NORTH SHORE COMMUNITY COLLEGE/NORTHEAST ARC College and Career Access Project (CCAP) Student Application

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1 Thank you for interest in the. Admittance to the program will be based on the following criteria: 1. Age 18 to 26 years prior to the start of the semester. 2. Documented intellectual, developmental or learning disability. 3. Reading and writing skills on a third grade level or higher. 4. Quality of personal recommendations and personal essay. 5. The ability to be independent and safe on a college campus and in the local community. 6. Interest in the Program of Study you have chosen to apply for. 7. Ability to meet the physical demands of your Program of Study. Your application will be reviewed only after all the application materials have been received. Once all the materials have been reviewed, applicants will receive written notice of pending acceptance. CCAP staff may invite some applicants in for an interview at this time. Admissions decisions will be made on a rolling basis. There are a limited number of spaces available in this program. Applications will be reviewed in the order they are received. We encourage interested students to apply as early as possible. Qualified applicants who apply after the program is fully enrolled will be placed on a waiting list and accepted into the program if a space becomes available. If you have any questions concerning or the application process, please contact either: Lea Hill Dylan Girard North Shore Community College Northeast Arc LHill04@northshore.edu DGirard@ne-arc.org , EXT Please submit all application materials directly to: North Shore Community College 1 Ferncroft Road/ P.O. Box 3340 Danvers, MA

2 Application Materials Checklist CCAP Application Form (completed by the student applicant) *Two written recommendations on the forms included in the application. At least one recommendation must be from a teacher or school official. The other should be from a non-family member who is familiar with the applicant. *Most recent Individualized Education Program including any educational assessments and/or educational test results indicating reading and writing ability. **Most recent Neuropsychological examination report or other psychological testing reports. Personal essay stating his/her reasons for applying to the program (must be written or typed by the applicant). Completed requirements for selected Program of Study (see attached requirements for each Program of Study). *This can be waived if student has successfully completed either a NSCC or a Northeast Arc program and has received a recommendation from that program. **This can be waived if either NSCC or the Northeast Arc already have the most recent Neuropsychological examination report on file.

3 Directions: Please print or type all answers. This form MUST be completed by the Student Applicant. Name Last First Middle Address Street & Number Apt. number City/Town State Zip Social Security Number Phone Number Date of Birth Emergency Contact Information Parent I/Guardian Parent II/Guardian Address Address (Street) (Street) City, State, Zip City, State, Zip Telephone Telephone

4 Name In the space provided please list some of your experience in the following areas: School (current or most recent school) and the dates you attended: Work (any employment or volunteer experience) and the dates you worked: Leisure (hobbies, sports, clubs, interest, special skills): Personal Essay: On a separate sheet of paper print or type (1) a brief statement about yourself, (2) why you would like attend the, and (3) why you have chosen the vocational pathway you are applying to. Please sign your statement. This must be completed by the applicant.

5 Requirements for Basic Canine and Feline Care Program General Job Description: Attending to all aspects of husbandry in dogs and cats are the primary functions in the Basic Canine and Feline Care Program. These activities include: brushing, combing, bathing and drying all breeds and mixed breed of dogs and cats, cleaning and maintaining living quarters of animals, providing proper nutrition and exercise for animals, observing and communicating the health status of animals. Upon completion of the program, the student should be able to communicate well with people in order to make appointments, discuss care requirements, advise on general health issues and educate the owner on the care of their pet. The student will also need to keep accurate records, order supplies and equipment, maintain an inventory and evaluate products and equipment used in animal care facilities. The ability to function in a fast moving, sometimes stressful, loud, and occasionally wet environment is a must for the animal care professional. Classes will be held at the Danvers Campus of NSCC as well as designated community sites. Physical Standards that the Student must be able to do ALL of the time: LIFT: Up to 50 pounds to get dogs onto grooming tables and into tubs. HANDLE: Heavy dryers, cages and strong, sometimes aggressive dogs and cats. REACH: 5½ feet above the floor to move animals in upper level cages. GRASP: STAND: FEEL: HEAR: SEE: TALK: READ: Some grooming tools, leashes, other animal restraints and strong, sometimes frightened or aggressive dogs and cats. For prolonged periods of time while performing grooming tasks and bathing and exercising animals. Growths on skin, mats in coat, soap and water in coat. Barking, whining and other sounds of distressed dogs and cats. Membrane colors, facial expressions of dogs and cats. To communicate in English, welfare and health issues to clients and coworkers. Typed, handwritten, computer information in English; including precautions and instructions for use of products used in the Basic Canine

