Thank you for your interest in the Medical Laboratory Science Program (Medical Technology at the University of Colorado Springs (UCCS).

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1 Thank you for your interest in the Medical Laboratory Science Program (Medical Technology at the University of Colorado Springs (UCCS). UCCS offers two options for students desiring to enter the MLS career field. One program allows students to pursue a Baccalaureate Degree in Health Care Science with an emphasis in Medical Laboratory Science through the Department of Health Sciences at UCCS. Students with a MLS major spend three years taking courses at UCCS, and the senior year is dedicated to a 12 month accredited MLS internship at one of our affiliate hospitals (3 + 1 students). Alternatively, individuals who already have a degree, and who have the appropriate academic prerequisites, may apply for the clinical internship in MLS with our program as a student. All students earn 43 academic semester credits from UCCS for the clinical year. With successful completion of the MLS internship, students will be eligible for certification by the American Society of Clinical Pathologists (ASCP) as a Medical Laboratory Scientist, MLS (ASCP). The MLS professional internship at UCCS is offered in conjunction with the University of Nebraska Medical Center (UNMC). UNMC has one of the top MLS programs in the country, and because of the shortage of accredited programs, UNMC takes advantage of online technology to out-source their curriculum to several universities, of which we are one. As a part of the UNMC network, our students spend 11 weeks at a student lab in Omaha, Nebraska, returning to Colorado for the remaining nine months of clinical internship. The student lab is a non-negotiable requirement, and being able to attend this 11 week lab is a major consideration for students applying for our program. If you are interested in pursuing a career in Medical Laboratory Science, please do not hesitate to contact me with questions. The priority application deadline is November 30th of each year. The final application deadline is January 14th. Applicants submitting an application after the priority deadline will only be considered on a space available basis. All academic prerequisites must be completed by May 20. For more information about the program or to download an application go to our website at: For more information o n t h e a c a d e m i c prerequisites and the summer lab at UNMC go to: or contact me for a review of your coursework. Sincerely, Diane Weimar, MT (ASCP), MEd MLS Program Academic Coordinator Department of Health Sciences Springs Office phone: (leave a message)

2 APPLICATION FOR MLS CLINICAL INTERSHIP Part I: General Information Date : Name : Present Address Street City State Zip Code Phone home - cell - work - (not optional) fax Citizenship Foreign address if non-us citizen Is English your second language Yes No If Yes, have you taken an English proficiency test? Yes No Test Name Score Date of Test Type of test: computer based paper based Internet based (The applicant must provide official scores of the TOEFL English proficiency test. The Dean of Beth-El College of Nursing and Health Sciences reserves the right to ask any foreign student to take the TOEFL exam). Type of MLS applicant: UCCS student I have have have not met with Diane Weimar (previous four year college degree)

3 Please list ALL accredited colleges you attended, the dates, and any degrees awarded College or University Dates Attended Major Degree Date granted Major Degree Date granted Major Degree Date granted Major Degree Date granted If additional space is required please use the back of this form.

4 Application Instructions and checklist Complete the MLS clinical internship application. Request two official transcripts from ALL colleges attended. Transcripts must be sent by the University and must be received at UCCS unopened. Request one copy of an official SAT, ACT, or GRE results to be sent by the scoring agency to UCCS at or scores may also be sent by an official high school transcript. If scores are on file with UCCS please notify the MLS academic coordinator who can then retrieve the official scores from UCCS Admissions and Records. Scores sent by the scoring agency or by a high school must be received by UCCS unopened. Request three Letters of Recommendation from individuals who know you well and can address your ability to complete this program successfully. Two letters should be from professors or research directors, and the third letter should be from an employer. References must be received in a sealed envelope with a signature across the seal. Request one official copy of TOEFL English Proficiency Test (if applicable). Scores must be sent by the scoring agency and must be received by UCCS unopened. I have asked the following individuals to submit letters of recommendation: Name Relationship Name Relationship Name Relationship Submit a 1-2 page essay, Times New Roman 12 point font with 1 inch margins. Your essay should contain personal background information, interest and attraction to the MLS profession, personal strengths for success in this intensive program, and how your desire to be a Medical Laboratory Scientist can benefit society. Read and sign each statement under Terms of Agreement.

5 Please send all documents and correspondence to: Diane Weimar, MT(ASCP), MEd Department of Health Sciences Beth-El College of Nursing and Health Sciences University Hall Room 213 Springs 1420 Austin Bluffs Parkway Colorado Springs, Colorado The priority deadline for an application requesting an MLS internship is November 30 of each academic year. The final deadline is January 14. Applicants submitting an application after the priority deadline will only be considered on a space available basis. Please note that all academic prerequisites must be satisfactorily completed with a grade of C or above by the following May. Diane Weimar, MT (ASCP), MEd MLS Program Academic Coordinator Department of Health Sciences University of Colorado at Colorado Springs office phone: (leave a message) * UCCS 3+1 students must go through the application process for clinical placement. UCCS 3+1 students are not guaranteed admission to clinicals. Deadline for the application process for the clinical year is November 30 of the third year.

