MODESTO JUNIOR COLLEGE RESPIRATORY CARE PROGRAM APPLICATION GUIDELINES. Fall 2015 Application Period for Spring 2016

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1 MODESTO JUNIOR COLLEGE RESPIRATORY CARE PROGRAM APPLICATION GUIDELINES Fall 2015 Application Period for Spring 2016 Please read all application guidelines carefully. It is the applicant s responsibility to read all guidelines carefully and make sure that all requirements have been met prior to the Program application deadline. If any of these requirements have not been met, your application packet will not be processed and you will be found ineligible for the program. If you have any questions regarding the application guidelines call Allied Health at or us at blaggd@mjc.edu. Admission to Modesto Junior College (MJC): If you are not currently a MJC student, you must apply for admission to MJC. You can apply for admission at or in person at MJC Enrollment Services on either campus. High school graduation or equivalent (GED or college degree): High school graduation or equivalent is highly recommended, but not required. Official College transcripts: If you have attended college(s) other than Modesto Junior College or Columbia College, official college transcripts must be submitted with your program application by the October 15 application deadline unless your transcripts are already on file in the MJC Enrollment Services, East Campus, Student Services building 102, You should have someone from Allied Health or Enrollment Services initial the Transcript Verification Form included in your application packet to verify that your transcripts are already on file or to verify receipt of your official transcripts. Only official transcripts submitted by the application deadline will be used to determine program eligibility. It is the applicant s responsibility to ensure that all transcripts are on file and up-todate. NOTE: Students submitting transcripts from colleges out of district or from any college prior to 1995 must provide course descriptions on coursework required for the respiratory care program including math, English and sciences. A copy of the cover of the catalog for the year the course was taken must be included along with the course description from that catalog. Note to International Students: Modesto Junior College does not evaluate international transcripts. A student must first have their foreign coursework evaluated by a National Association of Credential Evaluation Services (NACES) affiliated foreign transcript service. The Records Office in Student Services Building, Room 102 has a list of transcript services. The cost of the evaluation is the student s responsibility. Please refer to the current MJC catalog under section Credit from Institutions Outside the United States for more information.

2 Required Math Competency for acceptance into the Respiratory Care Program has been met by one of the following: (Check appropriate boxes below.) The following competency must be met prior to the October 15 program application deadline. Eligibility for entrance into any 100-level MATH course through the MJC Assessment Process.See or phone for the math assessment testing calendar. or Score of 3, 4, or 5 on AP Exam: Calculus AB or Calculus BC or Statistics or Completion of MATH 89 or higher level MATH course, or an equivalent course from another institution with a grade of C or higher or Score of 5 of IB Exam: Mathematics HL or Transcript on file verifying baccalaureate or higher degree from a regionally accredited college or university. Students who possess a baccalaureate or higher degree completed at a regionally accredited college or university will have satisfied general education and competency requirements including guidance and activities for the associate of arts or associate of science degree. PREREQUISITES: The following 2 prerequisites must be completed with a grade of C or better prior to entering the Respiratory Care Program. Priority will be given to applicants who have completed both prerequisites prior to the application deadline. Units Chemistry Anatomy & Physiology or Anatomy 125 and Physiology 101

3 RESPIRATORY CARE PROGRAM APPLICATION: Please fill out the application and all attached forms as completely as possible. Completed Respiratory Care Program Application Packets must be submitted to the Allied Health office (or postmarked) by October 15. Late application packets will not be accepted. Incomplete application packets will not be processed. Respiratory Care Program Application packets must include the following: Applicant Declaration of Completed Requirements Sign this form verifying you have read all application guidelines and have completed all requirements. Respiratory Care Program Application Please fill out both pages as completely as possible. Transcript/Evaluation Request Form This form must be filled out as completely as possible and submitted with your Respiratory Care Program Application. Please list all colleges including Columbia College for which you are submitting transcripts and/or have transcripts on file. MJC does not need to be listed. Applicant Profile This form is not used in the selection process. It is used for statistical reporting only. Application packets may be mailed to: OR Submitted in person to: Modesto Junior College Modesto Junior College West Campus Respiratory Care Program Corner of Carpenter and Blue Gum 435 College Ave. Allied Health Modesto, CA Glacier Hall, Room 165 PLEASE NOTE APPLICATION DEADLINE IS OCTOBER 15. All requirements must be met and completed application packet submitted to the Allied Health Office by the application deadline. Late application packets will not be accepted. POLICY FOR IMPOSING PENALTIES OR DENIAL OF LICENSURE The law provides for denial of licensure for crimes or acts, which may in any way be related to patient care activities, i.e. sex crimes, drug crimes, alcohol or drug abuse, and crimes of violence. In such cases, it is the applicant s responsibility to present sufficient evidence of rehabilitation to the Respiratory Care Board of California prior to taking the licensure examination. If the above violations are only misdemeanors, an in-house review and penalty determination may be performed and fines, warning letters, and/or probation may be issued without denial of a license. The Respiratory Care Board of California will screen applicants individually. Any student considering a career as a Respiratory Therapist who might be denied licensure is advised to consult the Disciplinary Guidelines (California Code of Regulations, ) published by the Respiratory Care Board of California before entering the program. This document is available on reserve in the MJC library. Further information on disciplinary guidelines may be obtained from: Respiratory Care Board of California 444 North 3 rd Street, Suite 270 Sacramento, CA Toll Free in California (866)

