Application Overview Police Academy

Transcription

1 Application Overview Police Academy Dear Police Recruit Applicant, Thank you for your interest in attending our 28th Basic Course for Police to be conducted April 2016 March 2017 through our Rural Police Training Academy. Please carefully review the materials, forms and requirements contained in your RPTA application packet. It is important that you understand and submit all required documentation and payments prior to the start of classes. The class is filled in the order completed applications are received. Several critical items to assist you in your enrollment decision and application are noted here. Tuition for the Police Academy is $3,950. A $350, non-refundable fee is submitted with your completed application. The tuition balance of $3,600 must be paid in full prior to the start of the first class. The college does not offer loan or payment plans. Also VA, TAP or PELL funding you may be eligible for may not be applied to defer your tuition payment. Cash, check, money order or credit card payments are accepted and payable to GCC. Tuition includes texts. Uniforms, firearms and range ammunition are the responsibility of sponsoring Departments and/or individual recruits. Veterans and Financial Aid questions should be directed to the Financial Aid Office, ext Recruits are encouraged to take advantage of the Credit Option, providing permanent transferable college credits. Sworn recruits can earn up to 22 college credits and Pre- Employment recruits may earn 16 credits. No additional fees are required. Enrollments are distributed over summer and fall terms enabling eligible recruits to receive both TAP and PELL grants. If you select the credit option, complete items A & B below. Two Certificates of Residency must be secured from your County Clerk s office. The first should be secured after March 15, 2016 and submitted to the College by April 15, The second Certificate should be secured after July 1, 2016 and submitted by August 1, (Please check your county s requirements. Some counties require that you apply in person at the Clerk s office.) You must provide proof of your Immunizations. Refer to the requirements based on your age. If your records are not available, you may be required to receive a current vaccination. Please consult our Health Office with any questions at Ext If you have any questions regarding the Police course please contact Doug Brooks at rpolice@genesee.edu. For enrollment requirement questions please contact The BEST Center directly at We look forward to your training with us and establishing your new career as a police officer. Sincerely, Douglas C. Brooks Director Rural Police Training Academy

2 Required Forms & Special Notices Application Checklist Dear Police Recruit Applicant: Thank you for your interest in our Rural Police Training Academy Basic Course for Police or Pre-Employment Basic. The academy begins April of each year and ends the following March. Classes meet Tuesdays and Thursdays from 6:30 p.m.-10:30 p.m. and Saturdays, 8:00 a.m.-5:00 p.m, as well as a number of Wednesdays throughout the year. Tuition (which includes all texts) is $3,950. A $350 non-refundable deposit must accompany your paperwork and should be submitted as soon as possible to reserve a spot in the next academy. Recruit Name: Phone Cell: Home: Address: The $350 deposit, this checklist and the following completed forms should be enclosed and mailed to: RPTA, GENESEE COMMUNITY COLLEGE, ONE COLLEGE ROAD, BATAVIA, NY 14020, ATTN: D. Brooks Basic Course. Recruit Information Form Health Evaluation Form Physical Evaluation Form **Sworn ONLY Police Officer Certification of Initial Employment **Pre-Employment ONLY Pre-Employment Student Advisory Notice Agreement to Conduct Code Credit Confirmation Request Application Acknowledgement **Pre-Employment ONLY Background Investigation Waiver Certificate of Residence (secured after March 15) GCC Health Center Form GCC Health History Form GCC Health Insurance Form GCC Application (Check Summer 2015) **Pre-Employment ONLY Reference letter from Chief/Sheriff in your community or county to support your application Included for your information are Physical Fitness Training Standards Form,Veterans Education Benefits, Immunization Documentation Instructions and the College Credit Options. It is imperative that you complete this paperwork ASAP, by March 1, if possible (MAXIMUM CLASS SIZE: 27). Tuition must be paid in full by the time the class begins. Minimum age is 19 to insure that the candidate reaches the age of 21 in the two-year period that the Pre-Employment certificate is valid. No maximum age for admission, as long as the candidate can pass all entrance and exit physical testing requirements. No criminal history whatsoever. A background investigation will be conducted by the Rural Police Training Academy. A mandatory physical fitness agility pre-test is scheduled for a Saturday in April. Sneakers, shorts, sweats, etc. are required for this day. You must meet the minimum requirements as per Physical Fitness Training Standards form (enclosed) or you will NOT be allowed to enter the Basic Course. You will be placed on a preferred list for the next class. If you are denied access to this course due to class size, but otherwise complete all the required paperwork properly, your deposit will be returned to you and your name will be placed on a preferred list for the next Basic Course. If you have any questions, please call Douglas Brooks at ext or use rpolice@genesee.edu. Thank you for your interest and we hope you will give us this opportunity to serve your educational needs. Sincerely, Douglas C. Brooks, Director Rural Police Training Academy

