Surgical Technology Application

Thank you for applying for Lasell's Associate of Science - Surgical Technology degree.

For your application to be considered complete and ready for review, you must submit the following items:

Official College Transcript (if you have completed college-level coursework)
If you have not attended college or have earned fewer than 12 college credits, Lasell University will need your Official High School Transcript (with GPA listed) or GED record.

(Official transcripts must be sent to your Enrollment Counselor Marc Gaffney electronically either from the school or a 3^rd party such as Parchment)

We cannot accept Diplomas.
- Transcripts, coursework completed outside the United States must be evaluated and translated by a third party documentation service such as CED, WES, or SpanTran.
- The equivalent GPA on a 4.0 scale must be present in the evaluation.

Personal Statement: In 500 words, tell us why you have chosen the path to become a Surgical Technologist and how you see yourself caring for patients.
1 Letter of Recommendation from supervisors, teachers, or counselor.

If you have any questions, please email your enrollment counselor Marc Gaffney at mgaffney@lasell.edu

Fields marked with an * are required.

First Name*

Last Name*

Preferred Name

Personal Email Address*

Mobile Phone Number*

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Mailing Address*

Country

Street

City

Region

Postal Code

Date of Birth*

School Currently Attending*
(or school most recently attended)

Are you applying through a partner hospital, and if so which hospital?

Gender Identity*

Preferred Pronouns

Sex: Female

Sex: Male

In which country do you currently live full-time?*

Citizenship*

U.S. Citizen

U.S. Dual Citizen

U.S. Permanent Resident

U.S. Refugee

Other

If you are a U.S. Dual Citizen, of which country are you also a citizen?

US Citizen (hidden)

Permanent Resident (hidden)

Social Security Number (to enroll we will need your SSN prior to classes starting)

Are you a current employee of Lasell University?

Yes

Are you a US Armed Services Member, Veteran, or Dependent?

Yes

Are you a dependent of a member of the Armed Services?

Yes

Please select the branch of the military that you served in:

Do you plan on using VA Education Benefits?

Yes

Are you currently under investigation for, or have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in a disciplinary action? These actions could include, but are not limited to: probation, suspension, removal, dismissal, or expulsion from the institution.*

Please provide a brief explanation.

Have you ever been convicted of a felony?*

Please provide a brief explanation.

Personal Statement Upload:

Letter of Recommendation
Would you like to submit your Letter of Recommendation via file upload now, or provide us with your recommender's contact information so that we can reach out to them for a reference?

File Upload

Email a Reference

Upload Letter

Please fill in your recommender's information below. Note: your recommender will be able to see what you place in these fields.

Recommender First Name:

Recommender Last Name:

Recommender Email:

Your relationship to the recommender:

Please provide a brief explanation

Have you ever been convicted of a felony?

Please provide a brief explanation

Transcript Upload Instructions

If you would like to submit a copy of your transcript, you may do so here. This can be an unofficial copy of your transcript in a screenshot, photo, pdf, etc...

In consideration of the undertaking by the Office of Graduate Enrollment to process this information, the applicant agrees that the information furnished on the application for admission, together with all information on materials of any kind received by the Admission from any source, or prepared by anyone at its request, shall be, to the extent permitted by federal law, completely confidential and shall not be disclosed to anyone, including the candidate and family, except that the Director of Graduate Enrollment, may, for official purposes at his/her discretion, disclose any part or all thereof to such person or persons as he/she deems advisable. It is also agreed that the University has permission to use in its publications or other promotions any University photograph in which this applicant may appear and his or her name.

I certify that all information submitted in the admission process — including this application and any other supporting materials — is my own work, factually true, and honestly presented, and that these documents will become the property of the institution to which I am applying and will not be returned to me. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation, expulsion, or revocation of course credit, grades, and degree should the information I have certified be false.

I agree to notify the University should there be any change to the information requested in this application.

I acknowledge that I have reviewed the application instructions for the University receiving this application. I understand that all offers of admission are conditional, pending receipt of final transcripts showing work comparable in quality to that upon which the offer was based, as well as honorable dismissal from the school.

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