Computed Tomography (CT) MoHealthWins funded courses

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1 3201 W. 16 th St. Sedalia, MO Applicant Information and Application Materials COMPUTED TOMOGRAPHY (CT) Computed Tomography (CT) MoHealthWins funded courses Applications being accepted now for the school year: Fall Semester: Wednesday, October 3 rd by 5:00 PM for priority enrollment This means all application materials must be received and date stamped in the MoHealthWins admissions office by 5:00 pm on October 3 rd to receive priority enrollment status. If you are mailing your materials, it is highly suggested you mail them one week prior to ensure timely arrival. Please return all application materials to: Kara Wheeler, Fielding 246 State Fair Community College 3201 West 16th St. Sedalia, MO Fax: (660) For Questions, contact Kara Wheeler at (660) or Ruth Ann Pfremmer at (660) State Fair Community College does not discriminate on the basis of race, color, national origin, sex, disability, religion, sexual orientation, veteran status, or age in its programs and activities or in employment. The following persons have been designated to handle inquiries regarding the nondiscrimination policy: Director of Human Resources, Hopkins Student Services Center, (660) , or Dean of Student and Academic Support Services, Hopkins Student Center, (660) The Hopkins Center is located on SFCC s Sedalia campus at 3201 W. 16 th St. Sedalia, MO Inquires also may be directed to the U.S Department of Education, Office of Civil Rights at

2 Dear Applicant: Thank you for your interest in State Fair Community College s Computed Tomography (CT) Courses. Students who choose to enroll in this/these courses are admitted to the college on the same basis as other students, but admission to the college does not ensure admission into the CT courses. These courses are a part of the MoHealthWins grant, which means eligibility requirements must be met for a student to enroll in any of these courses. To apply for the CT courses each applicant must complete the following items. Checklist of Required Materials begins here: Please check off as you complete each task. For your application to be considered, each bulleted item must be completed accurately. This checklist is provided for your benefit and should not be submitted with your application packet. Step One: Meet State Fair Community College Admission Procedures: (If you are currently attending SFCC you should have already completed the tasks listed in this section.) Submit a State Fair Community College application for admission form with application fee to: State Fair Community College, Student Services Office, 3201 W. 16 th Street, Sedalia, MO Step Two: Meet State Fair Community College CT (Computed Tomography) Course Procedures: Read through this entire application packet. o Complete eligibility form, located at the end of this packet and submit completed form to Kara Wheeler. Application materials received after cut off dates will be considered for the current semester if seats are available. If class is full application will be considered for the next available class offered. After each cutoff date, all complete applications will be evaluated. All incomplete packets will be considered ineligible. The first 12 students with complete applications, who meet the MoHealthWins eligibility requirements, will be invited to join the upcoming course. If student accepts, (s)he will be enrolled in the class by the MoHealthWins advisor. Didactic classes are limited to 12 students, clinical education is limited to 6 students. If class if full and more qualified individuals have applied, they will be placed on a waiting list and given first priority to the next course offered. All students who enroll in one or more CT courses as a part of the MoHealthWins grant will be required to enroll in Toolbox 2.0. You will be required to come to campus for an orientation day to complete this process and turn in necessary paperwork. Participant Guidance: MoHealthWins is required to serve a target population which includes Trade Adjustment Assistance eligible participants, unemployed participants, underemployed participants and low skilled participants. There is flexibility to include a broad spectrum of individuals (as participants) from varied socioeconomic backgrounds for training purposes.

