OCCUPATIONAL THERAPY ASSISTANT PROGRAM APPLICATION GUIDE AND CHECK LIST

Transcription

1 Allied Health Division OCCUPATIONAL THERAPY ASSISTANT PROGRAM APPLICATION GUIDE AND CHECK LIST To: Applicants of the Crowder College From: Debra Kennedy Allied Health Programs Division Chair Date: April 15, 2015 RE: OTA Program Application Materials Thank you for your interest in the Crowder College. If you have any questions, please don t hesitate to call our office at or thomasgreen@crowder.edu. Applications are due by August 1 st, 2015 to be considered for acceptance. If you are not already enrolled at Crowder College, you will need to apply for admission and request that all transcripts from other colleges you attended be sent to Crowder College. Complete a minimum of 12 hours volunteer work or in observation with Occupational Therapy/Occupational Therapy Assistant. Included in the application packet is a Volunteer/Observation Form which must be signed by the supervising Occupational Therapist/Occupational Therapy Assistant. You must complete the following course requirements prior to beginning the OTA program: ENGL 101 English Composition PSYC 101 General Psychology BIOL 152 Anatomy & Physiology I 3 credit hours 3 credit hours 5 credit hours SPCH 101 Fundamentals of Speech COLL 101 College Orientation 3 credit hours 1 credit hour (may not apply to returning students or those transferring in 12 or more credit hours) NOTE: OTA core courses must be completed at Crowder College and will not be substituted by courses taken at other institutions and/or from work experience.

2 APPLICATION CHECKLIST **Only completed application packets will be considered for acceptance into the OTA program.** The application packet and application fee is due on or before August 1 st, Application packets received after August 1 st will not be considered. Please ensure all items listed below are completed with your application process: Apply and be accepted for admission to Crowder College, a one-time application fee is required. (Application may be completed at any Crowder College campus or Online at Crowder.edu). Completed and signed OTA application for admission $40.00 non-refundable OTA application fee (make check or money orders payable to Crowder OTA. This is a separate fee from the Crowder College application fee for admission). Unofficial Transcripts Signed Criminal History Records Disclosure Consent form Complete and sign Request for Criminal Record Check Signed Missouri State Highway Patrol MoVECHS Waiver Agreement and Statement form Signed Limited Waiver of Confidentiality Completed Personal Essay Completed Volunteer/Observation Forms Reference Forms completed by three individuals Please mail application with all required documents, and $40.00 fee in a manila envelope to: Crowder College Allied Health Department 600 S. Ellis Webb City, MO Application Requirements page 1 of 3

3 PROGRAM ACCEPTANCE GUIDELINES Applicants will be selected for admission based on the following criteria: Applicant must be approved for admission to the college Applicant must have a high school diploma or G.E.D. certificate Completion of Pre-Admission requirements by the time OTA courses begin A cumulative score based on the following criteria: Grade Point Average Observation Experience Personal Essay College Degree Certificate/License Crowder College Student Previous Application References Interview Grade Point Average: Applicants will be evaluated based on grades earned in the prerequisite courses and all other courses the student intends to transfer to fulfill the OTA program requirements. A minimum GPA of 2.75 is required to apply to the program. Applicant must achieve a grade of C or better in the pre-admission required courses. Observation Experience: A minimum of 12 hours of observation experience in Occupational Therapy (OT) is required. Observation hours must be in: 1. At least two different treatment settings 2. At least 6 hours in each setting. The hours must be documented on the Volunteer/Observation Form included in the application packet by a registered and licensed Occupational Therapist (OTR/L) and/or licensed and certified Occupational Therapist Assistant (COTA/L) with one or more years of experience. You will be awarded points based on the score provided by the OT/OTA. In addition to the minimum 12 hours, the following will be considered: Volunteer/Observation hours over the required 12 hours Volunteer/Observation hours in more than the two required treatment settings must be at least 2 hours. Personal Essay: Applicants must submit a short essay. The essay must be at least one page long but not exceed two pages in length. Essay should be typed in Times New Roman 12 point font and be doublespaced utilizing correct grammar and spelling. The essay must address the following questions: 1) Why do you want to pursue a career as an Occupational Therapy Assistant? 2) What is your personal experience with Occupational Therapy? Application Requirements page 2 of 3

