Kapi`olani Community College MEDICAL ASSISTING PROGRAM Admission Application Checklist

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1 Health Sciences Dep artment Kapi`olani Community College MEDICAL ASSISTING PROGRAM Admission Application Checklist Fall Application Period: December 1 March 1 Directions: Please complete each item carefully and submit this Admission Application Check List and all required documents to a Health Sciences Counselor during office hours at the Health Career Counseling Center in Kauila 106. If the first day of the application period falls on a weekend or holiday, applications will be accepted on the following business day. Only this fully completed program Admission Application Checklist submitted to the Health Career Counseling Center (Kauila 106) by the appropriate deadline (see above) will be accepted for processing. APPLICANT INFORMATION Name: Mailing Address: Phone: Last Name First Name M.I. UH Number/Username Street / POB City State Zip Code Cell Home Work UH SYSTEM Address: List other name(s) used on documents: (Notify the KCC Kekaulike Information & Service Center regarding other names used on college documents.) ADMISSION APPLICATION CHECKLIST FOR MEDA PROGRAM 1. Attend a Mandatory MEDA Program Information Session. For more information visit or pick up an Information Session schedule from Kauila 122 or Kauila 106, Monday Friday from 8:00 AM to 4:00 PM. Date Attended: (Month / Day / Year) 2. Complete a UH System Application Form (New, Returning or Transfer) OR Change of Home Institution Form (Students currently enrolled at a UH System School other than KCC) Students currently enrolled at KCC do not need either of these forms. 3. Student copy of transcripts (for course work WITHIN the UH System). UH system colleges and university transcripts are downloadable from the internet (MyUH Portal). Student copies of transcripts must be submitted with this checklist. 4. Copy of COMPASS Reading and Math placement score taken within the last two years. COMPASS reading score of 74 or higher. COMPASS placement score of Math 24 or higher 5. College transcripts for courses completed outside of the University of Hawai i System Official transcript(s) should be sent to the KCC Kekaulike Information & Service Center. Institution: Institution: Institution: Transcript Request Date: Transcript Request Date: Transcript Request Date: 5/6/2015

2 Health Sciences Dep artment 6. Request for Transcript Evaluation Form - A request for transcript evaluation must be completed for coursework outside the UH System. Completion of this form is required in order to transfer credits to KCC. This form can be obtained at the Kekaulike Information & Service Center ( Ilima 102) or online at: (see Request for Transcript Evaluation) 7. My Plan Assessment. Complete reflection essays and self assessments for your program/career pathway. 8. Self-addressed, stamped #10 (4 1/8 X 9 1/2") envelope. APPLICANT CERTIFICATIONS: I certify that the answers and responses provided for all of the items on this Admission Application/Check List are true to the best of my knowledge and belief. I understand that providing incorrect or false information will subject me to the requirements and/or discipline measures as provided under the University s Student Conduct Code. I understand that if I am not accepted into the program of application, I must submit a new application and all required documents for any subsequent semester. I also allow KISC to change my major and home institution if I am accepted into the MEDA program. I understand that if I am not accepted into the MEDA program, my home institution and major will not change. Health care students are required to complete University prescribed academic requirements that involve practice in a University affiliated health care facility setting with no substitution allowable for the completion required clinical practice. Failure of a student to complete the prescribed clinical practices shall be deemed as not satisfying academic program requirements. It is the responsibility of the student to satisfactorily complete any criminal background checks and drug testing that may be required by the affiliated health care facility to which he/she is assigned for clinical practice in accordance with procedures and timelines as prescribed by that affiliated health care facility. I have read and understand the notification that a criminal background check and drug test may be required for entry into clinical practice. I also understand that clinical practice is required for completion of this program. (please initial) Print Name Signature Date EXAMPLE of how to complete the application: These are the requirements Fill in the information about the class you took to meet each requirement Required before application deadline COMPASS Placement Test Score of Math 24 or higher OR Completion of PCM 23 or higher. COMPASS Reading Test Score of 74 or higher OR Completion of ENG 22 Beginning Composition (3). Test Score OR Course Alpha Term of Completion Where Completed (i.e., Institution) Grade/Credit Math 100 Fall 2009 LCC A/3.0 Placement into ENG 100 Date of Test: 1/12/2011 KCC Testing Center N/A 5/6/2015