6 and Feline Care program. WRITE: To communicate in English pertinent information about an animal s physical condition. Physical Standards that the Student must be able to do MOST of the time: STOOP: CROUCH: To clean cages. To safely move animals in and out of cages. MANIPULATE: Large, sometimes uncooperative dogs and frisky cats. Mental/Attitudinal Standards that the Student must adhere to ALL of the time: Function safely, effectively, and calmly under stressful and loud conditions. Exhibit social skills necessary to interact effectively with clients and co-workers of the same or different cultures; such as respect, politeness, teamwork and tact. Display attitudes and actions consistent with the ethical standards of the Basic Canine and Feline Care profession. Mental/Attitudinal Standards that the Student must adhere to MOST of the time: Maintain composure while managing multiple tasks simultaneously. Prioritize multiple tasks. Applicants who are offered admission must document their ability to perform all essential tasks with or without reasonable accommodation in order to begin the professional courses. If you are an otherwise qualified individual with a disability who seeks a reasonable accommodation, you need to contact the Office of Disability Services for eligibility determination for reasonable accommodation(s). I have reviewed and understand all of the above policies/guidelines regarding the Basic Canine and Feline Care Program. Print your full name Signature date date

7 North Shore Community College Danvers Health Professions and Student Services Building Policy for Animal Use/Care on Campus North Shore Community College utilizes animals in the instruction of students in the Basic Canine and Feline Care Program. The purpose of animal utilization is to provide primary educational experiences for the students. In order to ensure that the animals are safe and humanely treated, and that students are safe and experience a maximal educational benefit from live animal use, North Shore Community College has developed the following policies: 1. All animals are to be brought into the building through the entrance located to the right of the fence of the outdoor dog run area. 2. All animals must be restrained at all times while on College property. 3. An instructor of North Shore Community College must be present when students are transferring animals from restraints to cages/kennel runs. 4. No animals are to be left unattended in the outdoor runs. 5. All animals are restricted to the Animal Science area only, HPSS rooms Animals are not allowed in the general classrooms; exception is a service animal. 7. All animals must be kenneled unless participating in a demonstration exercise. 8. Pre-approval by the instructor is required for any animals being brought to class. 9. If a student plans on arriving early for a class with an animal, prior arrangement must be made with the assigned Instructor. 10. Students MUST provide proof of Rabies vaccination of their animal(s) to the instructor. 11. No animals are permitted to congregate on the outdoor walkways or interior hallways of the College. 12. Animals are not to be kept or left in cars in the parking lot. 13. Animals that are deemed aggressive or disruptive by the assigned Instructor will be sent home and not permitted to return to campus. 14. Do not leave leashes or collars on animals in kennels. 15. Animals in kennels must be identified with a cage card listing the date, student s name, class, pet name, and student cell phone number. Kenneled animals must have a paper ID collar affixed to them at all times. 16. All pet accessories are to be labeled and placed in designated kennel baskets. 17. Students are responsible for providing water and general care to their pets while on campus. 18. Students are responsible for cleaning up after their pet while on campus. This includes cleaning any used kennels/runs and disposing of waste in appropriate receptacles. I have reviewed and understand all of the above policies/guidelines regarding Animal Care and Use on the campus of NSCC. NAME {please print} DATE SIGNATURE

8 Requirements for Horticulture Program General Job Description: Horticultural jobs are of interest to those who enjoy working with their hands and are comfortable in the ever changing outdoor environment. Employment may be seasonal in nature. Interested students will need to be comfortable working as part of a team. Students will need to have their work critiqued as part of the job process. The ability to accept and utilize critique and feedback will be important for the successful student. Students must be willing and able to work with employment staff to identify existing skills and skills in need of improvement. All classes will be held at the Lynn Campus of NSCC as well as designated community sites. Physical Standards that the Student must be able to do ALL of the time: GRASP: Horticultural hand tools and writing implements. LIFT AND CARRY: Up to 50 pounds. HANDLE: Sharp hand tools such as: hand pruners, trowels, shovels, rakes and edgers with precision. TALK: SEE: READ: WRITE: To communicate in English while seeking support or providing feedback. To communicate in English when working with customers/clients. Visual precision required while mowing, trimming and edging. Typed, handwritten, computer information in English on precautions and instruction for use of equipment, tools, company vehicles and job behavior. In work journal or log to record activities performed on the job. Record and report any customer communications to supervisor. TRAVEL: In company truck or other company vehicle from jobsite to jobsite. WORK: Outdoors where you may encounter insects, small animals or pets belonging to the customers/clients.

