Apply to a Medical Assistant, Dental Assistant, or Medical Insurance Billing Program with Ross

Submit your online application to launch your career! An admissions representative will contact you soon to arrange your campus visit and complete our application process.

* First Name:
* Last Name:
* E-mail:
* Address:
* City:
* State:
* Zip Code:
* Primary Phone:
Secondary Phone:

Educational Background

* Current Status:	High School Graduate
	GED Recipient
	High School Student

* Class Year / GED Date:

High School Attended:
City:
State:
Zip:

Additional Education

Name of school:
State:
Dates attended:

Status:	Currently Attending
	Certificate/Diploma
	Associate's Degree
	Bachelor's Degree
	Not Completed

Career Interests - (Programs vary by campus)

What area of allied healthcare are you interested in studying at Ross Medical Education Center?
Dental
Medical Assistant
Medical Insurance Billing and Office Administration
All

Do you have a specific career in mind? If yes, explain:

What type of schedule works best for you?
Morning
Afternoon
Evening

What best describes your current situation?
Actively pursuing education options
Gathering Information
Presently employed
Student at

When do you plan to enroll at Ross Medical Education Center?
Within 3 months
3-6 months
6 months - 1 year
High School Student

How long have you been considering additional education?

What prompted you to make this change in your career?

Please describe any obstacles you need assistance in overcoming in order to attend school.

Marital Status:	Children:
Single	Yes
Married	No
Widowed
Divorced

Do you plan to continue employment as a student?
Yes No

About Us

* What prompted you to contact Ross?
(select only one or best answer)

Ross Student
Referral from Professional
Ross Graduate
Yellow Pages
Search Engine - Google, etc
Postcard Sent to Me
Not Sure
Friend / Relative
Television Commercial
Teacher / Counselor
Career Fair
Other:

Admissions Appointment

Congratulations! You're almost done! The next step is to visit the campus so that you can benefit from a personalized career planning session with an admissions representative. We will help you determine if Ross Medical Education Center & an allied health career are right for you. This is your opportunity to make that choice with no obligation or cost. Parents and significant others are encouraged to attend the initial visit.

Appointments are available Mon-Thurs., 9am-7pm and Fridays from 9-3pm. If you already have an appointment, please indicate the name of your admissions rep below. The best day and time to schedule my personal tour and admissions interview:

Day of the week:
Time:
* Campus Location:

Comments

* Yes! I understand that by submitting this application, I am giving permission for representatives of Ross Medical Education Center to contact me via the email address I've provided until I request otherwise.

* By submitting this application for approval, I certify that the information is accurate and complete to the best of my knowledge. I have read and understand the application procedure.

Please enter code to prevent automatic non-human form submission.

* Required fields

My instructors are two of the best instructors that I have ever had. I'd refer anybody to Ross.
– April Rizzo