3 GENESEE COMMUNITY COLLEGE Basic Course for Police Recruit Information Form Social Security No. Date of Birth M or F Last Name First Name MI Home Address City State Zip Code Home/Cell Phone Work Phone Address Department Information: Department Date of Hire Department Head Address Department Phone Explain briefly your police or military experience: Would you like to volunteer to be a Class Team Leader for the Basic Course (circle one)? YES NO

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5 Part 6000 Medical and Physical Fitness Standards and Procedures for Police Officer Candidates Page -12 & 13- (b) Elements of the test battery. Elements of the test battery to be used for physical fitness screening are described below. Although these elements may not be directly representative of essential job functions to be performed by an entry-level police officer, such elements do measure the candidate's physiological capacity to learn and perform the essential job functions. The minimum scores for employment as an entry-level police officer as set forth below represent the 40th percentile of fitness. If a candidate does not successfully score to the 40th percentile of fitness for each of the elements of the test battery, the candidate shall not be deemed to have successfully completed the physical fitness screening test. Nothing herein shall preclude an administrator of such screening test from substituting an element of the test battery, which such administrator has determined and validated to accurately assess the candidate s physiological capacity to learn and perform essential job functions. The 1.5 mile run shall only be administered to such individuals who have successfully completed each of the other two elements of the test battery (sit-up and push-up). Sit-up Muscular endurance (core body) - The score indicated below is the number of bent-leg situps performed in one minute. Push-up Muscular endurance (upper body) - The score below is the number of full body repetitions that a candidate must complete without breaks. 1.5 Mile Run Cardiovascular capacity - The (time) score indicated below is calculated in minutes:seconds. (emphasis added) Age: Gender Test Age Sit Up Push Up 1.5 Mile Run Males : : : : :46 Females : : : : :16 Version 2011 (9/14/2011)

6 RURAL POLICE TRAINING ACADEMY Health Evaluation Last Name First Middle Social Security No. Date of Birth Address (permanent) City State Zip Phone Address (work) Department City State Zip Phone Person to be notified in case of emergency Relation Phone Address Do you have a personal physician? Address Phone Are you presently receiving medical or mental health services? No Yes If yes, please specify: Do you have any chronic diseases or disabilities? No Yes If yes, please specify: Do you take any medication? No Yes If yes, please list: Do you have any allergies? No Yes If yes, please specify: Do you have any health problems that would prevent you from participating in P.T. education? No Yes If yes, please specify: Do you have any health problems that your instructors should know about? No Yes If yes, please specify: Do you consider your health: Excellent Good Fair Poor The foregoing information is accurate to the best of my knowledge. Signature Date

7 PHYSICAL EVALUATION FORM Rural Police Training Academy Genesee Community College One College Rd Batavia NY (585) Ext PHYSICAL FITNESS STANDARDS FOR BASIC COURSE FOR POLICE RECRUIT TRAINING CLASS The attached Physical Fitness Standards are required of each Recruit Police Officer attending the Basic Police Training Course at the RPTA. Each Recruit Police Officer will be performing these types of exercises at various times during the course. Additionally, Recruit Police Officers will be required to participate in other strenuous group exercises and activities. Using the Physical Fitness Standards as a guide, please evaluate the Recruit Police Officer s physical well being and ability to perform strenuous physical exercises. I have examined Recruit Police Officer. (Full Name-Printed Clearly or Typed) This person IS IS NOT (Circle the correct response) physically able to participate in all of the strenuous physical exercises noted above and on the attached Physical Fitness Standard s sheet. Physician s Name Physician s Address Physician s Signature (Original No Stamp) Date This form is to be returned to the RPTA by the Recruit Officer with all registration materials.

8 SPECIAL NOTICE VETERANS EDUCATIONAL BENEFITS The RPTA s Basic Course for Police is approved by the New York State Division of Veterans Affairs for the training of veterans and other eligible persons. Veterans, individuals serving in the Reserves or National Guard, and surviving spouses or dependents of deceased or disabled veterans may be eligible for VA Educational Benefits for enrollment in the Basic Course for Police. If you believe you may qualify, complete and submit a VA application NOW! Certification can be obtained 120 days prior to the start of the educational program. For assistance and VA application forms call GCC Financial Aid Office directly at Ext Do not delay. Apply now to ensure timely processing of the benefits you may be entitled for this training program.

