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Occupational Therapy Assistant Request Information

Please fill out the following form.

* First Name:
* Last Name:
* Email Address:
* Preferred Phone (with area code)
* Date of Birth:
* Mailing Address:
* City:
* State:
* Zip:
* Preferred Method of Contact:
Email
Phone
U.S. Mail
Are you currently attending High School?
Yes
No
If YES, what High School do you attend?
If you are in High School, what is your current grade level?
9
10
11
12
I would like more information mailed to me about:
Admissions
Scholarships
Financial Aid
Testing
Campus Tours
Student Activities
Honors Program
New Student Orientation
How did you learn about the Occupational Therapy Assistant profession?
How did you learn about the Amarillo College Occupational Therapy Assistant program?
Why did you choose the Amarillo College Occupational Therapy Assistant program instead of other Occupational Therapy Assistant programs?
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