Name: (Last) (First) (other names used) (Number & Street (apt#) City State Zip Phone # (H) (Cell)# Social Security#:

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1 Lone Star College-Kingwood OCCUPATIONAL THERAPY ASSISTANT PROGRAM APPLICATION January Lone Star College-Kingwood Kingwood Dr. Kingwood, Tx (281) Name: (Last) (First) (other names used) Permanent Mailing Address: (Number & Street (apt#) City State Zip Phone # (H) (Cell)# Social Security#: Name of high school: Graduation date: City: State: GED Certificate: Y/N If Yes, Where received: City: State: Date Received: Have you taken a college entrance exam? Y/N If Yes, which exams? Date: Where: Have you previously attended any other college? Y/N If Yes, name of college attended: City, State Date(s) attended College Graduate: Y/N If Yes, Name of College: City State: Degree Received: Date Received: Have you previously attended any other Occupational Therapy Assistant Program? Yes No If Yes, name of school attended City State Date(s) Reason for leaving: Have you been employed in the health care field? Yes No If Yes, when: Where (City and State): Job Title: Responsibilities: Have you ever had a felony or misdemeanor conviction? Yes NO Applicant s Name: OVER 1

2 Applicant Essay: Provide a brief but concise essay on the following question. Please use only this space for essay. 1. What particular skills or attributes would make you a capable occupational therapy assistant? (Feel free to give examples from clinical observation or experience). If you have been convicted of a misdemeanor or felony, it is your responsibility to contact the Executive Council for Physical Therapy and Occupational Therapy Examiners at (512) , to determine your licensure eligibility. It is the policy of Lone Star College System to provide equal admission and educational opportunities without regard for race, color, religion, national origin, sex, age or handicap. I CERTIFY THE INFORMATION GIVEN ON THIS APPLICATION IS COMPLETE AND CORRECT. I ACKNOWLEDGE THAT OMISSIONS OR FALSIFICATONS MAY DISQUALIFY ME FOR ADMISSION AND/OR SUBJECT ME TO IMMEDIATE DISMISSAL FROM THE PROGRAM. Applicant s Printed Name: Signature Date 2

3 Admission Criteria: LONE STAR COLLEGE-KINGWOOD OTA PROGRAM APPLICATION PROCESS CHECKLIST (Materials required for a student file) 1. Apply to LSCS through the college Admission Office 2. Completion of the following required courses with a minimal grade of "C+" (2.5 GPA): English 1301 Composition and Rhetoric I Biology 2401 Human Anatomy and Physiology I Psychology 2301 General Psychology Courses should not have been completed more than five years prior to application to the program. Exceptions must be discussed with the Program Director. 3. Furnish official college transcripts of all previously taken college courses to the address listed above. If courses have been taken at any of the LSCS locations, you do not need to provide a transcript. 4. Furnish official documentation verifying that LSCS Student Success Initiative (SSI) requirements have been met even if student is exempt from Texas Success Initiative (TSI). This means that student must be at college level in reading and writing and must complete or test above the MATH 0308 level. For additional information contact Health Science Academic Counselor/Professor Suann Hereford, Ph.D. at (281) or Suann.L.Hereford@lonestar.edu. 5. Furnish verification of graduation from an accredited high school (official transcript or diploma), or official verification of completion of the General Education Development Test (GED). 6. Students who have been conditionally accepted into the program must have a clear criminal background check in order to complete the Fieldwork rotations (clinicals). Students are responsible for paying all fees and working with the background check company to clear up any reporting discrepancies. Students may also be asked to complete a drug screen (all fees are student s responsibilities). 3