3 Target Populations MoHealthWins training programs must give priority for training to the following target population participants: Trade Adjustment Assistance (TAA) An individual who has lost their job, through no fault of their own (due to lack of work), as a result of foreign trade. State merit staff (DOLR & DWD) administers this program and determines individual Trade eligibility. Unemployed An individual who has been terminated or laid off, or has received a notice of termination or layoff; employed at a facility at which the employer has made a general announcement the facility will close within 180 days; self-employed (including employment as a farmer, a rancher, or a fisherman) but unemployed as a result of general economic conditions or natural disasters; and a displaced homemaker. Underemployed An individual who is working part-time but desires full time employment, or is working in employment not commensurate with the individual s demonstrated level of educational and/or skill achievement. The local Workforce Investment Board negotiated average earnings target wage should be referenced to aid in eligibility determination. Low-Skilled An individual will be required to demonstrate college readiness for placement into college level coursework, (typically coursework numbered 100 level or above) as defined in the chart below. Individuals scoring below the designated cut-off score for any area will be defined as Low- Skilled for the purposes of MoHealthWins eligibility. All MoHealthWins participants will be assessed through the use of WorkKeys/NCRC assessment in each of the following areas: Applied Mathematics, Locating Information, and Reading for Information. Individuals scoring below a level 5 for any NCRC/WorkKeys area will be defined as Low-Skilled for the purposes of MoHealthWins eligibility. Other Grant Participant Specifications Veterans Priority The Jobs for Veterans Act (Pub. L ) requires priority of service to veterans and spouses of certain veterans for the receipt of employment, training, and placement services in any job training program directly funded, in whole or in part, by DOL. The regulations implementing this priority of service can be found at 20 CFR part1010. In circumstances where a grant recipient must choose between two qualified candidates for training or a service, one of whom is a veteran or eligible spouse, the Veterans Priority of Service provisions require that the grant recipient give the veteran or eligible spouse priority of service by admitting him or her into the training program or providing service. To obtain priority of service a veteran or spouse must meet the program s eligibility requirements. Grantees must comply with DOL guidance on veterans priority.

4 The community colleges have all agreed to a set of common cut-off scores. Such cut-off scores should serve as the starting point for the definition of "Low Skilled" for credit seeking participants. An entering student who is deficient in one or more areas will be defined as "Low Skilled". Missouri Community College Readiness Standards Missouri community colleges have developed a common standard for college readiness. All Missouri community college students will be required to demonstrate college readiness for placement into college level coursework (typically coursework numbered 100 level or above) as defined in the chart below using ACT scores as noted. Concordant scores in other placement tests, as indicated below, may also be used for students who do not present an ACT score. Point considered when determining common placement scores included: The adopted college readiness standard must be based on research and best practice. The standard must align with other placement testing tools. Consideration should be given to the approach other states took in adopting a statewide standard. In its review of ACT based college readiness materials and publications, and in consultation with ACT staff and researchers, community colleges believe these common core standards will promote student success, provide access to college and support student learning. These changes began in the Fall of The new testing scores are as follows: ACT COMPASS ASSET SAT Writing Critical Reading 450 Reading Critical Reading 460 Mathematics 23 Interm Test Math 460 Scores below these standards will result in development coursework. You may choose to enroll in one or more of the following Computed Tomography (CT) courses based on your needs. Students who have successfully completed the prior lower numbered course will be allowed to enroll in the next sequential course before new applicants may enroll. For example those students who have successfully completed RAD160 will be allowed to enroll in RAD162 before new applicants are allowed to enroll in RAD162. RAD160 CT Sectional Anatomy and Pathology (4 Cr Hrs) 2 nd 8 weeks fall semester 2012 RAD162 CT Physics and Instrumentation (3 Cr Hrs) 1 st 8 weeks spring semester 2013 RAD164 CT Imaging Procedures (3 Cr Hrs) 2 nd 8 weeks spring semester 2013 RAD166 CT Clinical Education (6 Cr Hrs) Summer semester 2013 RAD168 CT Registry Review (3 Cr Hrs) 2st 8 weeks fall semester 2013