4 College Degree: Any previously completed college degree will be considered in the cumulative score. Certificate/License: Any previously completed healthcare certificate or license will be considered in the cumulative score. Crowder College Student: Previously completed courses at Crowder College will receive consideration in the cumulative score. Previous Application: Previous application to the Crowder College OTA program will receive consideration in the cumulative score. Reference Forms: Each applicant will need to ask three (3) different individuals to fill out a personal Reference Form (included in this packet). These individuals should not be related to the applicant but has knowledge of the applicant s character, such as a co-worker, instructor or supervisor. The Reference Form must be filled out by the individual chosen as a personal reference. The Reference Form must be placed in an envelope, sealed and signed across the seal with the applicant s name. The Reference Form may be turned in with the application packet or mailed directly to the Allied Health Department. Interview: Written applications will be scored and you may be selected to come in for an interview by a panel of instructors and professionals. Interviews will be scored and added to the cumulative score. **Only completed application packets will be considered for acceptance into the OTA program** Application Requirements page 3 of 3

5 APPLICATION FOR ADMISSION Name: (last) (first) (middle) (maiden) Address: City: State: Zip: Social Security #: Telephone Number: Telephone Number to leave message if unable to reach at above number: address: _ I. Education: List high school or GED and all college (including classes currently in): Name of School Address From To Degree or Hours Earned II. Occupational Experience-list all employment within the past 5 years: Employer Address Type of Work From To List the names of the three individuals you have given reference forms to on your behalf: Allied Health Division included with application being mailed included with application being mailed included with application being mailed III. Have you previously applied to the Crowder College Occupational Therapy Program? Yes No IV. Do you have any certifications or licensures in the medical field? Yes No If yes, what is it for? Please attach a copy of certificate or license when submitting application. V. Yes, I have (OR) No, I have not been convicted of or plead guilty to a crime. If yes, describe the crime(s) and the particulars: If you have been convicted of a misdemeanor of felony, it is your responsibility to contact the National Board for Certification in Occupational Therapy, Inc. at , and the Executive Council for Physical and Occupational Therapy Examiners at , to determine your certification and licensure eligibility. I do hereby certify that the above information is complete and correct to the best of my knowledge, under penalty of perjury. I understand that any question answered in a false manner will result in the application being void, and therefore, not considered. I understand that as an occupational therapy assistant student I am required to have access to a computer with internet, Microsoft Office 2010, and printer. Access to this is available at all of our Crowder College campuses Monday through Friday from 8:00 a.m. to 5:00 p.m. It is HIGHLY recommended that you have access to high-speed internet, Microsoft Office 2010, and printer at home. I understand that I will not be considered for admission into the Occupational Therapy Assistant program until I have completed the application process as outlined in the application information sheet. Signature (written) Name (printed)

6 CRIMINAL HISTORY RECORDS DISCLOSURE CONSENT CROWDER COLLEGE OCCUPATIONAL THERAPY ASSISTANT PROGRAM As a requirement of the Crowder College application process, in response to the House Bill 1362, I consent to the release of my criminal history records to the Crowder College. The Crowder College will consider material contained in my criminal history solely for the purposes of determining my suitability for the position of student occupational therapy assistant for which I have applied. I do not authorize release of information for any purposes beyond the program admission decision. I understand that a prior conviction may not necessarily disqualify me for admission into the program, but will be a factor which may be considered before acceptance into the program. I further understand that a misdemeanor or felony conviction limits and/or prevents clinical placement and employability. Signature: Date: Witness: **This does not have to be notarized, but signed by an individual that has witnessed your signature. Are you on the disqualification list for the Department of Social Services? Yes No

7 REQUEST FOR CRIMINAL RECORD CHECK Crowder College PLEASE PRINT OR TYPE Name: Last First Middle Maiden/Alias (if applicable): Race: (please circle) American Indian/Alaskan Native Black/African Middle Eastern/East Indian Asian/Pacific Islander Hispanic/Latino White/Caucasian Social Security No.: Birthdate: month day year Address: City State Zip Code If at current address less than 1 year, list former address: I authorize the release of any criminal history record information to Crowder College Occupational Therapy Assistant/Allied Health Department. Signature Date

