Application for Admission
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First Name
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Last Name
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Email
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Mobile
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Program
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Start Date | Schedule
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Campus
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Location
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Gender
Male
Female
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Date of Birth
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Address/Street
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City
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State
Alabama
Alaska
Arizona
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Zip Code
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Social Security Number (SSN)
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Driver's License Number
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Official ID
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High School Diploma / Transcripts
Questionnaire
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Relative Name (In case of emergency)
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Relative Relationship
Father
Mother
Brother
Sister
Husband
Wife
Son
Daughter
Friend
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Relative Contact Number
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What is your educational background?
High School Graduate or Equivalent
Trade or Vocational Degree
Some College
Accociate Degree
Bachelor's Degree
Master's Degree
GED
Equivalent from a foreign country
Other
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Have you been convicted of any felonies or misdemeanors other than minor traffic violations?
Yes
No
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Are you currently employed?
Yes
No
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What is your ethnicity?
Caucasian
Hispanic
Asian
African American
Other
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Why are you interested in this program/package?
Job Requirement
New Career in the Medical Field
Gain a Competitive Edge (Already in the medical field)
Class Prerequisite
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Why did you choose AUMT?
Academic Reputation
Cost
Location
Online Presence
Other
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