Personal Information

Name*
Address*

Northwestern Memorial Healthcare welcomes students from all backgrounds and is dedicated to providing equal opportunity to applicants. The program does not discriminate in the recruitment and admission of students or in the operation of its educational programs or activities. Applicants are considered for admission based on individual merit and without regard to age, race, color, national origin, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity or expression, marital status, parental status, military or veteran status, or source of income in the provision of educational services. Your responses to survey questions on race and ethnicity are voluntary and will not be used in admissions decisions.

What is your race?
What is your ethnicity?

Northwestern Medicine Employment

Are you an employee of Northwestern Medicine?*
If yes, please specify schedule status:*
Start date (month/year) of employment at NM: *

Education

What is your highest level of education:*
Did you graduate from a Chicago Public Schools (CPS) high school? *

Work Experience

Work Experience 1

Start date:*
End date:*

Work Experience 2

Start date:
End date:

Work Experience 3

Start date:
End date:
Are you applying as a NM employee in good standing, seeking post-primary certification in MR that possesses R.T. (R), (T), (N), (S), CNMT or ARDMS credentials?*
Has your medical service license ever been revoked, suspended or subject to disciplinary measures?*
Please attach your personal statement.*
No File Chosen
File uploads may not work on some mobile devices.
I have requested official transcripts from my primary certification program to be sent to the NM Clinical Schools Registrar.*
I have requested submission of (2) NM Clinical Schools MRI Post-Primary Training Program Letter of Recommendation Forms.*

Application fee: $25

IMPORTANT: If paying with credit card, you will be directed to payment site and will be prompted to create an account at checkout.  You must RETURN TO THIS APPLICATION and click SUBMIT FORM in order to successfully submit your online application. 

Click HERE to pay with credit card

I have submitted a $25 application fee by credit card
I have submitted a $25 application fee by check
Cancel
Confirm