Medical Assisting Program Application Fall 2025

Medical Assisting Program Application

Please complete this application to be considered for our next Medical Assisting cohort. After you submit your application, you will be redirected to a website to pay the $50 non-refundable application fee.* The application fee is required regardless of your association with community and corporate partnerships. Application deadline for the Fall 2025 cohort is July 5, 2025.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Gender
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Education Level*
Are you a UofM GROWWTH participant?*
Why are you interested in the Medical Assisting program?*
Of the attributes and skills you possess, what do you believe will be the most helpful in the role as a medical assistant?*
What do you anticipate will be the most difficult part of the program?*
This program will require you to commit approximately 15-20 hours per week on your coursework. How do you intend to manage your time to meet the increased demands on you and your schedule?*
Tell us about a time that you demonstrated determination and perseverance in your life.*
How did you find out about this program?*
Application Attestation

By signing below, I hereby attest that all the information I provided is true and accurate. I acknowledge and agree that if I make any false or misleading statements during the application process, it may be considered grounds for elimination from consideration or subsequent removal from the program.
Signature*

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*Completion of application and fee payment does not guarantee acceptance into the program
Math Challenge (Please verify that you are human.)
The University of Memphis is an Equal Opportunity/Affirmative Action University. It is committed to the education of a non-racially identifiable student body.
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Medical Assisting Program Application

Application Attestation