4 PRIOR TO ENROLLING IN THE PROGRAM IMPORTANT: Students are strongly advised to complete the following required courses and the additional graduation requirements prior to entering the respiratory care program. These courses must be completed by the last semester of the program with a grade of C or better in order to complete the Respiratory Care Program and be eligible to take the State Board Respiratory Care Practitioner exam. Required non-respiratory care courses: Units Psychology Microbiology 101 (This course is a prerequisite to RSCR 242.). 4 Additional MJC GE Graduation Requirements: Activities 2 Guidance Humanities 3 (Students who possess a bachelor s degree or higher at a regionally accredited college or university will have satisfied general education and competency requirements for the associate of science degree including the activities and guidance requirements). NOTE: If you do not have Catalog Rights prior to summer 2009, you will need to successfully complete English 101 in order to receive your associate s degree. If you do have Catalog Rights prior to summer 2009, you will need to successfully complete English 50 in order to receive your associate s degree. D.1. English 101 (3 units) D.2. Communication and Analytical Thinking Communication 100 or 102 recommended (3 units) (or another course from Area D.2 of the MJC-GE pattern) Area E Health Education requirement is waived for Respiratory Care candidates. It is the student s responsibility to assure that all requirements for graduation have been met by the last semester of the Respiratory Care Program.

5 MODESTO JUNIOR COLLEGE ALLIED HEALTH RESPIRATORY CARE PROGRAM SELECTION PROCESS In order to be fully qualified for admission, applicants must have completed the program prerequisites with a grade of C or better at the time of application. In the event that there are more qualified applicants than space available, a weighted lottery will be employed. An applicant s name will be entered an extra time for meeting each of the criteria listed below: Microbiology Completion of Microbiology 101 with a grade of C or better. Psychology Completion of Psychology 101 with a grade of C or better. Science A grade point average (GPA) for chemistry and anatomy and physiology of 3.0 or better or a GPA of 2.75 or better for microbiology, chemistry, anatomy and physiology. Degree Requirements Completion of all the non-respiratory care degree requirements or holding a bachelor s degree from an accredited US college. Previously Qualified Applicant Being a qualified applicant who was not selected for the MJC Respiratory Care Program. The applicant s name will be entered an extra time for each qualified application in the last three application periods.

6 MODESTO JUNIOR COLLEGE RESPIRATORY CARE PROGRAM PROGRAM APPLICATION RECEIPT FOR FALL 2015 APPLICATION FOR SPRING 2016 This form is your verification that Allied Health has received your application packet. All complete application packets will be processed as quickly as possible after the closing date of October 15. All applicants will be notified of their acceptance status by mail or MJC student . Please do not call Allied Health prior to December 1 to check on your acceptance status or on the status of notifications. You will be notified as soon as selection has been made. IMPORTANT: If you move and/or change your telephone contact information, please Donna Blagg at blaggd@mjc.edu and update your information. Please note that mail from MJC will not be forwarded but will be returned to MJC. This can take weeks, even months, so please be sure to keep your address current. If you are waiting to see if space will become available for Spring 2016, it is also important that we have the ability to contact you by telephone. The Spring 2016 semester begins January 11, The Respiratory Care course begins Tuesday, January 12, However, if accepted, you may need to be available during the first week of January. Please take this into consideration when making plans for the winter break. When you submit your application packet the person accepting your application packet will sign for it in the box below and stamp the receipt date. Please keep this form for your records. MJC RC PROGRAM APPLICATION FOR: Applicant Name (Please Print or Type) OFFICE USE ONLY DO NOT WRITE IN THIS SPACE Received by: Allied Health Signature Allied Health Date Received TRANSCRIPTS RECEIVED