6 TERMS OF AGREEMENT: If available, I would would not be interested in a MLS internship through one of the other University of Nebraska/UCCS clinical affiliates. This could include but is not limited to positions in Nebraska, Kansa, Iowa, Missouri, Arizona, or Wyoming. (Note: this would involve moving to that facility for the 9 months following the student lab. Signature Date I understand that if accepted for a Medical Laboratory Science Internship at the University of Colorado at Colorado Springs, I will be expected to attend an 11-week student lab at the University of Nebraska Medical Center IN Omaha Nebraska. Further, I understand that all expenses associated with travel and living costs are my financial responsibility. Signature Date I understand and agree to obtain all necessary files, records, and biological samples requested by UCCS, UNMC, or the clinical facility. This may include but is not limited to transcripts, test scores, immunization records, background information, and drug testing. Further, I agree to abide by the policies and decisions made as a result of any of the above. Signature Date

7 Important: All applicants must answer the question below and sign the application Have you ever been convicted of a crime, made a plea of guilty, accepted a deferred judgment, been adjudicated, or been required to register as a sex offender? (misdemeanor traffic offenses are exempt). Yes No If you answered "Yes" to the above question, you must attach an explanation with this application. I hereby certify that to the best of my knowledge the information furnished in this application is true and complete. I understand that if found to be otherwise, it is sufficient cause for rejection or dismissal. Applicant's Signature Date

8 Thank you for your interest in the Medical Laboratory Science (MLS) Program at UCCS. This unique program offers both undergraduate (3+1) and previously degreed students (4+1) the opportunity to prepare for a career in clinical, research, reference, and forensic laboratories. Please carefully review the admission requirements listed below to determine if you are ready to apply for a MLS internship. Requirements and Pre-requisite Courses for the MLS program Admissions Requirements: A minimum of 77 semester hours. The 77 semester hours (or equivalent quarter hours) must include the following: Biology: Chemistry: Mathematics: 16 semester hours including Microbiology (with lab preferred) Immunology Genetics or Molecular Biology 14 semester hours including: A minimum of two upper level (200 level or above) Chemistry courses. Upper level chemistry courses may include Organic Chemistry I, Organic Chemistry II, Biochemistry or Analytical Chemistry. Biochemistry with a lab is recommended. 3 semester hours Statistics is preferred. English Comp: 3 semester hours Grade of C or better in all required courses Cumulative GPA of 3.0 on a 4.0 scale Math/Science GPA of 3.0 on a 4.0 scale Minimum of 20 on ACT exam; Minimum 1440 SAT Cumulative TOEFL exam for foreign students where English is a second language The clinical internship is organized into 3 phases: Phase 1: 11 week student laboratory / classroom at the University of Nebraska Medical Center (UNMC) in Omaha Nebraska. Students are responsible for their travel and living expenses during the student lab. UNMC has dormitory style housing available within walking distance. Topics include Phlebotomy, Urinalysis and Body Fluids, and an introduction to Chemistry, Hematology, Microbiology and Immunohematology (Blood Bank). Phase 2: Theory and Clinical Experience - Rotation I - consists of 13 weeks at clinical site (hospital laboratory). Topics include Management, Immunology/Molecular Diagnostics Diagnostics and Special Chemistry. Phase 3: Theory and Clinical Experience - Rotation II - consists of 25 weeks at clinical site (hospital laboratory). Topics include case studies, theory, application and correlation of laboratory tests.

9 Didactic lectures and case study discussions are video streamed from UNMC. Students use online materials, as well as objectives and study aids to prepare for lecture and laboratory exams. Tuition and costs: 3+1 students pay regular UCCS tuition (either in state or out of state) for the first three years. The clinical internship is administrated through Extended Studies at Beth-El College of Nursing and Health Sciences. The professional year consists of a total of 43 credit hours. Tuition is assessed on a per credit basis. Books: approximately $ Students are responsible for their own travel and living expenses during the student lab. Information on housing will be sent following acceptance into the clinical internship. UCCS students are eligible for scholarships through several national MLS/CLS organizations. UNMC and/or the academic coordinator can provide students with information about these scholarships and the deadlines for application. UNMC requires a student background check, CPR certification, and drug testing that is done at student expense before the program begins in May. Immunizations: Students will be notified of immunizations required by UNMC and the assigned clinical site. (This may vary depending on the clinical site.) Certification exams: After successful completion of the program, students are eligible to take the MLS (ASCP) exam. This exam represents the merger of the MT (ASCP) and CLS (NCA) exams, and is recognized throughout the United States. Some states also require a state certification exam. * UCCS 3+1 students must go through the application process for clinical placement. UCCS 3+1 students are not guaranteed admission to clinicals. Deadline for the application process for the clinical year is November 30 of the third year.

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