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RT Program Admission Application

Respiratory Therapy Program Admission Application

This form is to be completed in addition to the general admission application. Should the status of any of the information below change after you have submitted it, you are responsible for notifying the Respiratory Therapy Department Office as soon as possible with the updates. Please email Debra Grube, the Respiratory Therapy Department chair, at debra.grube@muskegoncc.edu.

You will not be placed on the “ready list” for admission to the MCC Respiratory Therapy Program until you have:

  1. Completed and submitted the online form below;
  2. Have demonstrated your ability to perform specific and essential functions outlined in the MCC Respiratory Therapy Program’s Technical Standards; and
  3. Met all of the RT program prerequisites for admission

RT Program Admission Application

Name(Required)
Address(Required)
Email(Required)
I intend on entering the MCC Respiratory Therapy sequence in the following semester:(Required)
Michigan Legal Requirement – I agree to a criminal background check.(Required)
Michigan Legal Requirement – I have been convicted of a misdemeanor in the past 10 years.(Required)
Michigan Legal Requirement – I have been convicted of a felony within the past 15 years(Required)
Michigan Legal Requirement – I have been treated for substance abuse in the past two years(Required)
Michigan Legal Requirement – My legal address has been outside the state of Michigan within the last three years
I agree that I am the individual identified above and that the information I have provided above is correct. I understand that providing false information can be punishable by law.(Required)
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