Application: Clinical Medical Assistant (CMA)

Transcription

1 Application: Clinical Medical Assistant (CMA) 1

2 Jefferson Community College (JCC) Continuing Education Division in partnership with Condensed Curriculum International (CCI) will offer a Clinical Medical Assistant (CMA) Program beginning October 1. Classes will be held at the Fort Drum Education Center Annex, th Armored Division Drive. Since 1993, CCI has been supporting innovative allied healthcare training and education programs online and in the classroom via partnerships with community colleges, universities, career colleges, workforce agencies, high schools and other education providers. Currently, CCI has over 300 partnerships operating in 40 states. The Clinical Medical Assistant Program is a 20-week program that prepares students to take the National Healthcareer Association Certified Clinical Medical Assistant National examination and begin work in the healthcare field. During the program, students will earn 140 hours of classroom lecture, 160 hours of clinical externship and hands-on lab experience. CMA program syllabus includes how to assist physicians by preparing patients for examination and treatment, routine laboratory procedures and diagnostic testing. Students will learn the technical aspects about phlebotomy and pharmacology, the proper use and administration of medications, taking and documenting vital signs, cardiology including proper lead placements and legal aspects of healthcare. Classes will be held Tuesday and Thursday evenings, October 1, 2013 through February 27, 2014 from 5:30 p.m. to 9:00 p.m. in the Fort Drum Education Center Annex. Tuition, including textbooks, is $2,399. Traditional financial aid and GI Bill funding will not pay for tuition. The deadline to apply is July 24, For more information, call the JCC Continuing Education Division at or Andrea Pedrick, Coordinator of Community Services, [email protected] or [email protected] 20-week Clinical Medical Assistant Training Program Fort Drum Annex Tuesday/Thursday October 1, 2013 February 27, 2014 (No class November 28 th, December 24, 26 or December 31) 5:30 9:00 p.m. $2,399 Application deadline: July 24,

3 Clinical Medical Assistant (CMA) 1) All information given on the application form must be typed or neatly printed. 2) The completed application, and any subsequent correspondence, must be mailed to the Continuing Education Division at Jefferson Community College; 1220 Coffeen Street, Watertown, NY Attention: Andrea Pedrick 3) Arrange for an official copy of your college transcript, or high school transcript or GED to be forwarded to the Continuing Education Division by contacting your high school and/or college. 4) Applicants are required to ask two individuals to provide letters of recommendation in support of their application. These references may not be family members. References should be responsible adults who can attest to your ability to successfully complete this training (e.g., employers, instructors, advisors, clergy or medical personnel). References are to be mailed by these individuals to the Continuing Education Division at Jefferson Community College; 1220 Coffeen Street, Watertown, NY Attention: Andrea Pedrick 5) In order for the application to be considered, it must be complete. 6) Application deadline is July 24, There are only 20-seats available in this program. Acceptance letters will be mailed to the 20 people selected for the program. Continuing Education will not notify applicants who are not accepted into the CMA program. 3

4 Fall 2013/ CMA Program APPLICATION Name Last First Middle Other/Previous Name (which may appear on records) Address Number & Street Apt. Number City State Zip code Phone: cell or day number: ( ) Work: ( ) Social Security Number Date of Birth How did you hear about the Clinical Medical Assistant Training Program? Extra Curricular Activities (please list all school, community or religious activities in which you have participated. Include all offices which you have held and honors you have received.) Give names and address of the persons to whom you have submitted the recommendation forms. These references must not be family members. The references should be responsible adults who can attest to your ability to successfully complete this training. Name Title/Position Address Phone ( ) Relationship to Applicant 4

5 Name Title/Position Address Phone ( ) Relationship to Applicant Educational Background School City Dates Attended Degree High School College Special Certification Employment Present Employer Phone ( ) Address Dates of Employment Nature of Work Name of Employer Phone ( ) Address Dates of Employment Nature of Work 5

6 Statement of Interest Please explain why you wish to be accepted into the CMA training and work in the allied health industry. Applicant s Name Date 6

7 Jefferson Community College CMA Program Certificate of Information & Commitment I certify, to the best of my knowledge, that the information supplied on this application is complete and accurate. Additionally, I certify that I understand this is a non-credit training program. Upon completion of this program, students would be eligible to sit for the National Healthcareer Association (NHA) Certified Clinical Medical Assistant (CCMA) national examination. This is not a college degree program through Jefferson Community College. Applicants signature Date Jefferson Community College admits students without regard for race, color, creed, sex, age, religion, national/ethnic origin, sexual orientation, disability, pregnancy or military status. 7

8 2013 Fall Application Checklist Completed Application Form Copy of GED, OR official high school OR college transcripts forwarded to Continuing Education Division. Two letters of recommendation mailed in sealed envelopes to Continuing Education. 8