5 For acceptance to RAD160, 162, and/or 164 you will be required to complete: 1. MoHealthWins eligibility form (last page of this application packet) 2. Applicant must be a registered technologist or registry eligible. Nuclear Medicine and Radiation Therapy certification will be reviewed on a case by case basis. 3. Second year radiology students attending an accredited radiology program are eligible if they currently have an overall GPA of 3.25 or above and a radiology GPA of 3.25 or above. For acceptance to RAD166 you will be required to complete: 1. MoHealthWins eligibility form (last page of this application packet - if you have previously completed this form, please disregard) 2. Provide documentation that student has passed ARRT registry in radiography and is in good standing. Nuclear Medicine and Radiation Therapy certification will be reviewed on case by case basis. 3. Provide documentation of the following immunizations: a. Three doses of Hepatitis B vaccine or documentation of having begun the series b. Two MMR immunizations since the age of 15 months c. DT/DPT within last 10 years d. PPD (TB skin test) within the nine months e. Chicken Pox (or documentation of having the disease) f. Other requirements required by the clinical site location. 4. Students must have a clear Criminal Background check from American Databank. 5. SFCC will make an inquiry to the Department of Social Services: Division of Aging to investigate whether the student is listed on the Employee Disqualification List as required by Section RsMo. 6. Students must pass the State of Missouri Caregiver Background Screening. 7. Students must undergo a drug screen and pass it before beginning training in a clinical site. For acceptance to RAD168 you will be required to: 1. Complete the MoHealthWins eligibility form (last page of this application packet - if you have previously completed this form, please disregard) 2. Provide documentation that student has passed ARRT registry in radiography and is in good standing. Nuclear Medicine and Radiation Therapy certification will be reviewed on case by case basis.

6 3. Submit a Clinical Experience Documentation form demonstrating you have met Computed Tomography Clinical Experience Requirements as listed in the ARRT Computed Tomography Certification Handbook. 4. Completed ARRT Computed Tomography registration form. 2x2 passport photo taken in July or August of year applying for this course must be taped to the application form. Notarization may be completed prior to submission or can be completed at SFCC if delivering this form in person. If you have questions, please feel free to contact us. Ruth Ann Pfremmer Radiologic Technology Program Director Phone: (660) Kara Wheeler Admissions and Advisement Specialist Phone: (660) SPECIAL SERVICES ACCOMMODATIONS: Students with disabilities who require special accommodations should contact the SFCC Access Office, located in Student Services, Hopkins Building, , at the beginning of the semester. If you have emergency medical information to share, or need special arrangements in case the building must be evacuated, please see instructor privately after class or make an appointment to meet with them. Please know that reasons for all disability services are confidential and will never be discussed with any instructor, student, or staff, without your written consent. Non-Discrimination/Accommodation Notice: State Fair Community College does not discriminate on the basis of race, color, national origin, sex, disability, religion, sexual orientation, veteran status, or age in its programs and activities or in employment. The following persons have been designated to handle inquiries regarding the nondiscrimination policy: Director of Human Resources, Hopkins Student Services Center, (660) , or Dean of Student and Academic Support Services, Hopkins Student Center, (660) The Hopkins Center is located on SFCC s Sedalia campus at 3201 W. 16th St. Sedalia, MO Inquires also may be directed to the U.S Department of Education, Office of Civil Rights at Accommodation Notice: Interested persons may obtain information as to the existence and location of services, activities and facilities at State Fair Community College that are accessible to and usable by persons with disabilities by contacting the Access Counselor, Student Services Office, Hopkins Student Services Center Room 751, SFCC, 3201 W. 16th Street Sedalia, MO , (660) Student Success Center: The mission of the Student Success Center is to work with you to help you define, clarify, and achieve your academic, personal, and professional goals. The Student Success Center connects students who are having difficulty in their courses with the support they may need to succeed. A number of support services are available at SFCC to help you achieve your educational goals. If you have questions or concerns about your ability to succeed during the semester, please do not hesitate to contact the Center at or or stop by Yeater 100.

