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Surgical Technology Application

Tuesday, April 29, 2025

Sciences, Math and Allied Health Departments

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This application is for students who have completed an application to UA - Pulaski Tech. If you have any questions about this form or about the Surgical Technology program, please contact surgicaltechnologyadmissions@uaptc.edu.

Full Name:

Student ID or Social Security Number:

Date of Birth:

Address:

City:

State:

Zip Code:

Phone:

Email:

Choose program:

Associate of Science in Surgical Technology

PLEASE SUBMIT THIS APPLICATION ONCE.