2015 ANATOMY & PHYSIOLOGY I Online

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1 Attn: KPSAHS Applicants You can now apply to KPSAHS Anatomy and Physiology I (AP I) course online! This is an easy way for you to provide all of the information we need about you, your program(s) of interest, documents required for admission, and even a link to pay the application fee online. Please review the attached 5 page application and payment instructions below before completing the online application process. To get started: Visit https://www.mykpsahs.com/applicant/apply_login.aspx. If it s your first visit, click on the Create Account button on the far right of the screen. o Select Richmond as the campus of interest. o Enter your First and Last Name and Address. o You will be given your user name (write it down for future reference) and asked to create/enter your password and a PIN (any four digit number you will easily remember). o You will be taken to the first step of the application process. If you ve already started an application, simply login again using your username and password previously created, and you ll be taken to the step in the application process where you left off. In Step 1: Enter all required personal information. Note that you can also opt-in to receive text message communications from KPSAHS a great way to receive important updates from us. (Standard messaging rates may apply.) Click Save and Continue after each step. In Step 2: Enter additional information as required. In Step 3: For Degree: select Course Completion, Program: AP I,and Start Date: September 28, In Step 4: Skip this Step In Step 5: Skip this Step. In Step 6: You ll be able to review your completed application and make any edits. Once you re satisfied with the information you ve entered, you may print a copy for your records. Click Submit. In Step 7: You will be required to pay the $55 Application Fee. In Step 8: Submit your application. Tuition is due at the time you submit your application: Once you have submitted the online application. Please use the payment link provided below on page 5 to pay your program tuition. Be sure to use the link on page 5 to pay your tuition. Applications will not be considered until the application fee and tuition is paid and all required supporting documentation has been received by the KPSAHS Admissions Office. Please contact Admissions at (510) with any questions. A&P Application Form A rev: 10//06, 8/07, 11/07, 10/08, 02/09, 02/10, 10/10, 03/11, 06//07, 11/13, 9/14, 7/15

2 Registration: Please call to confirm seating availability by contacting Admissions at (510) Course space is limited to 30 students. All applicants must be at least 18 years of age to apply. The application process is outlined below: 1. Application A completed Application Packet includes the following: 1. Submitted online application. 2. $55 Application Fee. (The application fee for AP II will be waived if you successfully complete AP1). 3. $500 Course Tuition. 4. $278 Lab Materials (plus shipping and handling) Lab materials are purchased separately. 5. $175 Book Fees (books are purchased separately) Instructions for ordering book and lab materials will be provided during the enrollment process. 6. Official Sealed Transcripts: High School or GED. All foreign diplomas and documents must include an official notarized translation in English and be evaluated by a foreign transcript evaluation agency prior to submission. Photocopies are not accepted. Mail Official Transcripts to: Kaiser Permanente School of Allied Health Sciences Attn: Admission Department- Anatomy & Physiology I 938 Marina Way South, Richmond, CA No mailed applications will be accepted. 2. Completing the Enrollment Process Once Admissions has reviewed your online application the following must be completed to finalize your enrollment: 1. Submit Official Transcripts 2. Complete and sign the course Enrollment Agreement. 3. Submit the signed the Student Tuition Recovery Fund (STRF) Form (to be submitted with the signed enrollment agreement). 4. Purchase the required book and lab materials (instructions for purchasing lab materials will be provided once program enrollment has been confirmed). 5. Attend the Mandatory Orientation on Wednesday, September 23, 2015 at 7:00pm. 3. Required Equipment: To be successful in the KPSAHS online Anatomy and Physiology course a student should have the following resources available: Personal computer with Internet Access Adobe Acrobat Microsoft Office Suite Web Browser (e.g. Chrome v.40, Firefox v.36, Internet Explorer v.11, Safari v.8) Web Camera A&P Application Form A rev: 10//06, 8/07, 11/07, 10/08, 02/09, 02/10, 10/10, 03/11, 06//07, 02/12, 7/12, 11/13, 9/14, 7/15 2