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9 LIMITED WAIVER OF CONFIDENTIALITY By execution of the Occupational Therapy Program application, I do hereby authorize Crowder College or its representatives to verify all information contained within this application, and do waive any privilege I may have as to confidentiality to Crowder College or its representatives, and do authorize any agency, educational, health, or law enforcement to furnish to Crowder College or its representatives the information necessary to validate the information contained upon my Occupational Therapy Assistant application, including a background check for criminal record if any. Signature of Applicant Date Submitted *Application cannot be processed without your signature in ink ACCESS TO RECORDS INFORMATION 10/93 The Family Educational Rights and Privacy Act of 1974, Public Law as amended and signed into law by President Ford on December 31, 1974, states that enrollees have the right to examine confidential files. It also states that they may waive this right if they do so desire. The law provides that references may be either confidential or non-confidential at the option of the registrant. The registrant has the option to inspect the references in a non-confidential file. Confidential references are those which the registrant has waived the right to see. Please consider the following in making a decision to have confidential or non-confidential references. 1. School officials prefer to see confidential references, believing the references are more frank in such credentials. The limited number of studies which have been made of confidential vs. nonconfidential references indicate a preference of both hiring officials and college faculty for confidential or enclosed references. 2. Registrants should be most selective in asking persons to write references for them. The persons selected should know the registrant well and be able to state facts and competencies of the registrant. 3. Writers of references will be informed at the time of writing that the reference is confidential or that the registrant will be permitted to see the reference. CROWDER COLLEGE Occupational Therapy Assistant Allied Health Department Webb City, Missouri I have elected: A confidential file. A non-confidential file. Signature of Applicant Date

10 Allied Health Division OCCUPATIONAL THERAPY ASSISTANT PROGRAM APPLICATION PERSONAL ESSAY ASSIGNMENT Complete an essay at least 1 page long but not to exceed 2 pages in length. Essay should be typed in Times New Roman 12 point font, be double spaced, and utilize correct grammar and spelling. Your essay must address the following questions: 1) Why do you want to pursue a career as an Occupational Therapy Assistant? 2) What is your personal experience with Occupational Therapy?

11 Allied Health Division VOLUNTEER/OBSERVATION and REFERENCE FORMS **The following pages are the forms needed for your Volunteer/Observation time and for your personal References. Please provide your Volunteer/Observation supervisor and your References with a stamped envelope addressed to: Crowder College Allied Health Department 600 S. Ellis Webb City, MO The supervisor/reference person must sign over the envelope seal before mailing in the forms.

12 VOLUNTEER/OBSERVATION FORM Applicant s Name: Date: **I am requesting completion of this evaluation form by an individual of my choosing to be used in the admission selection process for the at Crowder College and do hereby waive my right of access to this document.** Applicant s Signature: Printed Name of OTR/L or COTA completing this form: Signature of OTR/L or COTA: Facility Name: Address: Phone Number: Setting: Number of Volunteer/Observation hours completed by the applicant at your facility: Time In: Time Out: Please use the following scale to rate the behavioral characteristics observed: Below Expectations (1) Meets Expectations (2) Exceeds Expectations (3) The applicant demonstrated good time management skills as evidenced by making request for observation hours with appropriate advance notice, arrived promptly on scheduled dates, and remained engaged throughout the scheduled volunteer/observation time. Comments: Allied Health Division The applicant demonstrated good interpersonal skills during interactions with supervisor, patients/clients, and others in the facility as evidenced by body language, eye contact, listening skills, and the ability to verbalize thoughts in a clear manner. Comments: The applicant demonstrated appropriate dress and professional behavior, including emotional maturity during volunteer/observation hours. Comments: The applicant appeared to have a basic understanding of Occupational Therapy services, asked relevant questions and demonstrated appropriate reasoning and insight. Comments:

13 Allied Health Division Please summarize your overall recommendation by checking one of the following: Strongly recommend (3) Recommend (2) Recommend with reservations (1) Do not recommend (0) Please Explain: Signature/Title: OTR/L or COTA: Please place this Volunteer/Observation form in the envelope provided by the student. Seal and place your signature across the seal of the envelope. Applicant: Please write your name and Observation Form on the envelope and return it with your application packet.