9 New York State Division of Criminal Justice Services POLICE OFFICER REGISTRY ENTRY FORM - CERTIFICATION OF INITIAL EMPLOYMENT (Executive Law 845) THIS FORM IS USED TO REGISTER A POLICE OFFICER WITH THE DIVISION OF CRIMINAL JUSTICE SERVICES. USE THIS FORM FOR ALL INITIAL APPOINTMENTS AND TRANSFERS. FORMS PRESENTED FOR FILING MUST CONTAIN ORIGINAL SIGNATURES. ALTHOUGH THE BLANK FORM MAY BE DUPLICATED, PHOTOCOPIES OF COMPLETED FORMS, OR FORMS WITH PHOTOCOPIED SIGNATURES WILL NOT BE ACCEPTED. Pursuant to Executive Law 845, police officer employers are required to register police officers with the Division of Criminal Justice Services (DCJS). DCJS uses the police registry to determine an individual s eligibility to receive a police training certificate, and for other lawful purposes. DCJS reserves the right to require further documentation as necessary to properly classify a registrant. The information provided may be added to the registry and made available pursuant to law. SECTION I: REGISTRANT INFORMATION This section must be completed by the police officer registrant. Only individuals appointed to positions defined in Criminal Procedure Law 1.20(34) are eligible for registration. If you were previously employed as a police officer in the State of New York, please circle Yes then proceed with completing the remainder of Section I. Officers previously employed as police officers in the State of New York who possess a valid certificate of completion for a Municipal Police Training Council approved Basic Course for Police Officers are not required by law or regulation to repeat police basic training. Validity of a certificate of completion is governed by General Municipal Law 209-q. This does not preclude an employer from requiring any appointee to attend police basic training. Type or print legibly, the registrant s last name, first name, middle initial, date of birth, gender and Social Security Number. Enter the home mailing address, county of residence, home street address (if different) of the registrant. Temporary addresses are not acceptable. If the registrant is temporarily living away from home (e.g. enrolled at a college or university, on military assignment, etc.) DO NOT list the temporary address. Enter the registrant s city/state/country of birth (if other than U.S.). Registrants not born in the United States MUST include a certified copy of one of the following: (1) naturalization papers; (2) Department of State Birth certificate; or (3) currently valid United States Passport. Carefully read the certification. Sign and date in the area provided. Incomplete submissions will not be processed. Pursuant to the New York State Personal Privacy Protection Law, DCJS is authorized to collect personal identifying information as part of a public safety agency record. Personal identifying information on this form shall not be revealed, released, transferred, disseminated or otherwise communicated orally, in writing, or by electronic means other than to the registrant. Disclosure of personal identifying information is voluntary, and refusal to provide personal identifying information shall not result in the denial of any right, benefit, or privilege. SECTION II: AGENCY INFORMATION Unless a written agreement is on file with DCJS, this section must be completed by the Chief Law Enforcement Officer (Chief, Sheriff, Director) of the appointing authority. The Executive Law mandates that all police officers must be registered with the Division of Criminal Justice Services. The information in Section II identifies the law enforcement agency with which the registrant is a police officer. Type, or print legibly, the chief law enforcement officer s last name, first name, middle initial and title. Enter the name, telephone number (including area code) and address of the law enforcement agency. Indicate whether the appointment is full-time or part-time, whether background and residency checks were conducted, and if fingerprints were submitted to DCJS. Carefully read the certification. Sign and date in the area provided. All the information in Section II is required. When signing this section, the CEO is verifying their responsibility to COPYRIGHT 2007 NEW YORK STATE DIVISION OF CRIMINAL JUSTICE SERVICES (JAN 2013) DCJS 2214-A

10 New York State Division of Criminal Justice Services POLICE OFFICER REGISTRY ENTRY FORM - CERTIFICATION OF INITIAL EMPLOYMENT (Executive Law 845) provide the registrant with the requisite basic training pursuant to General Municipal Law 209-q. Incomplete submissions will not be processed. SECTION III: CIVIL SERVICE INFORMATION The appropriate civil service commission officer must complete this section for all registrants, both full and part time. Civil Service Law mandates that the appointment of officers to the police force of a police department or police district must meet certain requirements. The information in Section III describes the registrant s appointment. Type or print legibly, the civil service officer s last name, first name, middle initial and title. Enter the name, telephone number (including area code) and address of the civil service commission. Enter the job title and civil service classification of the person named in Section I. This should be the specific title/classification to which the registrant was appointed and that appears on the agency payroll. Carefully read the certification. Sign and date in the area provided. The information in Section III is required. Incomplete submissions will not be processed. SECTION IV: OATH OF OFFICE This section must be completed by the appropriate registrar/recorder of oaths of office. The Public Officers Law mandates that every officer take and file an oath of office. The Information in Section IV indicates the date the oath was taken by the registrant, the place of filing, and title of the office. Type or print legibly, the registrar/recording officer s last name, first name, middle initial and title. Enter the name, telephone number (including area code) and address of the registrar s/recorder s office. Enter the date the person named in Section I took and filed the oath of office for the position to which he or she was appointed with the agency named in Section II. Indicate the title of the office to which the registrant was sworn (e.g. police officer, deputy sheriff, etc). The oath of office date is the date recorded by DCJS as the appointment date of the officer. Carefully read the certification. Sign and date in the area provided. The information in Section IV is required. Incomplete submissions will not be processed. MAILING INSTRUCTIONS Mail completed forms to: NYS Division of Criminal Justice Services Alfred E. Smith State Office Building Office of Public Safety Records Unit 80 South Swan St., 3rd Floor Albany, NY QUESTIONS If you have any questions regarding this form, call (518) for assistance. COPYRIGHT 2007 NEW YORK STATE DIVISION OF CRIMINAL JUSTICE SERVICES (JAN 2013) DCJS 2214-A

