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1 EMERGENCY MEDICAL SCIENCE PARAMEDIC ASSOCIATE IN APPLIED SCIENCE DEGREE (A45340) APPLICATION PACKET Thank you for your interest in the Emergency Medical Science Paramedic Program. Included in this packet is information about the program curriculum, requirements, and application process. After reviewing this packet, if you have any questions, please contact Kent Spitler, Director of the Department for EMS Education, at or Curriculum Description The Emergency Medical Science curriculum provides individuals with the knowledge, skills and attributes to provide advanced emergency medical care as a paramedic for critical and emergent patients who access the emergency medical system and prepares graduates to enter the workforce. Students will gain complex knowledge, competency, and experience while employing evidence based practice under medical oversight, and serve as a link from the scene into the healthcare system. Graduates of this program may be eligible to take state and/or national certification examinations. Employment opportunities include providers of emergency medical services, fire departments, rescue agencies hospital specialty areas, industry, educational and government agencies. The Gaston College Department for EMS Education Emergency Medical Science Paramedic Program is accredited by the Commission on Accreditation of Allied Health Education Programs ( upon the recommendation of the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP). To contact CAAHEP: Commission on Accreditation of Allied Health Education Programs 1361 Park Street Clearwater, FL To contact CoAEMSP: 8301 Lakeview Parkway, Suite Rowlett TX (214) FAX (214)

2 Student Information The EMT course (EMS 110) is offered each semester. It is recommended that those who are entering the Paramedic Program, who are not currently certified as an EMT, to register for EMS 110 and Anatomy and Physiology I (BIO 168) as soon as possible; they are required to complete BIO 168 no later than the first fall semester of the program. Students with current EMT certification through continuing education may receive curriculum college credit for Emergency Medical Technician, EMS 110. There are two ways to receive credit for EMS 110: 1. Complete the NREMT exam and receive national registration as an EMT. Go to for information. The student must show proof of NREMT registration as an EMT to receive credit for EMS 110. Cost is $70 and the applicant must have successfully completed an EMT skills evaluation within the last 12 months. 2. Complete a Credit by Exam for EMS 110 by applying for a request to test. The student must show proof of successful completion and certification as an EMT in North Carolina. Contact the Department for EMS Education for information and testing. The cost to obtain credit by exam is $50. Paramedic Program Admission Process Step One: Admission to the College Contact the Admissions Department for College admission requirements. The student will complete placement testing, submit high school/ged transcripts, and attend the College orientation. Admission to the Paramedic Program is a separate process and instructions are listed in Step Two. Step Two: Admission to the Paramedic Program Meet the equivalent or take DMA 030. Meet the equivalent of DRE 098. An overall GPA minimum of 2.0 in college level coursework in related classes and core courses in the EMS program of study. Complete program application (separate from the College admissions application) Provide a copy of valid state driver s license (attach to program application) Application materials should be mailed to: Gaston College Department for EMS Education, Campus Box 10 Applications are accepted at any time, but are assigned to each program depending on space. The application deadline for the Paramedic Program is April 1, (CONTINUED ON PAGE 3)

3 Step Three: After a Paramedic AAS Degree Program acceptance letter is received In addition to maintaining a 2.0 GPA and earning a minimum grade of "C" in all EMS and other related curriculum courses, applicants accepted in the Emergency Medical Science - Paramedic program must meet the following requirements in order to enroll and continue in the EMS program. 1. Attend a program orientation session. 2. Schedule to meet with a faculty advisor to register for classes 3. Complete a student Medical Form, provided by the Department for EMS Education, documenting satisfactory emotional and physical health. 4. Immunizations required by the N.C. Community College System and clinical agencies. Criminal Background Check, FBI fingerprinting, and random drug screening Clinical agencies reserve the right to deny a student access to the facility based on failure to meet the above requirements. If a student is denied access to any clinical agency, the student will not be allowed to continue in the Emergency Medical Science - Paramedic program. Detailed information regarding these agency requirements will be provided upon conditional acceptance into the paramedic program. Program Costs 1. In addition to tuition and textbooks, costs of this program include the following: EMS Testing, FISDAP Clinical Competency Tracking, uniforms (shirts, pants, shoes, and jacket), stethoscope, physical examination, immunizations, criminal background check, FBI fingerprinting, and drug screening at a time designated by the EMS faculty. 2. Students are responsible for their own transportation to and from all clinical, laboratory, and class activities. Clinical and EMS field internship experiences may be scheduled morning, afternoons, or evenings, and weekends. 3. Students who seek credit for EMT-Basic Certification, taken through continuing education, may request to seek course credit by examination or experiential credit. Experiential credit is obtained by successfully completing the NREMT computer adaptive testing and receiving subsequent national registration as an EMT.

