Course: Certified Clinical Medical Assistant


NOTE: Fields marked with are required.

Student Information

Email is the preferred method of communication. Please provide an email address that you check regularly. If you do not have an email address, please make sure you provide good contact phone numbers.

Demographic Information

A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

American Indian or Alaskan Native: American Indian or Alaskan Native A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

Asian: Asian A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian subcontinent including, for example,Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine islands, Thailand, and Vietnam.

Black or African American: Black or African American A person having origins in any of the black racial groups of Africa.

White: Caucasian/White A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Native Hawaiian or Other Pacific Islander: Native Hawaiian or Other Pacific Islander A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific islands.

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PLEASE READ CAREFULLY

If you have any questions or concerns prior to submitting your application, please contact the Dean of Technical Programs/Workforce Training Office at (409) 984-6238.

Space is limited so registration for the course will be a first come, first serve basis.

Applicants Eligibility and General Requirements

Applicants must:

  • Complete and submit this application form
  • Tuition and Fees must be paid in full and all admission requirements satisfied by published deadlines.
  • Submit completed documentation of ALL requirements prior to being able to register for the class.

Please note some of these requirements have time-sensitive deadlines.

Acceptance of an application does not guarantee a student a seat in the course. Classes may fill quickly, preventing you from registering even though you have completed the application process. Students must notify the Workforce/Continuing Education and the Admission and Records offices of any change in applicant data. Failure to do so may result in the withdrawal of permission to register in the classes or the inactivation of the application. The tuition payment must be paid in full and all admission requirements satisfied by published deadlines or students will be dropped from the program.

Access to Lamar State College-Port Arthur's programs or activities shall not be limited on the basis of race, color, creed, national origin, religion, age, gender, sexual orientation, political affiliation, or physical disability. Applications accepted year round.

Completed forms may be submitted in person to the Workforce & Continuing Education Department located on the second floor of the Industry Training Facility at 1048 Lakeshore, or by mail to:

Workforce & Continuing Education
Lamar State College Port Arthur
P. O. Box 310
Port Arthur, TX 77641

Acknowledge and Submit Application

By checking this box, I acknowledge and agree to the following statements:
  • I hereby certify that the information contained in this application is true and complete to the best of my knowledge.
  • I understand that any misrepresentation or falsification of information is cause for denial of admission or expulsion from the College.
  • I understand that the faculty and staff of the Continuing Education and Admission and Records offices will read the information contained in this application.
  • I have read and understood all information included on this application and all related documents and requirements.