11 New York State Division of Criminal Justice Services POLICE OFFICER REGISTRY ENTRY FORM - CERTIFICATION OF INITIAL EMPLOYMENT (Executive Law 845) SECTION I REGISTRANT INFORMATION (To be completed by the registrant) Were you previously a police officer in NYS? Yes No Last Name First Name MI Date of Birth Gender M F Social Security Number* Home Residence Mailing Address City, State, Zip County of Home Residence Police Officer as defined by NYS Criminal Procedure Law Home Residence Street Address (if Different) City, State, Zip City, State, Country of birth (if other than U.S.) I am the person named above. I understand that the information in Section I is part of a written statement that will be presented to the Division of Criminal Justice Services for filing, and I certify that it is true to the best of my knowledge and belief. Signature Date *Pursuant to the New York State Personal Privacy Protection Law, DCJS is authorized to collect personal identifying information as part of a public safety agency record. Personal identifying information on this form shall not be revealed, released, transferred, disseminated or otherwise communicated orally, in writing, or by electronic means other than to the registrant. Disclosure of personal identifying information is voluntary. Refusal to provide personal identifying information shall not result in the denial of any right, benefit, or privilege. SECTION II AGENCY INFORMATION (To be completed by the chief law enforcement officer) Last Name First Name MI Title of Person Signing Section II Name of Law Enforcement Agency Telephone Address City, State, ZIP Type of Appointment Full-time Part-time Background Check Conducted Yes No Residency Verified Yes No Fingerprints submitted to DCJS Yes No I am the chief law enforcement officer responsible for appointing the person named in Section I as a police officer of the above named law enforcement agency. I understand that the information in Section II is part of a written statement that will be presented to the Division of Criminal Justice Services for filing, and I certify that it is true to the best of my knowledge and belief. I understand I am responsible for providing the registrant with the requisite training pursuant to 209-q of the General Municipal Law. Signature Date SECTION III CIVIL SERVICE INFORMATION (To be completed by the civil service officer for all registrants Full or Part-time) Last Name First Name MI Title of Person Signing Section III Name of Civil Service or Personnel Agency Telephone Address City, State, ZIP Title and Civil Service Classification of the Registrant I am the civil service officer responsible for certifying the appointment of individuals appearing on the payroll of the law enforcement agency named in Section II. I understand that the information in Section III is part of a written statement that will be presented to the Division of Criminal Justice Services for filing, and I certify that it is true to the best of my knowledge and belief. Signature Date SECTION IV OATH OF OFFICE (To be completed by the registrar responsible for recording oaths of office) Last Name First Name MI Title of Person Signing Section IV Name of Recording Office Telephone Address City, State, ZIP Oath of Office Date Oath of Office Title of the Registrant I am the officer responsible for recording the oaths of office of individuals appointed as police officers of the law enforcement agency named in Section II. The person named in Section I has filed an oath of office as a police officer, pursuant to an appointment received from the person named in Section II. I understand that the information in Section IV is part of a written statement that will be presented to the Division of Criminal Justice Services for filing, and I certify that it is true to the best of my knowledge and belief. Signature Date COPYRIGHT 2007 NEW YORK STATE DIVISION OF CRIMINAL JUSTICE SERVICES (JAN 2013) DCJS 2214-A