3 Anatomy & Physiology I Program Dates* Quarter Course Registration Deadline (or class capacity of 30 students.) AP I Course Dates Orientation is on the first day of class Fall 2015 AP I September 4, 2015 Sept 28 Dec 18, 2015 Wed., Sept. 23, 2015 at 7pm *Attendance in the online Orientation is mandatory for course enrollment. Dates and hours are subject to change, all Holidays are observed Course schedule will be given to students on the first day of instruction. Schedule is subject to change. Anatomy & Physiology I Lecture/Lab Schedule** QUARTERLY LECTURE LAB TIMES SCHEDULE Monday& Thursday TIME Fall 2015 AP I 7:00pm 8:30pm Lab schedule will be given in the course syllabi. **A&P Labs schedules will be given to students on their first day of instruction. Schedule is subject to change. A&P Application Form A rev: 10//06, 8/07, 11/07, 10/08, 02/09, 02/10, 10/10, 03/11, 06//07, 02/12, 7/12, 11/13, 9/14, 7/15 3

4 KPSAHS STUDENT TUITION RECOVERY FUND FORM The State of California created the Student Tuition Recovery Fund (STRF) to relieve or mitigate economic losses suffered by students in educational programs who are California residents, or are enrolled in a residency program attending certain schools regulated by the Bureau for Private Postsecondary Education. Please read the following: You must pay the state imposed assessment for the Student Tuition Recovery Fund (STRF) if all of the following applies to you: 1. You are a student in an educational program who is a California resident or are enrolled in a residency program, and prepay all or part of your tuition either by cash, guaranteed student loans, or personal loans, and 2. Your total charges are not paid by any third-party payer such as an employer, government program or other payer unless you have a separate agreement to repay the third party. You are not eligible for protection from the STRF and you are not required to pay the STRF assessment if either of the following applies: 1. You are not a California resident or are not enrolled in a residency program, or 2. Your total charges are paid by a third party, such as an employer, government program or other payer, and you have no separate agreement to repay the third party. You may be eligible for STRF if you are a California resident or are enrolled in a residency program, prepaid tuition, paid STRF assessment, and suffered an economic loss as a result of any of the following: 1. The school closed before the course of instruction was completed. 2. The school's failure to pay refunds or charges on behalf of a student to a third party for license fees or any other purpose, or to provide equipment or materials for which a charge was collected within 180 days before the closure of the school. 3. The school's failure to pay or reimburse loan proceeds under a federally guaranteed student loan program as required by law or to pay or reimburse proceeds received by the school prior to closure in excess of tuition and other costs. 4. There was a material failure to comply with the Act or the Division within 30-days before the school closed or, if the material failure began earlier than 30-days prior to closure, the period determined by the Bureau. 5. An inability after diligent efforts to prosecute, prove, and collect on a judgment against the institution for a violation of the Act. My third-party payer is: I understand that KPSAHS is required by the State of California to collect a STRF assessment from all eligible students based on the full institutional charges of the program in which I am enrolled. This is a one-time nonrefundable assessment fee collected by KPSAHS. The STRF assessment will not be collected in Student Signature: Date: Print Name: Program: Anatomy and Physiology I (AP I) *This form must be submitted during the enrollment process* A&P Application Form A rev: 10//06, 8/07, 11/07, 10/08, 02/09, 02/10, 10/10, 03/11, 06//07, 02/12, 7/12, 11/13, 9/14, 7/15 4

5 Anatomy and Physiology I Payment Instructions Please complete the KPSAHS Anatomy & Physiology Course Student Tuition Recovery Fund Form before remitting payment for the A & P Course. Fees do not include books and supplies Course Fees Course fee - $ There are two payment options, PayPal or Check. Payment by PayPal - Copy the correct link below directly into your internet browser: Anatomy and Physiology I $ https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=znlyz7xdky7kw Note: If another person is paying for your A & P course through PayPal, have that person enter your name in the section called Add special instructions to the seller. Payment by Check - Checks are to be payable to KPSAHS and must be mailed directly to the School s lockbox address below: Regular Mail The Permanente Medical Group Inc. P.O. Box Los Angeles, CA Overnight Mail (e.g., UPS FedEx) Bank of America Lockbox Services Lockbox Media Center Drive Los Angeles, CA In the memo section of the check include the applicant name, name of the course and the date of the course, for example, Jane Doe, CT, Winter NOTE: All returned checks are subject to an additional $25 non-refundable fee. A&P Application Form A rev: 10//06, 8/07, 11/07, 10/08, 02/09, 02/10, 10/10, 03/11, 06//07, 02/12, 7/12, 11/13, 9/14, 7/15 5

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