1 Revised 4/19/2019
Medical Laboratory
Technology Program
INFORMATION PAC
KET & APPLICATION
Application Period:
March 2, 2019 – March 2, 2020
GENERAL INFORMATION
Read all instructions carefully as procedures may change between application cycles
Complete all applicable information and sign in the appropriate places
A
PPLICATION DEADLINE
To begin Medical Laboratory Technology coursework in Fall 2020 (August 2020),
Deadline to submit Medical Laboratory Technology admission application:
March 2, 2020
N
OTICE OF ADMISSION
Students will be notified by mail and via their Manhattan Tech email address of their
admission status approximately 4-6 weeks after the deadline date. It is the
responsibility of the student to notify admissions if there is an address change after
submission of application.
2 Revised 4/19/2019
CONTENT
Information Packet
Letter of Greeting …………………………………………………………………………………….3
Medical Laboratory Technology Checklist………………………………………………...4
Academic Criteria………………………………………………………………………….………….5
Medical Laboratory Technology Prerequisites
Test of English as a Secondary Language (TOEFL)
Non-Academic Criteria …………………………………………………………………….……….6
Medical Laboratory Technology Immunizations
Medical Laboratory Technology Physical and Environmental Requirements
Background Checks
Acceptance Process…………………………………………….........................................7
Student Responsibilities Upon Acceptance………………………….…………………….7
Reapplication Process………………………………………………………………………….......7
Medical Laboratory Technology Admissions Scoring Rubric…………………….8
Explanation of Immunization Requirements………………………………………………9
Application Packet
Application for Medical Laboratory Technology Program ……………………………1-3
3 Revised 4/19/2019
Letter of Greeting
Medical Laboratory Technology Program
D
ear Prospective Medical Laboratory Technology Student,
The faculty and staff of the Manhattan Area Technical College and the Medical Laboratory Technology (MLT)
program appreciate your interest in our program. This packet will help guide you through the Application Process
and provide you with the information about our Admissions Criteria and Selection Process.
Th
e MLT program is accredited by the National Accrediting Agency for Clinical Laboratory Sciences. The program is
one year in length after 24 credit hours of prerequisites are completed. Upon completion of the program, students
earn an AAS in Medical Laboratory Technology and qualify to sit for a Medical Laboratory Technician certification
exam.
Admission into the program is competitive. Applicants must meet the minimum requirements of Manhattan Area
Technical College and the Medical Laboratory Technology program for admission to Manhattan Area Technical
College’s MLT program.
Note Deadline: Your Manhattan Tech Admissions Application as well as the required Medical Laboratory Technology
Admissions Packet and the documents listed within must be received on or before the 1
st
business day of March to
be considered for admission into the Medical Laboratory Technology program. Any exception to this date would be
at the discretion of the MLT Program Coordinator.
E
nclosed is information that is critical for a successful applicationplease read the entire packet carefully. I encourage
you to make an initial advising appointment by contacting the Student Services office at 785-587-2800, for information
about college admissions and the Medical Laboratory Technology program. The college website at
www.manhattantech.edu
also provides additional information about our programs.
S
pecific program requirements, program selection and acceptance criteria are subject to change at any time and
without notice. It is the applicant’s responsibility to keep informed of current program requirements.
W
e look forward to your application,
M
arcey Fickbohm MS, MT (ASCP) Neil Ross
MLT Program Coordinator Dean of Student Services
T
he MATC Board of Directors supports and complies with Title VI and Title VII of the Civil Rights Act of 1964 as amended, Section 504 of the Rehabilitation Act of
1973 and Amendments, The Americans with Disabilities Act, Title IX and all requirements imposed by or pursuant to the regulations of the Department of Health
and Human Services and the Department of Education. It is the policy of the Board of Directors that no person in the United States (on the grounds of gender, race,
color, national origin, disability, sexual orientation, gender identity, religion, age, genetic information, parental status, military status, or veteran status) shall be
excluded from participation in, denied the benefit of, or otherwise subjected to discrimination under any program or activity of, or employment with, Manhattan
Area Technical College.
Specific complaints of alleged discrimination should be referred to Title IX/Section 504/ADA Coordinator/ HR Director, 3136 Dickens Ave., Manhattan, KS 66503,
785.587.2800.
