The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit North American phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

639uRnuZxxbJJZyeBVxBazEtLcjau4KVqE5yI

Program Assessment Form (PAF)

Returning?

A A A

Thank you for your interest in the Histotechnology Program. As you complete the program assessment form below, please note the following:

This is NOT the general University application. This form will determine your eligibility for the program.

The program offers Fall term starts only (unless you are a recent HT Certificate graduate or ASCP-certified)

If you do not have a training lab, complete form for suggested lab options to be emailed to you.

Thank you!

Date PAF submitted

M-D-Y H:M

First Name

* must provide value

Last Name

* must provide value

E-mail

* must provide value

Phone number

Mailing Address (Street and number)

City

* must provide value

State

* must provide value

ZIP code

Our motto is: Meeting you where you are, academically and geographically, and taking you where you want to go.
To help us reach individuals interested in histotechnology training, Please answer the following question.

How did you learn about the Indiana University Histotechnology Program? (Check all that apply)

IU Online Website

NAACLS Website

NSH Website

NSH Symposium

Recommended by friend or colleague

Search engine (Google, Bing, etc)

Social Media (Instagram, Facebook, Twitter, etc)

Other

How did you hear about us?

Expand

It is important to the Histotechnology Program that you move through your education in a purposeful and efficient way.
We offer 3 Tracks: Certificate Track, Degree Track and Special Credit Track.

Please complete the following information so we can place you into the correct track.

Track#1 Certificate - If you currently hold a college degree

Track#2 Degree - If you do not have a college degree

Track#3 Special Credit - If you are already HT (ASCP) certified, but you do not hold a college degree

Which option applies to you?

* must provide value

Track#1, Certificate

Track #2, Degree

Special Credit, Track #3

reset

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.