HIT Admission Application

Name(Required)
First Last
Student ID Number(Required)

Do not enter your social security number.
Date of Birth(Required)
MM slash DD slash YYYY
Student Email Address(Required)
Personal Email Address
Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone Number(Required)
Do you have a high school diploma?(Required)
- Yes
- No
Are you a high school senior or GED student who will graduate by June of this year?(Required)
- Yes
- No
Are you an ECC Early College student who will be 18 years of age by the time health information technology clinical rotation begins (week 17 of the semester)?(Required)
- Yes
- No
Prior College Degrees
Select the '+' icon at the end of the row to add additional college degrees.
Degree Year Completed Name of School
I would like to begin my HIT studies(Required)
Program listed on ECC Admission Application(Required)
Is this the same Program of Study you intend to pursue?(Required)
- Yes
- No
In which HIT Program of Study do you wish to apply?
Have you completed the ECC Online Student Orientation?(Required)
- Yes
- No
How did you learn about the Health Information Technology Program at Edgecombe Community College?
We always want to give special thanks to our many friends that spread the good word about our program and help lead you to a brighter future!

Edgecombe Community College

Degree	Year Completed	Name of School