APPLICATION FOR Health Career Programs

Health Career Programs at MCCq Dental Assistantq Occupational Therapy Assistantq Radiation Therapyq Radiographyq Respiratory Careq MCC/Hartford Hospital Surgical Technology

Admissions: 860-512-3210

Financial Aid: 860-512-3380 ma-finaid@manchestercc.edu

STEM Division Office: 860-512-2704

Mail the completed application to: STEM Division Office, MS #17 Attention: Respiratory Care Program Coordinator Manchester Community College P.O. Box 1046, Manchester, CT 06045-1046

Or drop off completed application: STEM Division Office, LRC A237

IMPORTANT DATES:Application Deadline: February 1, 2020

Financial Aid: Priority deadline to be eligible for maximum grant aid is May 15 for fall; October 1 for spring.

Info Sessions: Applicants must register for a mandatory information session. Go to www.manchestercc.edu/respiratory.

PR/07/19

www.manchestercc.edu

Banner ID @ ___________________________________________

Net ID _______________________ @ student.commnet.edu

2020-21 Application Process for Respiratory CareComplete the Health Career Programs Application and sign, date and submit to the STEM Division office, LRC A237. Applications can be placed in the drop box outside if the office is closed. Deadline for the 2020-21 academic year is February 1, 2020.

July 2019/PR

QUESTIONS: Contact Nancy LaRoche-Shovak, MS, RRT, Respiratory Care Program Coordinator, 860-512-2714, email nlaroche-shovak@manchestercc.edu

1. Attend Respiratory Care information session before the application deadline date of February 1, 2020.

2. Complete Respiratory Care program prerequisites. All candidates must have a minimum GPA of 2.5. Respiratory Care program prerequisites include the following MCC courses or their equivalent, if transferring: • MAT* 109: Quantitative Literacy or higher (All math courses must be

completed with a “C” or better and taken in Spring 2015 or later.)• Eligibility for BIO* 211: Anatomy and Physiology I (All science courses

must be 4 credits, include a lab, completed with a “C” or better and taken in Spring 2015 or later.)

• Eligibility for ENG* 101: English Composition

3. Submit MCC Application for Admission by February 1, 2020. Applications are available at the Admissions office, SSC L156, or online at

www.manchestercc.edu/admissions.

4. Submit Health Career Programs Application to the STEM Division office, room LRC A237 by February 1, 2020. Applications are available at www.manchestercc.edu/respiratory and must include:

Official copies of transcripts Hard copies of official transcripts should be attached to the application. If the institution does not issue hard copies, then electronic copies can be sent by email directly to Nancy LaRoche-Shovak, Program Coordinator, at nlaroche-shovak@manchestercc.edu.

5. Complete clinical shadowing experience (optional). Will be arranged by program coordinator following application review.

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FIVE STEPS REQUIRED TO COMPLETE RESPIRATORY CARE APPLICATION PROCESS

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Health Career ProgramsApplication

Please complete this application and sign, date and submit to the STEM Division offce, LRC A237. Applications can be placed in the drop box outside if the offce is closed. APPLICATION DEADLINE for the 2020-21 academic year is February 1, 2020.

PROGRAM SELECTION

Please indicate the program for which you are applying. Use a separate application for each program to which you wish to apply. Program prerequisites and application requirements vary by program. It is the student ’s responsibility to meet all program prerequisites and to complete all application requirements.

n Dental Assistant certifcate program (applications will be accepted until class is flled)

n Occupational Therapy Assistant associate degree program

n Radiation Therapy associate degree program

n Radiography associate degree program

n Respiratory Care associate degree program

n Surgical Technology associate degree program

APPLICANT INFORMATION

Name Banner ID

Street Address (including apt/unit #)

City State Zip

Home Phone Number Cell Phone Number

Email Date Attended Information Session

HIGH SCHOOL INFORMATION

High School Attended High School Address/City/State

Date of Graduation GED n Yes n No

COLLEGE INFORMATION

College Attended Degree Earned Date of Graduation

College Attended Degree Earned Date of Graduation

College Attended Degree Earned Date of Graduation

REQUIRED

If I am selected for a program interview, I agree to be available for an in-person interview at the designated time. n Yes, I agree.

I certify that my answers are true and complete to the best of my knowledge. Signature Date

www.manchestercc.edu/health July 2019/PR