4 Revised 4/19/2019
Admission Checklist
Medical Laboratory Technology Program
*It is the responsibility of the student to ensure that all required materials for application are received by 5:00 pm on the
application deadline date. Any packets completed after this date will be reviewed at the discretion of the MLT Program
Coordinator and based upon program capacity.
Completed
Complete By Task to Complete
Completed by
March 1, 2020
APPLY TO MANHATTAN AREA TECHNICAL COLLEGE
Applications can be completed online: APPLY NOW
.
Completed prior to the
application deadline
SEND OFFICIAL TRANSCRIPTS
Send Official high school transcript or GED Certificate. Send Official transcripts from
ALL current and previously attended colleges/universities for which transfer credit is
anticipated.
Transcripts must be officialsent directly from the college where you took a course to the
Registrar at MATC. If the Institution has the capability, official transcripts can be sent via email,
to registrar@manhattantech.edu
. Please apply to the college before sending transcripts.
Completed prior to the
MLT Program Courses
COMPLETE PREREQUISITES (must attain a minimum grade of “C”)
Anatomy & Physiology, Microbiology with lab, Chemistry I with lab, English
Composition I, Public Speaking, and Intermediate Algebra or Higher. Additional
information can be found on page 5.
Completed after
acceptance into MLT
program
DOCUMENTATION OF REQUIRED IMMUNIZATIONS
MMR, Varicella, Tetanus, & Hepatitis B documentation.
Additional information can be found on page 6.
Completed prior to the
application deadline
MEDICAL LABORATORY TECHNOLOGY PHYSICAL & ENVIRONMENTAL REQUIREMENTS
Review the Medical Laboratory Technology Physical
and Environmental Requirements
and sign off acknowledging that you can meet the requirements.
At least 30 days prior to
application deadline
CALL WITH QUESTIONS
As the deadline gets closer, we get extremely busy and are not able to respond
to every last-minute inquiry, so please contact us early if you have questions.
Completed by the
application deadline
COMPLETE MEDICAL LABORATORY TECHNOLOGY APPLICATION
SEPARATE FROM COLLEGE
APPLICATION
Fill out the application thoroughly and completely.
Print application and sign the pages that require a signature.
Mail completed application (pages 1-3) to the college:
Manhattan Area Technical College – MLT Application
ATTN: Student Services
3136 Dickens Ave
Manhattan, KS 66503
*All application materials must be received BY THE APPLICATION DEADLINE in order to be considered for that application cycle.
*Late or incomplete applications will be reviewed based upon program capacity and at the discretion of the MLT Program
Coordinator.
5 Revised 4/19/2019
Academic Criteria
To be considered for admission in the MLT program, applicants must meet the following criteria and submit all requested
credentials and documentation:
Applicants are currently in progress OR have completed the following prerequisite courses with a grade of C or higher.
Note: ALL prerequisite courses must be COMPLETED OR IN PROGRESS PRIOR TO THE APPLICATION DEADLINE (March 1) to be
considered for admission. Any exceptions to prerequisite course completion dates would be at the discretion of the MLT
Program Coordinator.
Course Number
Credit Hours
Notes
BSC 125
5
Prerequisite course of Biology. Must have been taken
within 5 years of acceptance into program.
BSC 205
5
Must include a lab & Biology is a prerequisite.
Must
have been taken within 5 years of acceptance into
program.
CHM 110
5
Introduction to Chemistry and Algebra are
prerequisite courses. Must have been taken within 5
years of acceptance into program.
COM 105
3
Prerequisite course, ACCUPLACER, or ACT scores
COM 115
3
MAT 110
3
Prerequisite course, ACCUPLACER, or ACT scores
*Anatomy and Physiology: Course can be completed as one or broken up as two courses (must add up to a minimum of five (5)
credit hours).
Prerequisites exist for some courses. Check the Manhattan Tech catalog requirements and contact your advisor for more
information. College Placement testing may be required to determine where you place in math and English. Consult your advisor
for more information, and check well in advance of the semester when you plan to enroll in a math course.
6 Revised 4/19/2019
Non-Academic Criteria
The following criteria applies to ALL applicants:
Immunizations - DOCUMENTATION REQUIRED UPON ACCEPTANCE INTO THE MEDICAL LABORATORY TECHNOLOGY PROGRAM
These requirements are in place for the health and safety of Manhattan Tech MLT students. By contract with your academic
institution, all students participating in the MLT program must meet the following health and safety requirements. All
documentation must meet requirements at all times during the courses.
