School of Radiologic Technology Application

Please plan to complete your application in one sitting, as there is no option to save your progress. For questions about this application or any of the information required, please contact Justin Pannullo, Program Director, at jpannullo@saintlukeskc.org or 816-932-1604.

Current Personal information
Education
Employment history
Additional questions
Confirmation
Complete

Indicates required field

Full name

Former names (maiden, former married names, etc.)

Date of birth (mm/dd/yyyy)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone

Email

Citizenship

United States of America

Other

Country

Is English your second language?

Yes

No

If yes, please refer to International Student Policy.

Emergency contact

Name

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code