3 Health Sciences Department CRITERION FOR ACCEPTANCE: The first applicants to qualify by meeting the COMPASS Reading score (74 or higher) and Math score (placement into Math 24 or higher) will be accepted until the quota is met for the Medical Assisting program. Evidence of completion of ENG 22 and PCM 23 are accepted in lieu of placement test results. MINIMUM QUALIFICATIONS FOR PROGRAM ENTRY Required before application deadline Test Score or Course Alpha Term of Completion Where Completed (i.e., Institution) Grade/Credits COMPASS Placement Test Score of Math 24 or higher OR Completion of PCM 23 or higher. COMPASS Reading Test Score of 74 or higher OR Completion of ENG 22 Beginning Composition (3). COURSES FOR ASSOCIATE IN SCIENCE DEGREE Courses may be taken prior to program entry GENERAL EDUCATION REQUIREMENTS Course Alpha Term of Completion Where Completed (i.e., Institution) Grade/Credits ENG 100 Composition I (3) OR higher MATH 100 Survey of Mathematics (3) OR higher FAMR 230 Human Growth & Development (3) ZOOL 141 Human Anatomy & Physiology I (3) AND ZOOL 141L Human Anatomy & Physiology I Lab (1) A. S. Humanities elective (100 level or higher) (3). PROGRAM SUPPORT COURSE REQUIREMENT MLT 100 Introduction to the Clinical Laboratory (2) Application Summary: For office use only Date Received: Ethnic Code: Counselor s Initials: Application Complete: HI Resident: Y N KCC GPA Verified: 5/6/2015

4 Health Sciences Department Kapi`olani Community College MY PLAN Reflection Essays Name: UHID: Program: Please be clear and concise in your response for each reflective essay, limiting each question to 300 words. Career Pathway Preparation 1. In a brief statement describe your career goals in this pathway. Where do you see yourself in this career pathway in the next three years?

5 Health Sciences Dep artment Career Pathway Attributes 2. In viewing Health Careers at a Glance, what are your strongest and weakest professional qualities in your chosen career pathway? Please describe these attributes; how do you plan to overcome your challenges, how do you plan to improve on your strengths?

6 Health Sciences Dep artment Career Pathway Outlook 3. Describe any personal obstacles you face that may impact your current academic success and how you plan to overcome these challenges? (I.e. transportation, financial obligations, child care, time management). What support systems do you have in place to overcome them?

7 Health Sciences Department Kapi`olani Community College MY PLAN Self - Assessment The purpose of the self-assessment is to discover your strengths and areas of focus. Working in healthcare requires a combination of academic skills, social skills, and a commitment to public service. As you plan, find ways to make your strengths shine and to improve your weaker areas. Consider discussing your selfassessment and reflective essays with a counselor to understanding how they support your academic and career goals. Academic Strength Below Meets Exceeds Cumulative GPA Prerequisite Course GPA Completed prerequisites Completed support courses Writing ability Letters of evaluation Awards/Achievements Knowledge of the Profession Below Meets Exceeds Relevant experience volunteer Relevant experience for credit Relevant experience paid Relevant Public service/service Learning Understanding of current healthcare issues Comfort with bodily fluids Comfort with illness Comfort with injury Comfort with death Comfort with physical contact with people Ability to multitask and adapt to change Personal Characteristics Below Meets Exceeds Commitment to public service Empathy/altruism Moral/ethical integrity Emotional maturity Responsibility Leadership Dedication/hard-working Commitment to life-long learning Ability to work as a team Personal interests & experience