7 MODESTO JUNIOR COLLEGE RESPIRATORY CARE PROGRAM APPLICANT DECLARATION OF COMPLETED REQUIREMENTS FALL 2015 for SPRING 2016 Legal Name Last First Middle Previous/Maiden Name Mailing Address City State Zip Phone: Primary/Secondary/Other Date of Birth MJC Student ID Number Veteran Yes No MJC Student Address (Required) Personal Address (Optional) Must be on file with the MJC Veterans Office. I have read the Respiratory Care Program Application Guidelines and understand that I must have all program admission requirements met prior to the program application deadline, October 15. I have met all of the Respiratory Care Program application requirements listed below or will meet them by the Respiratory Care Program application deadline, October 15: (See Application Guidelines for description of each requirement) Admission to Modesto Junior College Official transcripts submitted (other than MJC/Columbia) Math and English/Reading assessment (or course work) has been completed Completion of Chemistry 143 with a grade of C or better (or current enrollment) Completion of Anatomy & Physiology 150 or Anatomy 125 & Physiology 101 with a minimum grade of C (or current enrollment) I understand that this application will not be processed unless all transcripts are on file in MJC Enrollment Services and all of the above requirements have been met. I understand that incomplete application packets will not be processed and that application packets will not be accepted after the Respiratory Care Program application deadline, October 15. Applicant s signature Date

8 RESPIRATORY CARE PROGRAM APPLICATION FOR SPRING 2016 MODESTO JUNIOR COLLEGE ALLIED HEALTH ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ PLEASE TYPE OR PRINT Last Name (Legal) First Middle Previous/Maiden Name Mailing Address City State Zip PHONE: Primary/Secondary/Other Date of Birth MJC Student ID Number MJC Student Address (Required) Personal Address (Optional) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ REQUIRED MATH COMPETENCY FOR ACCEPTANCE INTO THE RESPIRATORY CARE PROGRAM HAS BEEN MET BY ONE OF THE FOLLOWING: Eligibility for entrance into any 100-level math course through the MJC Assessment Process or Score of 3, 4, or 5 on AP Exam: Calculus AB or Calculus BC or Statistics or Completion of MATH 89 or higher level MATH course, or an equivalent course from another institution with a grade of C or higher or Score of 5 on IB Exam: Mathematics HL or Transcript on file verifying baccalaureate or higher degree from a regionally accredited college or university. Have you applied to another MJC Allied Health program this semester? Yes No If yes, which program:

9 MODESTO JUNIOR COLLEGE ALLIED HEALTH RESPIRATORY CARE PROGRAM Please fill out the form below as completely as possible. All coursework must be verifiable by official transcripts on file in MJC Enrollment Services. Prerequisites must be completed with a grade on official transcript prior to entering the Respiratory Care Program. COURSE NAME PREREQUISITES SEM/YR COLLEGE AND NUMBER GRADE UNITS Chemistry 143 AP 150 or Anatomy 125 and Physiology 101 Please list the courses that you have completed or are currently enrolled in. REQUIRED NON-RESPIRATORY SEM/YR COLLEGE COURSE NAME AND NUMBER GRADE UNITS CARE COURSES Microbiology 101 Prerequisite to RSCR 242 Psychology 101 The following additional graduation requirements must be completed by the end of the fourth semester of the Respiratory Care Program. Please list any of these courses that you have completed or are currently enrolled in. Bachelor s degree holders from an accredited US college have met these requirements. DEGREE REQUIREMENTS SEM/YR COLLEGE D.1 English 101 D.2 Speech 100 or 102 recommended or another course from D.2. of the MJC GE pattern COURSE NAME AND NUMBER GRADE UNITS Activities Guidance (2 units) (½ unit) Humanities (3 units) If you were a qualified applicant who was not selected for the Respiratory Care Program during the past three application periods, your name will be entered an additional time for the application period(s) checked below. Spring 2013 Spring 2014 Spring 2015

10 MJC RESPIRATORY CARE PROGRAM TRANSCRIPT VERIFICATION FORM VERY IMPORTANT: THIS FORM MUST BE COMPLETED and submitted with your Respiratory Care Program application. Official transcripts from all colleges other than Modesto Junior College or Columbia College must be submitted with the Respiratory Care Program application unless they are already on file in the MJC Enrollment Services. Last Name (Legal) First Middle Previous/Maiden Name Phone: Primary/Secondary/Other MJC Student ID Number LIST ALL COLLEGES (including Columbia College.) IMPORTANT: Official transcripts MUST BE submitted to Allied Health by the program application deadline, October 15 unless they are already on file in the MJC Enrollment Services. Use the back of this form if you need more room. Name of College: Degree (if any) OFFICE USE ONLY: INITIALS VERIFYING RECEIPT

11 MODESTO JUNIOR COLLEGE ALLIED HEALTH RESPIRATORY CARE PROGRAM APPLICANT PROFILE Fall 2015 application for Spring 2016 The following information is optional and is requested for demographic analysis only. This information will not be used in the admission process. ETHNIC BACKGROUND Check the category that best applies to you. African-American/Black Asian or Pacific Islander (other than Filipino) Filipino Latino/Hispanic Native American or Native Alaskan White, other than Hispanic Other/Unknown GENDER Female Male CURRENT AGE DATE OF BIRTH MM-DD-YYYY