WAC
246-901-030(2)] no student will be eligible for selection into the Medical Assistant program unless an
official high school transcript is on file.
Submit official college transcript(s) in sealed envelope(s) from ALL colleges you may have attended.
Course credit hours and equivalency will be determined by Clark College.
Reading: COMPASS score of 74 or higher or completion of READ 087 or equivalent with 2.0 or above.
Achieve a Clark cumulative 2.0 GPA or above and repeat required program courses no more than once.
THE FOLLOWING COURSES MUST BE COMPLETED WITH A 2.0 OR HIGHER GRADE

COURSE #
COURSE NAME
BMED 103
Math for Health Care Professionals
3
BMED 110
BMED 111
Medical Terminology I
Medical Terminology II
BMED 116
Medical Office Administrative Procedures I
3
3
3
BTEC 107
Business English
Introduction to Applied Technical Writing
Computer Applications Essentials
or PTWR 135
BTEC 149
HEOC 100
HEOC 104
HEOC 130
CREDIT HOURS
5
5
3
Basic Concepts of Anatomy and Physiology (or BIOL 164/165)
Health Care Delivery & Career Exploration
Pharmacology for Health Assistants
4-5
3
3
If you are currently enrolled in any of the above courses at a college other than Clark, you must enclose a copy
of your registration with this application. This information is needed each quarter you enroll at another college.
I UNDERSTAND COMPLETION OF THE PRE-ENTRANCE REQUIREMENTS DOES NOT GUARANTEE ENTRANCE INTO THE MEDICAL ASSISTANT PROGRAM.
___________________________________________
Signature
© BMED
_______________________
Date
Medical Assistant Application 06/27/2014