14 Allied Health Division VOLUNTEER/OBSERVATION FORM Applicant s Name: Date: **I am requesting completion of this evaluation form by an individual of my choosing to be used in the admission selection process for the at Crowder College and do hereby waive my right of access to this document.** Applicant s Signature: Printed Name of OTR/L or COTA completing this form: Signature of OTR/L or COTA: Facility Name: Address: Phone Number: Setting: Number of Volunteer/Observation hours completed by the applicant at your facility: Time In: Time Out: Please use the following scale to rate the behavioral characteristics observed: Below Expectations (1) Meets Expectations (2) Exceeds Expectations (3) The applicant demonstrated good time management skills as evidenced by making request for observation hours with appropriate advance notice, arrived promptly on scheduled dates, and remained engaged throughout the scheduled volunteer/observation time. Comments: The applicant demonstrated good interpersonal skills during interactions with supervisor, patients/clients, and others in the facility as evidenced by body language, eye contact, listening skills, and the ability to verbalize thoughts in a clear manner. Comments: The applicant demonstrated appropriate dress and professional behavior, including emotional maturity during volunteer/observation hours. Comments: The applicant appeared to have a basic understanding of Occupational Therapy services, asked relevant questions and demonstrated appropriate reasoning and insight. Comments:

16 Allied Health Division VOLUNTEER/OBSERVATION FORM Applicant s Name: Date: **I am requesting completion of this evaluation form by an individual of my choosing to be used in the admission selection process for the at Crowder College and do hereby waive my right of access to this document.** Applicant s Signature: Printed Name of OTR/L or COTA completing this form: Signature of OTR/L or COTA: Facility Name: Address: Phone Number: Setting: Number of Volunteer/Observation hours completed by the applicant at your facility: Time In: Time Out: Please use the following scale to rate the behavioral characteristics observed: Below Expectations (1) Meets Expectations (2) Exceeds Expectations (3) The applicant demonstrated good time management skills as evidenced by making request for observation hours with appropriate advance notice, arrived promptly on scheduled dates, and remained engaged throughout the scheduled volunteer/observation time. Comments: The applicant demonstrated good interpersonal skills during interactions with supervisor, patients/clients, and others in the facility as evidenced by body language, eye contact, listening skills, and the ability to verbalize thoughts in a clear manner. Comments: The applicant demonstrated appropriate dress and professional behavior, including emotional maturity during volunteer/observation hours. Comments: The applicant appeared to have a basic understanding of Occupational Therapy services, asked relevant questions and demonstrated appropriate reasoning and insight. Comments:

18 REFERENCE FORM Applicant s Name: The applicant has chosen this to be a confidential, non-confidential reference. The above applicant has given this form to you so that you may support his/her application for admission into the at Crowder College. The applicant should be someone you have personal knowledge about, but is not a family member. An honest and complete opinion will be most helpful. Please return this completed form as soon as possible. 1. How long have you known this individual and in what capacity? Allied Health Division 2. How well do you know this applicant? Very well Well Not well Not at all 3. From your experience with this individual please rate him/her in the following areas : Very Strong evidence skill is present Strong Evidence skill is present Some evidence skill is present Strong evidence skill is not present Insufficient evidence for or against skill /2 Communication Coping Commitment to Task Conflict Management Problem-Solving Organization & Planning Punctuality Grooming Grooming

19 Allied Health Division 4. Would you recommend this person for the OTA program? Yes No 5. Please make a statement regarding what you know about the applicant s personal characteristics, exceptional qualities, and work ethics. Signature/Title: Please mail this form in the envelope provided by the student. Thank you.