4 Additional information: interviews may be conducted as part of the admission criteria drug screens may be required background check will be required (mandatory clear results required, paid for by student) observation hours may be required (determined by the OTA faculty) date for physical examination and required immunizations will be determined in the first semester completion of CPR course for health care workers will be required prior to Level I Fieldwork course mandatory attendance for orientation sessions; details will be provided at a later date Student Selection Process: Students are ranked and selected on the following criteria by the admissions committee: 1. # of completed pre-requisites courses 2. GPA on pre-requisite courses 3. # of completed of co-requisite degree courses 4. GPA on co-requisite courses 5. previous degree earned 6. experience in health care industry Application for admission to the Spring semester will be accepted from June 1 st through August 31 st (subject to change). Please be sure that your file is complete and that all of the requested documents be mailed directly to: Lone Star College-Kingwood Alma Watson-OTA-Dept Kingwood Dr. Kingwood, TX Questions may be directed to Krystal Patterson at (281) , Alma Watson at (281) , or Linda Gallander at (281)

5 LONE STAR COLLEGE-KINGWOOD OTA PROGRAM COURSE SEQUENCING Required courses for program admission: Course Number Course Title Semester Hours BIOL 2401 Human Anatomy & Physiology I 4 PSYC 2301 General Psychology 3 ENGL 1301 Composition & Rhetoric 3 See #4 on Application Packet Checklist; students must meet the math requirement end of the first year of the program. Semester Hours 10 First Year Spring Semester: PSYC 2314 Life Span & Development 3 BIOL 2402 Anatomy & Physiology II 4 OTHA 1301 Intro to OT 3 OTHA 1315 Therapeutic Use of Occupations or Activities I 3 Semester Hours 13 First Year Summer Semester: OTHA 1309 Human Structure & Function in OT 3 OTHA 2301 Pathophysiology in OT 3 Semester Hours 6 First Year Fall Semester OTHA 2331 Physical Function in OT 3 OTHA 2309 Mental Health in OT 3 OTHA 2302 Therapeutic Use of Occupations or Activities II 3 OTHA 1319 Therapeutic Interventions I 3 SPCH 1318 Interpersonal Communication** 3 Semester Hours 15 Second Year Spring Semester OTHA 2335 Healthcare Management in OT 3 OTHA 1341 Occupational Performance from Birth through Adolescence 3 OTHA 1353 Occupational Performance for Elders 3 OTHA 2166 Practicum 1 Elective Humanities/Fine Arts** 3 Semester Hours 13 Second Year Simmer Semester OTHA 2460 OTA Clinical 4 OTHA 2461 OTA Clinical 4 Semester Hours 8 TOTAL CREDIT HOURS 65 ** courses can be taken prior to semester indicated** 5

6 LONE STAR COLLEGE-KINGWOOD OTA PROGRAM FREQUENTLY ASKED QUESTIONS FACT SHEET How long is the program? The program is a 2-year Associate of Applied Science Degree program. This includes one semester of pre-requisite courses, four on-campus semesters, and the capstone semester course of Fieldwork (clinicals) at the end of the program. When does the program begin? The program starts a new class each January (Spring semester) and ends in September of the following year. Are any courses offered at night or weekend? No. The courses are daytime, year-round classes; each class is offered only once a year. During the program, time is allowed to take the co-requisite general education courses. What are the pre-requisite courses? A letter grade of C+ (2.5 GPA) is required for the following courses: BIOL 2401 Human Anatomy & Physiology I PSYC 2301 General Psychology ENGL 1301 Composition and Rhetoric Courses should not have been completed more than five years prior to application to the program. Exceptions must be discussed with the Program Director. ** See #4 on Application Packet Checklist; students must meet the SSI requirements in Math by end of the first year of the program ** What is the approximate cost of the program? Estimated in-district costs for the 2-year program is approximately $ This includes books, tuition, lab fees, and other supplies. What if there is a problem with my background check? Area facilities are now requiring all health care students to have a background check and possibly a drug screen prior to clinical rotations. Students cannot begin or continue their studies until the background check process is satisfactorily cleared. The student is responsible for working with the background check company to clear up any reporting discrepancies prior to enrolling in the program. 6