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The form collects information about comfort with blood and/or needles, and self-assessed computer skills. It also asks applicants to indicate class availability by day and time blocks. The statement covers selection process, possible interview and references, student responsibility for scrubs, tuition payment terms ($3800), included course materials, deposit orientation conditions, and handbook-based tuition refund rules.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/medical-assisting-program-application/502497/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/medical-assisting-program-application/502497.png","ImageObject",300,407,{"name":92,"@type":93},"Connor ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-10-03",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Does submitting this application guarantee selection into the Medical Assisting Program?","Question",{"text":112,"@type":113},"No. Submitting the application does not guarantee selection as a student. Applicants are contacted by email to confirm whether they have been selected.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What information must be provided if selected, before a final decision?",{"text":117,"@type":113},"Selected applicants may be asked to participate in a face-to-face interview and provide three professional references.",{"name":119,"@type":110,"acceptedAnswer":120},"What are the tuition and payment requirements mentioned in the application?",{"text":121,"@type":113},"If accepted, full payment of $3800.00 is due before the first class starts, with exceptions noted for current Hancock Health Associates and approved WorkOne tuition. Payment plans may be considered, and tuition includes the listed textbook, clinical materials, and the first attempt of the NHA CCMA certification exam.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},502497,1792658340,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},687207022233,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Application for Medical Assisting Program-Please print.  \nDate:    \nFull Name:    \n(First) (Middle Initial) (Last)  \nDate of Birth:   Last Four of Social:    \nMailing Address:  \n\n|  |\n| --- |\n|  |\n\nEmail(s):   Phone Number(s):   Phone Number for Receiving Texts (if different):   Highest level of education completed:   Please list any past work, school or volunteer experiences you have had in healthcare and for how long:  \n_____________________________________________________________________________________  \n_____________________________________________________________________________________  \n\n| How do you feel about the sight of blood and/or needles?   |\n| --- |\n| How would you describe your computer skills?   |\n\nPlease check all that apply for your availability for classes:  \n\n|  | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |  | Sunday |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| Days (8:30-12) |  |  |  |  |  |  |  |  |\n| Evenings\u003Cbr>(5:30p-9p) |  |  |  |  |  |  |  |  |\n\nI, (print full name)   , understand that applying for the Hancock Health Medical Assisting Program does not mean that I will be selected as a student. I will be contacted by email by to let me know whether or not I have been selected to be in the program. I may be asked to participate in a face-to-face interview and provide three professional references before a final decision has been made. If I am selected to be a medical assisting student, I understand that I am responsible for supplying my own scrubs of any color.  \nIf I am accepted into the program, the full payment of $3800.00 is due prior to the start of the first class.(Exceptions: Current Hancock Health Associates and students who have been approved to have tuition paid for by WorkOne) Payment plans may be considered and can be set up with the Program Coordinator. Tuition includes Kinn’s The Medical Assistant textbook and study guide, 14th edition, all clinical materials needed for lab classes and the fee for the first attempt of the NHA CCMA certification exam. (A $50.00 cash deposit is due at the mandatory orientation class and will be refunded if your textbook is returned without torn pages or writing in it. )  \nAll medical assisting students will receive a handbook that explains how tuition refunds are handled if Ido not complete the program. (There will be no tuition refunds given after the third week of classes. )  \n  Date    \n(signature)  \nFOR CURRENT HANCOCK HEALTH ASSOCIATES ONLY:  \nWhat department/practice do you currently work in?   What is your current job title?   How long have you worked at Hancock Health?   Are you currently an associate in good standing at Hancock Health?   Who is your direct supervisor?","cbCaickEdI5q74bA","https://ap.wps.com/l/cbCaickEdI5q74bA","pdf",449723,"English","# Applicant Information\n## Education and Experience\n## Skills and Availability\n# Applicant Statements and Tuition Information\n## Selection, Interviews, and References\n## Payment, Materials, and Refund Policy\n# Signatures and Hancock Health Associate Section","[{\"question\":\"Does submitting this application guarantee selection into the Medical Assisting Program?\",\"answer\":\"No. Submitting the application does not guarantee selection as a student. Applicants are contacted by email to confirm whether they have been selected.\"},{\"question\":\"What information must be provided if selected, before a final decision?\",\"answer\":\"Selected applicants may be asked to participate in a face-to-face interview and provide three professional references.\"},{\"question\":\"What are the tuition and payment requirements mentioned in the application?\",\"answer\":\"If accepted, full payment of $3800.00 is due before the first class starts, with exceptions noted for current Hancock Health Associates and approved WorkOne tuition. Payment plans may be considered, and tuition includes the listed textbook, clinical materials, and the first attempt of the NHA CCMA certification exam.\"}]","Medical Assisting Program Application | PDF",1791035278]