12 Rural Police Training Academy Agreement to Conduct Code Illegal Drugs and Motor Vehicle Inspections 1. Attending class sessions under the influence of alcohol or illegal drugs: If suspected of being under the influence of alcohol or illegal drugs (obvious scent of alcoholic beverages on breath or from person, abnormal behavior, odor indicating recent use of Marijuana, etc.), the situation will be immediately investigated by a member of the RPTA Staff (Director, Asst. Director, Lead Counselor or Counselor). If necessary, the recruit under suspicion will be removed from class immediately and sent home, if so doing can be done safely. Once the investigation is complete, if the use of alcoholic beverage and/or illegal drug proves to be positive, that recruit will be immediately terminated from the Academy. 2. Inspection of Motor Vehicles while a Recruit in the Basic Course for Police/Pre- Employment: During the course of the Academy, there will be instances where a Recruit s vehicle will be inspected by Academy Staff for the purpose of pointing out and thereby preventing Vehicle and Traffic Law violations. While in any Police Academy and throughout an Officer s career, he/she should do the best job possible to obey all Laws while on and off duty, and in this case it would be the Vehicle and Traffic Law of the State of New York. An Officer can t very well expect others to obey the law and be able to enforce the law, while they (The Officer/Recruit) drives a vehicle with violations such as: Expired Inspection or Registration, improperly tinted windows, unsafe tires or inoperative headlights, tail lights, brake lights, turn signals etc. With this in mind, the Recruit should be prepared to have their vehicles inspected by Academy Staff, generally unannounced, at any time deemed necessary throughout the length of the course. In submitting my application for the Rural Police Training Academy Basic Course for Police/Pre- Employment I confirm that I have read the Paragraph 1 & 2 explained above. Further, I understand and accept the consequences of Paragraph 1 and I give permission for my vehicle (or any such vehicle I am driving) to be Inspected by Academy Staff as per Paragraph 2. Print Name Date Signature Print name, sign and submit with completed application packet.

13 RPTA BASIC COURSE FOR POLICE Recruit Credit Confirmation Request I,, understand that I may be registered for and receive up to 16 credit hours as a Pre-Employment Recruit or up to 22 credit hours as a Sworn Recruit in the following Criminal Justice and Health/PED courses as part of my participation in the RPTA Basic Course for Police. I also understand that my decision to be eligible for enrollment must be confirmed, and all required college application, high school/ged diploma, proof of immunization and certificate of residency forms must be submitted with my RPTA Application. I understand that I may be ineligible for this college credit option if I do not submit these documents by the start of the Academy. I confirm my decision to accept/decline the credit option as checked below: Accept Decline Credit Hours Course Title 3 CRJ101 Intro to Criminal Justice 3 CRJ110 Legal Aspects in Criminal Justice 3 CRJ112 Police 3 CRJ206 Criminal Investigation 3 *CRJ222 Field Studies in Law Enforcement 3 *CRJ121 Firearms 3 HED205 Responding to Emergencies 1 PED132 Beginning Karate Total Credit Hours Accepted & Declined NOTE: *CRJ222 and CRJ160 require Sworn Certification by a Chief or Sheriff I am applying for TAP/PELL grants: Yes No I am applying for VA benefits: Yes No Recruit Signature Confirming Academy Official Date Date

14 RPTA BASIC COURSE FOR POLICE COLLEGE CREDIT OPTION Please review these instructions for the COLLEGE CREDIT OPTION available at no additional cost through the Basic Course for Police program. Recruits may also qualify for and receive TAP or PELL grant aid or apply for student loans. The credit option is only available at the start of the Basic Police Course. Sponsored Recruits are eligible for a maximum of 22 credit hours and Pre-Employment Recruits are eligible for a maximum of 16 credit hours. Action 1. Complete the Credit Confirmation Request form. (If no hours desired, state 0 Totals Hours Requested, sign and date.) Action 2. Complete the GCC **Application for Admission. Check Summer 2016 Term. Action 3. Secure an official copy of your High School Transcript or GED Certificate. Action 4. Review and submit Proof of Immunizations per attached materials. Those who fail to comply with these New York State laws will be prohibited from attending classes. Contact the Health Office (585) or fax number (585) with any questions. Action 5. File an online *FAFSA application(s) if seeking TAP and PELL financial Aid. Action 6. Return #1-4 with your completed RPTA Application Packet. Action 7. Secure and submit after March 15 th a Certificate of Residency from your County Treasurer s office. (An application form is provided. Note: your County may require presenting applications in person at the Treasurer s Office). *Recruits who believe they are eligible for and are applying for TAP and PELL financial aid must immediately file FAFSA applications for BOTH the and the academic years. (Recruits who filed a FAFSA AND were enrolled in college courses during the spring 2016 term do not have to re-file a FAFSA). Go to to file online. You will also need to secure a pin number for yourself, which you can do at **Recruits applying for financial aid must also check seeking a degree on the GCC Application Considerations for taking for credit: *If you are a GCC student who has already earned credit in any of the credit courses available through this RPTA Credit Option program, it may be an opportunity to raise one s final grade. *If you do not have a college degree it is an opportunity to secure these credits for use now or in the future at GCC or another college. It is highly recommended that the courses be taken for credit, even if you are not currently interested in a degree. In previous academies, some recruits passed on this opportunity only to come back after they are on the job, seeking advancement and needing the credentials- but it is too late! *If you have a college degree, but did not take these courses, enrolling now is an easy way to enhance your qualifications/experience. *Courses taken for credit are awarded a grade (A-F) which is entered on one s permanent transcript and can be transferred to other college credit programs or document learning for job applications or promotions. Contact The BEST Center with questions or for assistance regarding the Credit Option. For Financial Aid or Veterans Benefits, call the Financial Aid Office at Ext