7 Computed Tomography (CT) Fee Schedule The CT Courses are being offered through the MoHealthWins Grant, so all eligible participants will receive tuition for free. This does not include fees or additional expenses needed to complete the class. There will be expenses incurred in addition to class tuition and fees. While we have tried to be as thorough as possible, expenses may vary from the estimates listed. Student expenses not covered by grant Student savings covered by grant RAD 160 Book $ RAD160 $ In district $95 p/credit - 4 credit s $ Missouri $ resident $127 p/credit - 4 credit s $ Total for RAD160 $ Out of state $190 p/credit 4 credit s $ RAD162 Book $ RAD162 $ In district $95 p/credit - 3 credit s $ Missouri $90.00 resident $127 p/credit - 3 credit s $ Total for RAD162 $ Out of state $190 p/credit 3 credit s $ RAD164 book $ RAD164 $ In district $95 p/credit - 3 credit s $ Missouri $90.00 resident $127 p/credit - 3 credit s $ Total for RAD164 $ Out of state $190 p/credit 3 credit s $ RAD168 book $ RAD168 $ In district $95 p/credit - 3 credit s $ Missouri $90.00 resident $127 p/credit - 3 credit s $ ARRT Registry Fee $ Out of state $190 p/credit 3 credit s $ Total for RAD 168 $ RAD166 - CT Clinical Education RAD166 Uniforms $ In district $95 p/credit - 6 credit s $ Current Criminal Background Check $60.00 Missouri resident $127 p/credit - 6 credit s $ Drug Testing $26.00 Out of state $190 p/credit 6 credit s $ $ $ Total for RAD166 $636.00

8 Available Financial Aid Most of the estimated additional expenses above can be covered through any additional financial aid you receive through SFCC. Examples would be a Pell Grant, scholarships, loans, etc. Once your funding is depleted, all expenses left will be the responsibility of the student. IMPORTANT FINANCIAL AID INFORMATION FOR STUDENTS WITH AN ASSOCIATE OR HIGHER DEGREE Already having a degree impacts your eligibility for federal and state financial aid programs. This is especially true if you are planning on taking pre-requisite courses prior to being accepted into one of the allied health programs. If this is the case for you, please contact the Financial Aid Services Office. They will be more than happy to review your situation and discuss your options. ***Please complete the following page and , mail, or hand deliver to Kara Wheeler or Ruth Ann Pfremmer***

9 ELIGIBILITY FORM PLEASE PRINT (Some programs of study require a social security number in order to comply with Admission s background check and drug testing requirements.) Office Use Only Referral Source ABC Date Inst. Referral CSC Foundation Seminar Scholarship Recipient MoHealthWINs Other Office Use Only Data Entry Toolbox Date Master Spreadsheet Other File Date Today s date: STUDENT INFORMATION Last name: First: Middle: Birth date: Age: Gender: / / M F Street address: City: State, ZIP Code: Contact phone # : ( ) Social Security#: address: Ethnicity: Black, Non-Hispanic American Indian/Alaskan Native Asian/Pacific Hispanic White, Non- Hispanic Other Are you of Hispanic/Latino origin? Are you a US Citizen?, but work authorized MILITARY/DISABILITY/EMPLOYMENT/SCHOOL INFORMATION DISABILITY INFORMATION TAA/TRA INFORMATION Are you disabled? If yes, what percent? Are you eligible for TAA/TRA benefits? Are you currently employed? If no, do you receive Unemployment Benefits? EMPLOYMENT INFORMATION If yes, who is your employer? What is your occupation? What is your current monthly gross earnings? $ MILITARY INFORMATION Have you completed your Selective Service Registration? t Applicable Are you a US Military Veteran? Branch of Military Service From (dates) To (dates) Are You a Spouse to a Veteran? / / / / SCHOOL INFORMATION Are you currently attending State Fair Community College? Highest Educational Level Completed: Semester: Less than HS Diploma/ no GED Are you Full time or Part time? HS Diploma/GED FALL Some College, no degree Full Time (12 or more credit s for fall/spring, 6 or more credit SPRING s for summer) Completed AA/AAS degree SUMMER Bachelor s Degree Part Time (less than 12 for fall/spring, less than 6 for summer) Graduate Study above Bachelor s Year: Please check ALL classes interested in: RAD 160 RAD 162 RAD 164 RAD 166 RAD 168 This workforce solution was funded by a grant awarded by the U.S. Department of Labor s Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership.

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