4 Emergency Medical Science Associate Degree A45340 Suggested Course Sequence Course Title Class Lab Clinical Credit Fall Semester I EMS 110 EMT Basic BIO 168 Anatomy-Physiology I MED 120 Medical Terminology ENG 111 Writing and Inquiry Semester Total: Spring Semester I BIO 169 Anatomy-Physiology II EMS 122 EMS Clinical Practicum I EMS 130 Pharmacology EMS 131 Advanced Airway Management EMS 160 Cardiology I Semester Total: Summer Semester I EMS 220 Cardiology II EMS 221 EMS Clinical Practicum II EMS 240 Patients with Special Challenges Semester Total: Fall Semester II EMS 250 Medical Emergencies EMS 260 Trauma Emergencies EMS 270 Life Span Emergencies ENG 112 Writing/Research in the Disciplines PSY 150 General Psychology Semester Total: Spring Semester II EMS 231 Clinical Practicum III EMS 235 EMS Management EMS 241 EMS Clinical Practicum IV EMS 285 EMS Capstone PHI 240 Introduction to Ethics Semester Total: Total Semester Hour Credits: 66

5 PARAMEDIC AAS DEGREE PROGRAM APPLICATION Disclaimer: Completing this form does not guarantee entry into the Paramedic program. Specific program requirements must be met prior to acceptance. Please print: Name (First) (Middle Initial) (Last) Current Physical Address (do not use P.O. Box numbers) City State Zip County / / Birthdate MM/DD/YY Home Phone Cell Phone Emergency Contact Phone Address: Admissions placement testing requirements: Accuplacer Reading and Writing Meets requirement for DRE 098 Accuplacer Mathematics Must meet requirement for DMA 030 Recent high school graduates who have a high school grade point average (unweighted 2.6 or higher) may receive a waiver from placement testing. SAT Score Place out of: ACT Score Place out of: ENG 090 & English OR English 18 or higher ENG 090 & 500 or higher RED 090 Reading RED 090 Writing OR Critical Reading Reading 20 or higher Mathematics 500 or higher DMA Mathematics 22 or higher DMA The student must meet Gaston College admission requirements. It is the student s responsibility to apply to the College, complete placement testing and complete a general college orientation either in person or online. The Admissions department can answer any questions regarding this process by calling Hospital clinical agencies and EMS agencies that have contracts with Gaston College require criminal background checks, a urine drug screen, and FBI fingerprinting prior to entering their facilities. Failure to meet these requirements will subject the student to dismissal from the program. The program will comply with all clinical affiliation agreements. You will receive a packet that includes the information to meet these requirements. I certify that the above information is correct and complete to the best of my knowledge and belief. I understand and agree that misrepresentation, falsification or omission of material fact may be cause for rejection of my application or for termination after acceptance into the EMS program. Applicant Signature X Date of Application (please sign your name above) (mm/dd/yyyy) Orientation and acceptance into the Paramedic AAS Degree Program Student needs to declare EMS as major, a45340, in the Gaston College Admissions office. Any student receiving a program acceptance letter must attend an orientation session on one of the following dates: April 15, :00 pm to 2:30 pm or April 17, 2015 from 9:00 am to 10:30 am in the Albright Public Safety Building, Room 131. The orientation will include an overview of the program requirements, acceptance and/or change of major to EMS, clinical packets, and program information. Space for the Paramedic AAS Degree Program is limited. Early submission of this application is encouraged. For Office Use Only: Received by on Reviewed by on Conditional Acceptance Does not currently meet requirements Letter sent

6 Application Acknowledgement I have read and understand the Emergency Medical Science Paramedic AAS Degree Application Packet for the Paramedic AAS Degree Program at Gaston College. I understand that I am accountable for the information contained within the packet and agree to contact the Department for EMS Education with questions that I may have regarding any information contained within the packet. I fully understand that if I do not comply with the guidelines within the packet that my application may be incomplete and I will not be considered for admission into the program. I give permission for Gaston College to take steps to verify the information I have given them. I understand that my admission and continuation in the program is contingent on my fulfillment of all program requirements. I will not hold Gaston College or any of its agents responsible for my failure to provide information or fulfill my obligations for acceptance or completion of this program. I understand that completion of this application is a component of the student file and does not in itself grant admission to the EMS program. I further understand that I must submit a new application if I am not selected for the Paramedic AAS Degree Program. Minimum admission requirements for the Paramedic AAS Degree Program include: Having unconditional admission to the College Submitting a completed application for the EMS program(s) in the Department for EMS Education Meeting eligibility requirements for ENG 111, BIO 168 and BIO 169. Meeting essential functions or technical standards required for EMS providers Current EMT certification in North Carolina Admission to the EMS program is competitive, and the number of students is limited by the number of faculty, clinical sites, and classroom facilities. Meeting minimum requirements does not guarantee acceptance in to the Paramedic AAS Degree Program. Applicant s Signature Date Please return this application to: Gaston College Department for EMS Education

