Surgical Technology Online Application for Admission

Your Application will not be completed until all paperwork has been approved.

All Items must be answered completely.
You will need to print out this form after filling it out,
then please be sure to sign and date it.

Date of application:

Applicant's Legal Name

First name: Middle:

Last name:

Home Address

Address: City:

Address2:

State: Zip:

Home Phone: Email:

Date of Birth:

Select one: Male:Female:

Are you a United States Citizen: Yes:No:

Are you a Resident Alien: Yes:No:

Are you a Non-Resident Alien: Yes:No:

Date that you will receive (or have received) your high school diploma, either:

by graduating from high school:

Or by earning a GED:

Please answer the following questions:

1. Are you currently employed as a surgical technologist? Yes No

2. When did you complete your training to become a surgical technologist?

Month/Year:

3. Do you have at least 2 years of experience in this field following the completion of your training? Yes No

I certify that to the best of my knowledge all the information reported in this Application for Admissions is true and accurate.

Signature______________________________________________Date_____________
(You may also want to keep a copy of this for further reference.)

New England Institute of Technology admits qualified students of any race, color, religion, sex, age, disability or national and ethnic origin to all the rights and privileges, programs and activities generally accorded or made available to students at the school. New England Institute of Technology does not discriminate on the basis of race, color, religion, sex, disability, age, or national and ethnic origin in the administration of its educational policies, admissions policies scholarship and loan programs, and other school-administered programs.

The Application and pre-test assessment fee is $100.

Checks should be mailed with a printout of this page to:

ATTN: Bob Larrabee
NEW ENGLAND INSTITUTE OF TECHNOLOGY
2500 Post Road
Warwick, RI 02886-2266

Your application is not complete until you submit the following documents:

Application for Admission
A copy of your High School Diploma or GED
2 Letters of Recommendation
A copy of your transcript if you have attended any institution of higher education
A completed Employment Verification Form
A completed Surgical Procedures Log
A completed Verification of Surgical Experience Form

(The above 3 links will open in a new window or right-click to save the pdf forms to your desktop)

After receipt of all of this material and the $100 fee you will be scheduled for your pre-test assessment.

Print This Document

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