Current Personal Information Education Employment History Preview Complete 1 of 5 To apply online for the Nuclear Medicine/PET Technology Program, please fill out the application form listed below. Your information will be submitted via a secure server. In order for your application to be complete, you must also submit the following information.Three letters of recommendation (download recommendation form)Official college transcripts (mailed directly from school or college)All requirements must be postmarked by Dec. 31 to be eligible for the July class.If you have additional questions about admission, please reference the admission information portion of this site or contact us. Name Title Title - None -MissMsMrMrsDrOther… Enter other… First Middle Last Suffix Degree Previous Names Contact E-mail Phone Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code When is best to reach you? Mornings Evenings Date of Birth Date must be entered as MM/DD/YYYY. Will you be over 18 years of age by the start of the program? - Select -YesNo Are you authorized to work in the U.S. for Froedtert ThedaCare Health? Yes No Are you legally authorized to work in the United States? Yes No Have you ever been convicted of a felony? Yes No Have your rights been restored? Yes No CAPTCHA By clicking “next page” or “submit,” you agree to the processing and storage of your information in accordance with our Website Privacy Policy. While we take reasonable precautions to protect your data, please be aware that no internet transmission is completely secure. Your form data will not be delivered via e-mail or shared with unaffiliated third parties and will be removed from our website database after 90 days. Save Draft Next Page > Leave this field blank For Professionals Nuclear Medicine Technology Program Admission Information Course Description Application