15 Genesee Community College Rural Police Training Academy Basic Course for Police Pre-Employment & Sworn Recruit Application Acknowledgment The Basic Course for Police is presented in accordance with provisions of the New York State Bureau of Criminal Justice Services (DCJS). It is imperative that all recruit applicants are fully informed and agree to perform all College and DCJS program requirements. The requirements include: Time Commitment Be prompt and prepared to attend all training sessions: General Class schedule Tuesday and Thursday evenings, 6:30-10:30 p.m. and Saturdays, 8:00 a.m. to 5:00 p.m. (with a number of additional Wednesday evenings). Absences cannot exceed 10% of the total class hours. No excuses allowed for Mandatory Topics classes: Firearms, Article 35, Physical Agility/Arrest Techniques, Domestic Violence, Ethics, and Radar/Lidar. Tuition Commitment Tuition down payment $350 submitted with completed application packet. Full tuition balance $3,600 paid in advance of first class session. Uniform, Firearm and Ammunition Commitment Pre-Employments Uniform, leather gear ($1,000 est.) Sworn Recruits Uniform, leather gear, weapon ammunition ($2,000 est.) In submitting my application the Rural Police Training Academy Basic Course for Police and Pre-Employment, I confirm that I have read, accept and am prepared to fulfill the obligations listed above. Print Name Date Signature Print name, sign and submit with completed application packet.

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24 Genesee Community College Campus Mandates, Policies, Reports, and Related Consumer Information Genesee Community College shall comply with all state and federal mandates. The vice president for student and enrollment services and the vice president for human resources and planning shall be responsible for the publication and dissemination of information related to such mandates, with the cooperation of the director of institutional research; the director of intercollegiate athletics; the senior campus security officer; and other Genesee Community College personnel as may be needed to provide timely and accurate information. Early in the fall of each year (or other such deadline as is established by legislation), Genesee Community College shall publish a document under the title, Student Rights and Responsibilities Handbook. This single document shall contain all information related to compliance with all legislation and any new amendments and similar compliance legislation enacted subsequent to the establishment of this policy. This document shall also be posted on the Genesee Community College website. Genesee Community College shall notify in writing every prospective student and employee of the College regarding the availability of this information in printed and electronic form, and shall, in the same notification, provide instruction on how copies of this information may be obtained. Genesee Community College shall electronically notify, every current student, faculty member, and staff member of the College of the availability of this information in printed and electronic form, and shall, in the same notification, provide instruction on how copies of this information may be obtained. Gender equity information shall also be made available on request to parents and coaches of high school athletes. The Student Rights and Responsibilities Handbook contains information on a wide range of College policies and procedures (drug and alcohol abuse prevention, drug-free workplace, bias crimes, directory information, nondiscrimination, smoking, sexual assault, and sexual harassment), consumer information regarding student financial assistance and tuition liability, refund, and repayment of Title IV funds policies, and graduation and completion rates. Information regarding the Family Educational Rights and Privacy Act (FERPA) are included along with the most recent Cleary Act and Equity in Athletics Disclosure Act (EADA) reports. Additional information about Genesee Community College is available through numerous publications including, but not limited to, the College catalog and our website ( request a copy of any Genesee Community College publication, please write or call: Genesee Community College Vice President for Student and Enrollment Services One College Road Batavia, NY (585)

25 FREE APPLICATION FOR ADMISSION Complete and mail this form and transcripts to: Genesee Community College, Admissions Office, 1 College Rd., Batavia, NY A PERSONAL INFORMATION 1 Social Security # 2 Name last first middle initial 3 Birth name last first middle initial 4 Mailing address street apartment # city state ZIP code 5 Permanent address check here if same as mailing address street apartment # city state ZIP code 6 County of residence 7 Home phone # 8 Cell phone # 9 address 10 Gender Male Female 11 Date of birth month day year 12 Are you a citizen of the United States? Yes No 13 Are you Hispanic/Latino? Yes No A If Hispanic/Latino, is your background (SELECT ONE): Central American Dominican Mexican Puerto Rican South American Other Hispanic/Latino 14 Is your race (select as many as apply): American Indian/Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Your response to questions 13 and 14 is voluntary and confidential. Self-disclosure of racial or ethnic information will not be used to evaluate your application. Refusal to provide such information will not subject the applicant to any adverse treatment. 15 Check here if your parent is a Genesee Community College graduate. 16 Have you been convicted of a felony or received a disciplinary dismissal from college? Yes No If you have a learning disability or handicapping condition that may require accommodation, you may call our Center for Academic Progress at or write to: CAP, Genesee Community College, 1 College Road, Batavia, NY Self-disclosure of disability information is solely voluntary. Such information will be kept confidential. Refusal to provide such information will not subject the applicant to any adverse treatment. B ADMISSIONS INFORMATION 17 In which semester and year do you wish to enroll? Fall Spring Summer Year 18 Will you enroll full-time or part-time? Full-time Part-time You cannot enroll full-time in summer. 19 Check here if you plan to seek a degree or certificate from Genesee. Students not seeking a degree or certificate are not eligible for financial aid /12

