Reference Form

1. Please download the School of Radiologic Technology official reference forms by clicking here.
2. Print 3 copies of the form
3. Give each form to one reference of your choice
4. Ask each reference to mail completed form to:

School of Radiologic Technology
Program Office
Wilkes Regional Medical Center
P. O. Box 609/1370 West D. St
N. Wilkesboro, NC 28659

The reference should be mailed by the person who is asked to provide the reference.