Respiratory Care Application

Respiratory Care Program Application

All admission requirements, materials, and the interview must be completed before the May 1 application deadline. Selection into the Respiratory Care Program is competitive based on the application materials.

The application period is from January 1 to May 1 each year.

  • Your college application must be on file in the Columbia State Admissions Office.
  • Your high school transcript must be on file in the Columbia State Admissions Office.
  • All college transcripts must be on file in the in the Columbia State Admissions Office.
  • A copy of your college transcripts must be sent to:

Respiratory Care Program Director
Columbia State Community College
1665 Hampshire Pike
Columbia, TN 38401

  • Your ACT or placement test scores must be on file in the Columbia State Admissions Office.
  • All applicable developmental requirements must be completed by the application deadline.


After submitting the program application, contact the Program Director at (931) 540-2663 or by emailing David.Johnson@columbiastate.edu to schedule an interview.

 

Part 1

How did you learn of the Respiratory Care Program at Columbia State?

If you marked "other" for the question above, please provide more details here:

Today's Date:

A Number: 
(Mark as "N/A" if you are not a currently enrolled Columbia State student.)

Last Name: 

First Name:

Middle Name: 

Address: 

City: 

State: 

Zip Code: 

Phone Number: 

Email: 

High School: 

Birth Date: 

Emergency Name and Contact Information: 

When Do You Wish To Enter The Respiratory Care Program? August 


Part 2

If you are taking college classes during the spring semester in which you are applying to this program, provide that information below. If you are not taking classes, then indicate that.

College You Are Attending: (write "none" if not attending college)

Course Name 1:

  • Course # 1: 
  • Credit Hours 

Course Name 2:

  • Course # 2: 
  • Credit Hours 

Course Name 3: 

  • Course # 3: 
  • Credit Hours 

Course Name 4: 

  • Course # 4: 
  • Credit Hours 

Course Name 5: 

  • Course # 5: 
  • Credit Hours 

Part 3

Use the following guidelines in approximately 500 words, describe yourself in the field below. Grammar and punctuation will be assessed.

1. Give a brief history of yourself: your education, work experiences, honors, church or community services, etc.
2. What are your personal and professional goals?
3. Describe any healthcare experiences you have had, such as HOSA, hospital volunteer, employment in healthcare, etc.
4. Describe why you want to be a respiratory therapist.
5. At the conclusion of your essay, describe your college experiences, listing colleges attended, majors, degrees, awards, recognitions, accomplishments, etc.