26 B ADMISSIONS INFORMATION (CONTINUED) 20 If you checked the box in 19, please enter the code associated with the program that you wish to pursue. Refer to back page to see a list of programs or enter the code for General Studies if undecided. If you are applying for admission into a restricted program, such as Nursing (including LPN to RN), Physical Therapist Asst., Respiratory Care, Paralegal, Veterinary Tech., Polysomnographic Tech., or Engineering Science, please be aware there are additional admissions requirements beyond completing an application. 21 If major has a concentration, list code. Refer to back page to see a list of concentrations. 22 If you answered Nursing to 20, are you a licensed practical nurse? Yes No 23 Do you intend to enroll in one of GCC s distance learning programs? Yes No I m not sure Refer to back page for programs marked * - available online. 24 List the codes for all activities in which you have participated in. Refer to back page for a list of activities and codes. 25 In case of emergency, notify: Name last 26 Emergency contact s phone # HIGH SCHOOL INFORMATION first Applicants must have an official high school transcript sent to the Admissions Office. GED recipients must send a copy of their equivalency scores. 27 In which month and year did you (or will you) graduate? month year 28 Which type of high school diploma did you (or will you) earn? Regents Advanced Designation Regents Local Individualized Education Home School Out of State GED None 29 What is your high school CEEB code? Go to to find your high school s code. -If you are a GED recipient, please enter as your high school code. -If you graduated from an out-of-state high school, please enter as your high school code. -If your high school is located outside the U.S., please enter as your high school code. -If your high school code cannot be found, please enter as your high school code. -If you are a home schooled student, please enter as your high school code. High School Name (if CEEB code is unknown) COLLEGE INFORMATION 30 What is your college FICE code? Go to app/schoolsearch?locale=en_en to find your college s code. Transfer students must have official college transcripts sent to the Admissions Office. College Name If your college is located outside the U.S., please enter as your college code. -If your college code cannot be found, please enter as your college code. ANSWER QUESTIONS ONLY IF YOU ARE NOT A CITIZEN OF THE UNITED STATES 31 Country of citizenship 32 Are you a permanent United States resident? Yes No 33 If you answered Yes to 32, what is your alien registration number? # A 34 If you answered No to 32, indicate your visa type. B-2 F-1 H-4 J-1 A-2 Other (specify) Check F-1 if you need a student visa. By my signature below I attest that all information provided is accurate and complete. I understand that inaccurate or incomplete information may nullify my acceptance to Genesee Community College. 35 APPLICANT SIGNATURE 36 DATE 2 0 month day year

27 C IS TO BE COMPLETED BY YOUR HIGH SCHOOL COUNSELOR IF YOU ARE A HIGH SCHOOL STUDENT If you are under 21 and plan to enroll full-time, then your high school counselor must complete section C below and attach a final high school transcript to this application. If you are 21 or older or you do not plan to enroll full-time, then leave section C blank. 37 School name 38 If applicable, provide a brief statement regarding any matter of interest to the Admissions Committee Student s graduation date 40 Student s diploma type: Regents Advanced Designation Regents Local Individualized Education An Individualized Education diploma does not meet the requirement for admissions. 41 Counselor signature 42 Date month day year 2 0 What will happen after I apply? Good question. But first, take a minute to make sure that you ve filled out everything that you need to on the application form. Most importantly, don t forget to sign and date your application. Next, you may have noticed that the application is divided into sections A, B, and C. All applicants need to complete sections A and B. If you are a high school student, your counselor must fill out section C. Did you pick a major (called a program in question 20)? The two-year degrees we offer are listed on the back. Applicants must have an official high school transcript sent to our Admissions Office. If you hold a GED, you also must submit a copy of your equivalency scores. If you have not taken the ACT test, you must take Genesee Community College s Compass placement test, which is free of charge. The placement test can be taken at any campus location. GCC almost always uses the Compass placement test or ACT test for placement purposes. What about financial aid? Roughly eight out of 10 full-time students at Genesee receive financial aid. In fact, the College awarded more than $26 million in aid in Here are three tips to get you started on the financial aid process: File a Free Application for Federal Student Aid (FAFSA). For the fastest turnaround time, file electronically at fafsa.ed.gov. If you d prefer to file paper FAFSA, copies are available at our Financial Aid Office. Next, follow through with the paperwork you ll be sent after filing a FAFSA. You ll receive a Student Aid Report (SAR), which will be sent automatically to our Financial Aid Office if you have listed Genesee s SAR code (006782)on your FAFSA. If you are a New York state resident, then you also should receive information from the New York State Tuition Assistance Program (TAP) after your FAFSA is processed. Finally, apply for scholarships. We offer many awards that help qualified students afford school. Check them out online at genesee. edu/scholarships or call the Financial Aid Office at How will I know what to do next? With few exceptions, Genesee is an open-admission institution. We notify in writing all applicants who have been accepted. However, if your application is incomplete, you ll receive a checklist detailing what we need in order to move ahead. Sometimes we also call applicants to let them know about the status of their applications and to ask for documentation that we need. In the meantime, if you have any questions about the application process or would be interested in taking a tour of our campus or meeting some of the faculty, staff, and students, call our Admissions Office toll-free at CALL-GCC ( ) or check our open house schedule online at genesee.edu/openhouse. In accordance with federal regulations, the New York State Human Rights Law, Section 504 of the Rehabilitation Act of 1973, and the Americans With Disabilities Act, Genesee Community College does not discriminate on the basis of age, race, color, creed, gender, religion, marital status, veteran status, national origin, disability, or sexual orientation in educational programs, activities, admissions, or employment.

