BRG School of Radiologic Technology Application

School of Radiologic Technology Admissions Application
Each student requesting admission to the Baton Rouge General School of Radiologic Technology must complete this admission application in ALL PARTS fully and completely prior to the deadline of August 29, 2025 at 4 p.m. for the Admissions class starting January 2026. Applications that are incomplete or missing information will NOT be processed and the application will be considered VOID. Any associated fees paid will NOT be refunded if application is voided for any noncompliance issues.

Once submitted, this application cannot be edited. Please ensure that you are prepared to include all required information before hitting "Submit" at the bottom. Any documented false answers or incorrect information submitted will be considered as a violation of the expectations of submitting the application correctly/truthfully. This will result in a revocation of the applicant for admissions no matter what stage of the process the information provided is determined to be falsified. No refund of any fees or costs incurred will be granted. Any questions on this application or any portion of this process should be directed to the Registrar/SORT Program Operations Coordinator, via phone at 225-387-7024 or email RadiologySchool@BRGeneral.org.
Personal Information
Have you ever applied to this school?*

YesNo
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Email Address*
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mailing Address (If different than Home Address)

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Social Security Number*
no dashes
Are you a US citizen?*

YesNo
If no, what country?
Visa Number
Visa Type
Will you be 18 years of age by October 1, 2025? (We are required to accurately monitor students for radiation dose during the program, and those under 18 cannot be accurately measured by our standard dosimeters.)*

YesNo

Emergency Contact Information

Persons to be notified in case of an emergency
Emergency Contact #1*

First NameLast Name
Relationship*
Phone Number*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact #2*

First NameLast Name
Relationship*
Phone Number*
Address*

Street Address

Street Address Line 2

CityState

Zip Code

Because of National Ethics Review Standards for being eligible for ARRT National Certification Exam Testing, you must complete the questions below. PLEASE read them carefully. Any questions or documentation regarding these answers should be submitted immediately to the Program Director for review.
Has any regulatory authority or certification board (national or state) ever done one of the following?

(If yes, SORT will require the completion of the ARRT Pre-Ethics Authorization to be completed and ARRT response of clearance prior to Jan 1, 2026 start to ensure Registry eligibility and ability to complete the program. This is a 6-8 week process so starting as soon as your application is submitted is HIGHLY recommended.)

Answer "Yes" if one or more of these apply to you and the organization imposing the action wasn't ARRT:
- Denied, revoked, or suspended your professional license, permit, registration or certification?
- Placed you on probation (excluding ARTT Continuing Education probation), under consent agreement, or under consent order?
- Allowed voluntary surrender of your professional license, permit, registration, or certification?
- Subjected you to any conditions or disciplinary actions?
Answer "No":
- If you have no offenses
- If your only offense is ARRT Continuing Education (CE) probation
- For offenses previously reported to ARRT and for which ARRT has sent you communication
Have you ever been charged with or convicted of a Misdemeanor or Felony? (This includes court convictions and military court martial.)

(If yes, SORT will require the completion of the ARRT Pre-Ethics Authorization to be completed and ARRT response of clearance prior to Jan 1, 2026 start to ensure Registry eligibility and ability to complete the program. This is a 6-8 week process so starting as soon as your application is submitted is HIGHLY recommended.)

Answer "Yes" if you have:
- Charges or convictions - including those that were stayed, witheld or deferred, set aside, or suspended
- Any plea of guilty, Alford plea, or plea of no contest (nolo contendre)
- Court conditions appliedd to your charge - including court supervision, probation, or pretrial diversion
- Traffic violation that involved drugs or alcohol
- Traffic violations charged as misdemeanors or felonies
Answer "No" if you have no offenses. Also answer "No" if you have:
- Offenses and convictions that occurred before you turned 18 and that were processed in juvenile court
- Speeding and parking tickets that weren't charged as misdemeanors or felonies and that didn't involve drugs or alcohol (if you have any traffic violation that involved drugs and/or alcohol, you must answer "Yes")
- Charges that were dismissed with no court conditions required (if conditions were required, you must answer "Yes")
- Court records that were sealed or expunged (if you don't have court documents that prove your case was sealed or expunged, you must answer "Yes")
- Offenses you've already reported to ARRT and about which ARRT has sent you communication
Have you ever been charged with or convicted of a Misdemeanor or Felony? Select Yes or No*

YesNo
Has any regulatory authority or certification board (national or state) ever done one of the following? Select Yes or No*

YesNo
Have you ever voluntarily withdrawn - or been suspended, dismissed, or expelled - from an educational program you attended to meet ARRT certification and registration requirements? Select Yes or No*

YesNo

Because of National Ethics Review Standards for being eligible for ARRT National Certification Exam Testing and Academic Admissions into the Professional Program at BRG SORT, you must complete the questions below. PLEASE read them carefully. Any questions or documentation regarding these answers should be submitted immediately to the Program Director for review.
Have you ever been dismissed/removed/officially reprimanded from a professional program, college or educational institution for any of the following ethical, behavioral, honor code or academic violations?

(If yes to any of the below, SORT will require the submission of correlating/supportive documentation and a student narrative with the application. The violation may require the completion of the ARRT Pre-Ethics Authorization to be completed and ARRT response of clearance prior to Jan 1, 2026 start to ensure Registry eligibility and ability to complete the program. This is a 6-8 week process so starting as soon as your application is submitted is HIGHLY recommended.)
Have you ever been removed/dismissed/officially reprimanded from the above mentioned for an honor code or academic dishonesty violation? Select Yes or No*

YesNo
Have you ever been removed/dismissed/officially reprimanded from the above mentioned for an academic violation? Select Yes or No*

YesNo
Have you ever been removed/dismissed/officially reprimanded from the above mentioned for a behavioral or student/program policy violation? Select Yes or No*

YesNo
Have you ever been removed/dismissed/officially reprimanded from the above mentioned for a safety or ethical violation? Select Yes or No*

YesNo

Payment & Application Signature

Payment*

BRG School of Radiologic Technology Application Fee$50.00

I understand that in addition to the submission of this application, I as the applicant must submit a $50 non-refundable application fee via debit or credit card.

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Applicant Acknowledgement Statement:

I understand that this is an application being submitted to a professional healthcare program which is bound by practices with high standards of ethics and national programmatic accreditation. I verify that the information in this application and all submitted documentation (attachments as required, additional letters, essay responses, evaluations, core performance, etc.) is accurate, truthful, and complete to the best of my knowledge.

I understand that if any portion of the information provided is found to be fraudulent or incorrect, in an effort to be misleading, or inaccurate, my application will be considered invalid, admissions will be revoked, or I may be subject to dismissal from the Baton Rouge General School of Radiologic Technology (if already enroled in courses).
To agree and sign this statement legally, type in your full legal name in the space below, followed by the date you are submitting the application to BRG School of Radiologic Technology. If you do not agree, type in a statement signifying your disagreement in the space provided below.

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Please allow a few moments for the submission to process after clicking Submit and do not click Submit more than once.
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School of Radiologic Technology Admissions Application