GC Computed Tomography Application

GC Computed Tomography Program Application 2025

All components and questions in this application must be complete in their entirety to be eligible for consideration for admissions into the GC computed tomography program. Once the application is completely filled out, you may submit the application. After submitting the application, no edits can be made. If you have any problems with the form, email us at smithmo@grayson.edu

Applicant Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Alternate Phone Number
Personal E-mail (non-GC Viking email)*
GC Student Information

If you do not have a GC Viking Email or GC Student ID Number, you will need to apply to GC.
GC Viking Email*
GC Student ID Number *

Academic Requirements
Colleges/ Universities Attended
In the text box(es) below, list all colleges/universities you have attended.*
Unofficial Transcipts

You must upload all unofficial transcripts from every college/university you have attended. This does include unofficial transcripts if you took any courses at GC
Upload unofficial transcripts from every college/university attended.*

PDF files only
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Additional Requirements
ARRT or NMTCB License

You must upload a copy of your current, active, and non-restricted ARRT or NMTCB in Radiography, Radiation Therapy, or Nuclear Medicine.
Upload ARRT or NMTCB License*

PDF files only
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CPR Certification

We require that you submit a copy of your current CPR card with your application to the program
Upload CPR Certification*

PDF files only
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Immunizations

We require that you submit copies of following completed immunizations:
- 2 doses of live MMR vaccine (measles, mumps, rubella)
- TB Screening (or negative chest x-ray within the last 2 years)
- 2 doses of Varicella (chicken pox) or proof of illness
- Td/Tdap - one dose of Tdap and TD boosters every 10 years thereafter
- Hepatitis B series
- Seasonal Flu Immunization (September - March)
Note: Titers showing positive immunity to the diseases will be acceptable.
Upload Completed Immunizations*

PDF files only
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Do you have a state agency licensure (e.g., Texas Medical Board)*

YesNo
You must upload a copy of your current, active, and non-restricted state agency licensure.*

PDF files only
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What state do you live in?*
Background Check and Drug Screen
If accepted into the GC computed tomography program, students must successfully pass a negative background check and drug screen.*

Yes, I acknowledge that I will be required to submit a negative drug screen and undergo a background check as part of the program's requirements.

Signature, Save, and Submit
To the best of my knowledge, the information contained in this application is a true and correct representation of my qualifications. I acknowledge: (must select all)*

Any missing information is cause for disqualificationNo edits or additions (including attaching transcripts/documents)can be made to the application once its submittedOnly one application is allowed per person per application cycle. Multiple submissions will disqualify the applicant.
Signature*

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GC Computed Tomography Program Application 2025