28 CODE PROGRAMS/MAJORS/ CONCENTRATIONS Accounting 730 -AAS 629 -AS 929 -CERT 726 Administrative Assistant (AAS) 260 Alcohol & Substance Abuse Studies (AS) 230 Biotechnology (AS) Business Administration *732 -AAS *771 -AS 679 Communications & Media Arts (AS) 210 Computer Information Systems (AS) 990 Computer Repair (CERTIFICATE) 505 Computer Support & Operations (AAS) 494 Computer Systems & Network Technologies (AAS) Computerized Drafting & Design 453 -AAS 953 -CERT Criminal Justice *640 -AAS *640P -Policing *640H -Homeland Security/Emergency Management *640C -Corrections Counseling *640F -Forensics *640G -General *240 -AS *920 -CERT 733 Customer Relationship Management (AAS) 904 Deaf Studies (CERTIFICATE) 908 Developmental Disabilities Studies (CERTIFICATE) 500 Digital Art (AAS) 906 Early Childhood (CERTIFICATE) 242 Economic Crime Investigation (AS) 530 Engineering Science (AS) Entrepreneurship *734 -AAS *994 -CERT 220 Environmental Studies (AS) 751 Fashion Merchandising Management (AAS) 751D -Fashion Design 751M -Fashion Merchandising 205 Fine Arts (AS) 428 Fitness & Recreation Sports Management (AAS) *985 General Education (CERTIFICATE) 905 Gerontology (CERTIFICATE) 907 Health Studies (CERTIFICATE) 996 Help Desk Support (CERTIFICATE) 975 Hospitality Management (CERTIFICATE) Human Services 605 -AAS 650 -AS *250 Liberal Arts & Science: General Studies (AS) *201 Liberal Arts & Science: Humanities & Social Science (AA) *201E -English/Literature/Humanities *201S -Social Science *201F -Foreign Language *201H -History/Political Science CODE PROGRAMS/MAJORS/ CONCENTRATIONS CONTINUED 224 Liberal Arts & Science: Math & Science (AS) 224G -General Math/Science 224C -Chemistry 270 Liberal Arts & Science: Sport Management (AS) *425 Liberal Arts & Science: Teacher Education (AS) 720 Medical Administrative Assistant (AAS) 927 Medical Office Assistant (CERTIFICATE) 987 Musical Theatre (CERTIFICATE) 621 Nursing (AAS) 937 Office Assistant (CERTIFICATE) 743 Paralegal Studies (AAS) 426 Physical Education Studies (AS) 623 Physical Therapist Assistant (AAS) 647 Polysomnographic Technology (AAS) 645 Respiratory Care (AAS) *932 Sales & Customer Service (CERTIFICATE) Teaching Assistant 470 -AAS 470D -Developmental Disabilities 470L -Learning Strategies and Technologies 470G -Generalist *925 -CERT 206 Theatre Arts (AA) 461 Theatre Technology (AAS) 738 Tourism & Hospitality Management (AAS) 235 Veterinary Technology (AAS) Web Design 493 -AAS 993 -CERT *Also available online as a Distance Learning program CODE ACTIVITIES HO MB MG ML MS SG SM SO SW TA WB WC WG WL WS WV Honors Program Men s Varsity Basketball Men s Golf Men s Lacrosse Men s Varsity Soccer Student Government Men s Swimming Women s Varsity Softball Women s Swimming Theatre Women s Varsity Basketball Cheer/Dance Team Women s Golf Women s Lacrosse Women s Varsity Soccer Women s Varsity Volleyball