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Good Samaritan College Medical Assistant Application Form

To submit an application to our school, please complete the following form and select Submit Application.

= Required

Note: If you have previously attended Good Samaritan College, please contact the Admissions Office for additional materials by calling 513-862-2743 or emailing admissions@email.gscollege.edu.

Personal Information

Please enter your Legal Name on your application.

Address Information
    1.  
Contact Information

Make certain you have added your cell provider and cell number as well as business/home phone number if applicable.

  1. Phone Type Country Phone Number Primary
Demographic Information
Ethnicity and Race Information
  1. Are you of Hispanic/Latino ethnicity or descent? Yes No
    Select one or more races with which you identify yourself:
    American Indian or Alaska Native
    Asian
    Black or African American
    Native Hawaiian or Other Pacific Islander
    White
Citizenship Information
Academic Information
  1. Program Commitment
Campus
Employment

Please list your current employment information.

  1. Employer Name Position Start Date End Date
Education History

List all education you have received including all high schools, colleges and universities attended. (Even if it was for one class or if it was a long time ago.) Failure to list ALL of you Educational Background could result in rejection of your application, admission, and/or enrollment to the College.

***If you are a GSC graduate please submit information on any institutions you have attended since graduating from GSC.***

***If you have a GED or high school diploma, declare it in the "Degree" and leave "Program" blank.***


  1. Schools Attended

     

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Additional Questions
School Policy
  1. Select "I accept" to confirm that you have read and fully understand the terms and conditions set forth in our Application Policy

    I do not accept I accept