8 Program Dental Assisting (DENT) HEALTH CAREERS COUNSELING CENTER HEALTH A GLANCE FOR HEALTH SCIENCES/EMS Health Services Occupational Cluster Dental Professional Qualities Professional Attitude Time Management Compassion Flexibility Adapt to Changes Ability to Multitask Starting Semester Application Period Fall Dec 1 - June 30 Selection Process Selection Criteria Prerequisites Qualifying Placement Tests COMPASS Reading score of 74 or higher Math 100 (or higher) Prerequisites SP 151 ZOOL L UPDATED: 06/2015 All programs give priority seating to qualified Hawai`i state residents. Each student should develop a My Plan with the Health Sciences/Nursing Counselor(s) for their intended program/career pathway. Suggested Degree Support Courses (Credits) CA:39 Emergency Medical Technician (EMT) Direct Patient Care Empathy Self Motivation Appearance & Hygiene Self Confidence Time Management Teamwork & Diplomacy Respect Patient Advocacy Fall Spring Dec 1 - June 1 June 2 - Oct 1 Prerequisites, Supplemental Application Requirements, & Interview COMPASS MATH 24 or higher or evidence of completion English 100 Health 125 MATH 24 or Equivalent coursework CC:13 Medical Assisting (MEDA) Patient Care, Health Info & Diagnostic Compassion Attention to Detail Ability to Multitask, Organizational Skills, Good Verbal & Written Adaptability & Flexibility Fall Dec 1 March 1 Qualifying Scores/ Courses COMPASS ENG 22 or higher & COMPASS MATH 24 or higher, or evidence of completion of both ENG 100 MATH 100 ZOOL L FAMR 230 AS/AH CC:33 AS:64 Medical Laboratory Technician (MLT) Diagnostic Laboratory Attention To Detail Dependability Good Verbal & Written Self-Starter Ability To Multi-Task Spring June 1 Sept 1 Prerequisites & Support Courses MATH 103 or higher CHEM L MLT 100 BIOL 130 or BIOL 171 or ZOOL 141 & ZOOL 142 CHEM L MICR 130 MICR 161 AS/SS AS/AH AS:70-73 Mobile Intensive Care Technician (MICT) Direct Patient Care Empathy Self Motivation Appearance & Hygiene Self Confidence Time Management Critical Thinking * Problem Solving Skills Teamwork & Diplomacy Respect Patient Advocacy Spring June 1 Oct 1 (every other year) Best Qualified Prerequisites, Supplemental Application Requirements, & Interview ENG 100 HLTH 125 MATH 103 EMT 100 EMT 101 BIO L or ZOOL 141,141L, & 142,142L FAMR 230 AS CC:44 AS:69 Information is subject to change without notice. Updated: 7/9/2015

9 HEALTH CAREERS COUNSELING CENTER HEALTH A GLANCE FOR HEALTH SCIENCES/EMS UPDATED: 06/2015 All programs give priority seating to qualified Hawai`i state residents. Each student should develop a My Plan with the Health Sciences/Nursing Counselor(s) for your intended program/career pathway. Program Health Services Occupational Cluster Personal Qualities Starting Semester Application Period Selection Process Selection Criteria Qualifying Placement Tests Prerequisites Suggested Support Courses Degree (Credits) Occupational Therapy Assistant (OTA) Rehabilitation Able to Relate & Engage With People; people person Self Motivated & Responsible Organizational Skills Commit To Rigorous Study Critical Thinking Skills Creative & Adaptability Teamwork Skills Fall April 1 May 31 Qualifying Scores/ Courses COMPASS ENG 100, & COM- PASS MATH 24 or higher, or evidence of completion of both MATH 100 or higher BIOL 130, 130L or ZOOL 141,141L + 142,142L HLTH 125 OTA 110 OTA 119 AS/AH FAMR 230 CC: 5 AS: Physical Therapist Assistant (PTA) Rehabilitation Accountability Altruism Compassion and Caring Culture Competence Duty Social Responsibility Communication Problem Solving Fall Apr 1 May 25 Prerequisites & Observation Reference Score MATH 103 or higher SP 181 FAMR 230 ZOOL 141,141L, 142,142L PTA 101W HLTH 120 HLTH 125 HLTH 290, 290L A.S. Humanities Course AS:72 Radiologic Technician (RAD) Diagnostic Imaging Compassion Hand-Eye Coordination and Visualization Acute Problem Solving Skills/ Ability to Adapt Function Under Pressure Good Work Ethic Fall Apr 1 May 31 Prerequisites & Support Courses, & A 2 Exam HESI A 2 Exam MATH 135 or higher HLTH 125 BIOL L or ZOOL141,141L, 142,+142L AS/AH AS/SS AS: Respiratory Care Practitioner (RESPI) Direct Patient Care Compassion and Caring Culture Competence Ability to Adapt Ability to Multitask Organizational Skills Problem Solving Skills Teamwork & Diplomacy Good Work Ethic Fall April 1 May 30 Prerequisites, Interview, Essay, & Evidence of Degree Earned MATH 100 or higher HLTH125 or HLTH110 PSY100 or FAMR230 CHEM100 or higher ZOOL141,141L, 142,+142L MICR 130 or MICR 135 MICR 140 A.S. Humanities Course AS: Information is subject to change without notice. Updated: 7/9/2015

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