24 Allied Health Division GRADUATE LEARNING OUTCOMES 1. Provide occupation-based, client-centered care that is inclusive of values, beliefs and needs. 2. Promote health and wellbeing for individuals and populations through the use of occupation. 3. Consider evidence-based resources in delivery of client services. 4. Actively participate in and advocate for healthcare change. 5. Identify and address professional ethical challenges by applying the AOTA Code of Ethics. 6. Recognize and respond to social, economic and political factors that influence and change occupational therapy services and healthcare. 7. Interact professionally with consumers, caregivers, families and/or professional colleagues to achieve service objectives. 8. Interact and collaborate, directly and indirectly, with personnel needed to provide comprehensive occupational therapy services. 9. Demonstrate effective communication practices needed to function effectively as a member of an inter-professional healthcare team.

25 Program Curriculum Plan Associates of Science Degree Total credit hours - 72 Pre-Admission ENGL 101 English Composition-3 credit hours PSYC 101 General Psychology-3 credit hours BIOL 152 Human Anatomy and Physiology I-5 credit hours COLL 101 College Orientation -1 credit hour SPCH 101 Fundamentals of Speech-3 credit hours Total: 15 credit hours Spring OTA 101 Principles of Occupational Therapy-2 credit hours OTA 111 Occupational Performance Across the LifeSpan-3 credit hours OTA 116 Principles of Therapeutic Intervention-2 credit hours BIOL 252 Human Anatomy and Physiology II-5 credit hours OA 215 Medical Terminology-3 credit hours Total: 15 credit hours Summer MATH 111 College Algebra or Math credit hours HIST 106 U.S. History 1 or PLSC credit hours Total: 6 credit hours Fall OTA 201 Principles of Occupational Therapy Practice: Children and Adolescents-5 credit hours OTA 131 Functional Movement: Occupation and Adaptation-3 credit hours OTA 140 Occupational Therapy Trends and Issues-2 credit hours Humanities 3 credit hours (Recommend: Cultural Diversity HUM 102 or Critical Thinking PHIL 110) Total: 13 credit hours Spring OTA 211 Principles of Occupational Therapy Practice: Mental Health-5 credit hours OTA 221 Principles of Occupational Therapy Practice: Physical Rehabilitation-5 credit hours OTA 236 Occupational Performance Issues in Later Adulthood-3 credit hours Total: 13 credit hours Fall OTA 240 Fieldwork level II A-5 credit hours OTA 250 Fieldwork level II B-5 credit hours Total: 10 credit hours Total Hours: 72 credit hours Allied Health Division

26 Tuition, Fees, and licensure Tuition In district: General Education Classes $82.00 per semester hour x 32= $2, OTA Classes $99.00 per semester hour x 40=$3, Facility Use Fee $16.00 per semester hour x 72=$1, Total in district tuition: $7, Out of district: General Education classes $ per semester hour x 32=$3, OTA Classes $ per semester hour x 40=$5, Facility Use Fee $16.00 per semester x 72=$1, Total Out of district: $10, Pre-Admission Application Fee* $40.00 Criminal Background check * $52.50 Physical Exam and Immunizations * $ TB Test * $20.00 CPR Certification* $55.00 Total $ Spring 1 st year Polo Shirt * $20.00 Drug Screen $20.00 Lab Fee $50.00 Textbooks * Fall 1 st year Lab coat (if required by site) * $20.00 Lab fee $50.00 Total $70.00 Spring 2 nd year Liability Insurance $13.00 Lab Fee $ TB Test* $20.00 Drug Screen $20.00 Total $ Fall 2 nd year Graduation Fee * $35.00 Liability Insurance $13.00 Pictures (optional)* $20.00 School Pin $45.00 Exam Review and book $ Lab Fee $15.00 Total $ Licensure Fees NBCOT Exam Fee * $ State Score reporting fee * $40.00 Confirmation of Exam Registration * $45.00 Missouri Limited Permit* $15.00 Missouri full licensure* $30.00 Total $ Total estimated in district cost $ 13, Total estimated out of district cost $ 16, (All charges are an estimated cost and is subject to change) Allied Health Division $1, (approximate amount for all semesters) Total $1, *out of pocket (all other fees will be billed to student account)