7 Paramedic Essential Functions Area Function Yes No If no, please comment 1. Have physical stamina to stand and walk for 8+ hours in a clinical or field setting Mobility 2. Can stand on both legs, move about freely, and maneuver in small spaces. Physical disabilities must not pose a threat to safety of the student, faculty, patients, or other healthcare workers. 1. Can bend the body downward and forward by bending at the spine and waist. Flexibility 2. Can flex and extend all joints freely 1. Can raise objects from a lower to a higher position or move objects horizontally from position to position. Strength This factor requires the substantial use of the upper extremities and back muscles. 2. Possess mobility, coordination and strength to push, pull or transfer heavy objects. (Strength to lift 50 lbs. frequently and 75 lbs. or more occasionally). 1. Possess manual dexterity, mobility, and stamina to perform CPR Fine Motor Skills 2. Can seize, hold, grasp, turn, apply pressure and otherwise work with both hands. and Hand/Eye Coordination 3. Can pick, pinch, or otherwise work with fingers Auditory Ability Communication 1. Possess sufficient hearing to assess patient s needs, make fine discrimination in sound, follow instructions, communicate with other healthcare workers. Please comment if corrective devices are required 1. Possess verbal/nonverbal and written communication skills adequate to exchange ideas, detailed information, and instructions accurately. 2. Able to read, comprehend, and write legibly in the English language Interpersonal Skills 1. Able to interact purposefully and effectively with others. 2. Able to convey sensitivity, integrity, respect, compassion, and a mentally healthy attitude 3. Oriented to reality and not mentally impaired by mind altering substances 4. Able to function safely and effectively during high stress periods If you are unable to fully meet any of the listed criteria, you will need to meet with the Gaston College ADA Coordinator. A student who is seeking accommodations and services on the basis of a disability are required to submit documentation to verify eligibility for services. Receiving academic accommodations at Gaston College takes several steps: 1. Students must complete an accommodation request form from the ADA Coordinator s office each semester. 2. Students may hand-deliver the letter or have it sent to to each instructor through campus Students must arrange a meeting with their instructor(s) to discuss the proposed accommodations listed in the letter. 4. Students with disabilities must maintain the same responsibility for their education as students who do not have disabilities. This includes maintaining the same academic levels, maintaining appropriate behavior and giving timely notification of any special needs. Utilize accommodations available to you; asking for assistance is not a sign of weakness or dependence. It is our goal to help you achieve your educational pursuits. Upon reading and reviewing the Essential Functions, I have selected the appropriate boxes above attesting to my ability to perform the indicated function area. I further understand that I may be required by the EMS faculty to be re-evaluated if deemed necessary based on my ability to perform essential functions during the program, for retention, and progression through the program. Please mark the box that meets your ability to perform the Essential Functions I currently have the ability to perform the Essential Functions I currently am unable to perform the Essential Functions indicated without accommodations. Print Name Student Signature Date

8 Paramedic AAS Degree Program Application Checklist (This checklist is provided to assist you with the application process, please keep for your records) YOU SHOULD RETAIN COPIES OF ALL DOCUMENTS SUBMITTED. You will be notified in April for Fall semester admission. SUBMIT TO ADMISSIONS OFFICE PRIOR TO PARAMEDIC PROGRAM ORIENTATION, COMPLETE THE FOLLOWING: College application Official Transcripts from high school or GED Official Transcripts from each college previously attended Any other documents required by admissions SUBMIT TO THE DEPARTMENT FOR EMS EDUCATION Paramedic AAS Degree Program Application Each student must schedule an appointment with the program director Copy of Healthcare Provider CPR Card (if holding current certification) Copy of state driver s license Placement Test Scores Completed Essential Functions Form Application Acknowledgement Form ORIENTATION AND ACCEPTANCE INTO THE PARAMEDIC AAS DEGREE PROGRAM Students must declare EMS as major, A45340, in the Gaston College Admissions office. Any student receiving a program acceptance letter must attend an orientation session on one of the following dates: April 15, :00 pm to 2:30 pm or April 17, 2015 from 9:00 am to 10:30 am in the Albright Public Safety Building, Room 131. The orientation will include an overview of the program requirements, acceptance and/or change of major to EMS, clinical packets, and program information. Space for the Paramedic AAS Degree Program is limited. Early submission of this application is encouraged. AFTER THE PARAMEDIC PROGRAM ORIENTATION, COMPLETE THE FOLLOWING: (Deadline will be given at orientation) Upon acceptance into the Paramedic AAS Degree Program each student will be required to submit a background check, FBI fingerprint record, and drug testing. Packets will be distributed during the Paramedic AAS Degree Program orientation session. Upon acceptance into the Paramedic AAS Degree Program each student will also be required to submit medical form documents including a physical exam, medical history, and immunization records. The AAS Degree Program application must be submitted in person or by mail. When you mail your application and, to ensure receipt, it is suggested that you mail your completed packet by certified mail. Due to the high number of applications we receive it is department policy that the receipt of an application will not be confirmed. Applications will not be accepted by or fax.