9 Physical Standards that the Student must be able to do MOST of the time: STAND: While working. STOOP/BEND AT WAIST: While working. STRENGTH: HANDLE: WORK: Physical strength of arms and legs needed to use mowers, string trimmers and edgers. Small power equipment including leaf blowers, string trimmers and gas powered mowers of various sizes must be handled with safety and precision. Outdoors in inclimate weather, such as heat, rain, cold. Mental/Attitudinal Standards that the Student must adhere to ALL of the time: Be timely and consistent in work attendance. Dress appropriately for the job. This would include dressing for weather, wearing work boots and work gloves. Function safely, effectively, and calmly, especially while learning tasks and skills/concepts that may be new. Exhibit social skills necessary to interact effectively with co-workers and mentors of the same or different cultures; such as respect, politeness, teamwork and tact. Maintain composure while accepting critiques and feedback regarding personal work. Applicants who are offered admission must document their ability to perform all essential tasks with or without reasonable accommodation in order to begin the professional courses. If you are an otherwise qualified individual with a disability who seeks a reasonable accommodation, you need to contact the Office of Disability Services for eligibility determination for reasonable accommodation(s). I have reviewed and understand all of the above policies/guidelines regarding the Horticulture Program. Print your full name Signature date date

10 Recommendation Form Recommendation Form for. The individual named above has applied for admission into the College and Career Access Project (CCAP) at North Shore Community College. CCAP is a full-time non-credit vocational education program for young people with intellectual, developmental, and learning disabilities. Students apply to a specific vocational track. This student has applied to the program of study. Please review the requirements for this program of study before completing the recommendation. Requirements can be found at: Individuals accepted into the program will be those who are eager and motivated to develop or refine the abilities necessary to succeed in integrated work environments. The applicant must demonstrate the emotional maturity to function independently in a community college setting and work setting, and have the ability to work with peers and instructors with minimal supervision. With this information in mind please answer the following questions. Your assessment will assist the admissions team in determining if the applicant is a good candidate for acceptance into. Please rate the applicant on the following characteristics on a scale of one to five in relation to his/her similar age peers. Key: 5 = exceeds expectations 4 = above expectations most of the time 3 = average, same as peers 2 = sometimes demonstrates this quality but not consistently 1 = seldom or never demonstrates this quality Motivation to do well Able to work independently Able to work with peers Able to work with teachers/work supervisors Reliability and dependability Social interaction with others Open to learn new things

11 Recommendation Form (cont.) In the space provided or on a separate sheet of paper please comment or expand upon the applicant s abilities and how you feel he/she will do in the CCAP program. Name Title Relationship to the Applicant Length of time Known Organization Phone Signature Date Please return completed form to: North Shore Community College 1 Ferncroft Road/ P.O. Box 3340 Danvers, MA

12 Recommendation Form Recommendation Form for. The individual named above has applied for admission into the College and Career Access Project (CCAP) at North Shore Community College. CCAP is a full-time non-credit vocational education program for young people with intellectual, developmental, and learning disabilities. Students apply to a specific vocational track. This student has applied to the program of study. Please review the requirements for this program of study before completing the recommendation. Requirements can be found at: Individuals accepted into the program will be those who are eager and motivated to develop or refine the abilities necessary to succeed in integrated work environments. The applicant must demonstrate the emotional maturity to function independently in a community college setting and work setting, and have the ability to work with peers and instructors with minimal supervision. With this information in mind please answer the following questions. Your assessment will assist the admissions team in determining if the applicant is a good candidate for acceptance into. Please rate the applicant on the following characteristics on a scale of one to five in relation to his/her similar age peers. Key: 5 = exceeds expectations 4 = above expectations most of the time 3 = average, same as peers 2 = sometimes demonstrates this quality but not consistently 1 = seldom or never demonstrates this quality Motivation to do well Able to work independently Able to work with peers Able to work with teachers/work supervisors Reliability and dependability Social interaction with others Open to learn new things

13 Recommendation Form (cont.) In the space provided or on a separate sheet of paper please comment or expand upon the applicant s abilities and how you feel he/she will do in the CCAP program. Name Title Relationship to the Applicant Length of time Known Organization Phone Signature Date Please return completed form to: North Shore Community College 1 Ferncroft Road/ P.O. Box 3340 Danvers, MA

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