1) MMR Documentation
a. Two (2) doses or proof of immunity by titer
2) Chickenpox (Varicella)
a. Two (2) doses or proof of immunity by titer
b. Will NOT ACCEPT HISTORY OF CHICKENPOX - Chickenpox is an immunization that is often incomplete. We can
only accept proof of vaccination or a titer. We cannot take anyone’s testimony that you had chickenpox, not even
a physician. Make sure that you have either vaccines or a titer. Paperwork for a low titer will not be accepted.
3) Tetanus (TDAP)
a. One (1) dose taken less than 10 years ago
4) Hepatitis B (Hep B)
a. Three (3) doses or proof of immunity by titer - Hepatitis B is required by vaccine or titer. If your titer is low, you
should get the vaccine. Paperwork for a low titer will not be accepted. As the Application Information and
Instructions state, you should get the Hepatitis B early, as it takes 6 months to complete the series as required.
5) TB (tuberculosis) test
a. Not due until end of August once accepted into program. Information given at orientation.
Medical Laboratory Technology Physical and Environmental Requirements
The MLT Program is a discipline with cognitive, sensory, affective and psychomotor performance requirements. Based on these
requirements, the following list highlights the
Physical and Environmental Requirements that have been developed. Each standard
has an example of activities which a student will be required to perform, with or without an accommodation, while enrolled in the
MLT program at Manhattan Tech. The Physical and Environmental Requirements should be used as a guide to assist applicants in
determining whether or not accommodations or modifications are necessary in order to meet program participation requirements.
Ap
plicants who identify potential difficulties with meeting the Physical and Environmental Requirements should communicate their
concerns to the MLT Coordinator. If the concern is related to a documented disability, applicants are responsible for contacting the
Student Retention Specialist. Determination of reasonable and appropriate accommodation will be made on an individual basis in
consultation with the Student Retention Specialist. Additionally, applicants should assess their aptitude and ability to perform
professional duties by reviewing the Physical and Environmental Requirements and; if necessary; discuss them with their
healthcare provider.
Background Check - COMPLETED UPON ACCEPTANCE INTO THE MEDICAL LABORATORY TECHNOLOGY PROGRAM
The completion of a criminal background check is one of the admission requirements to the MLT program. Specific requirements in
regards to the background check will be given at orientation. The background check is required to ascertain:
1) The ability of students to attend mandatory rotations at external facilities in accordance with the requirements of the
program.
B
ecause a criminal history can have different effects at the educational and employment levels, when a person is considering
pursuing a health career, it is best to have as much information as possible prior to deciding to enroll in a health program.
Manhattan Tech encourages individuals who have criminal histories and who are interested in pursuing a health career to:
1) Contact approved MLT education programs and ask about the programs’ enrollment criteria with respect to criminal
convictions; AND
2) Contact healthcare facilities and inquire about hiring criteria with respect to criminal convictions.
7 Revised 4/19/2019
Acceptance Process
Admission to the Manhattan Tech MLT program is determined through a competitive selection process. Submission of an
application does not guarantee a position in the program. Refer to page eight (8) for the Medical Laboratory Technology
Admissions Scoring Rubric. Interviews will be conducted by the MLT Coordinator if the applicant number exceeds the total seat
allotment for the program.
If you are admitted into the MLT program without having all required prerequisite courses completed at the time of the application
deadline, you will be required to have the remaining prerequisite courses completed with a “C” (2.0) or better before the MLT
program starts. Official transcripts will need to be submitted to the Registrar for these courses. This also applies to those who are
placed on the alternate list and then asked to join the MLT program.
After the application deadline, files will be scored utilizing the MLT scoring rubric and applicants that completed an MLT Packet will
be notified in writing of their acceptance, alternate, or denied status. Applicants offered a seat in the program must complete a
letter of intent indicating their plan to accept or decline enrollment in the MLT program by the date designated in the notification
letter.
Failure to respond will result in forfeiture of a seat in the MLT Program.
Student Responsibilities Upon Acceptance
After acceptance to the program, students will be required to attend program orientation. Students will be notified of the date and
time of the orientation in the acceptance letter. Specific information about the requirements bulleted below will be provided at
program orientation and will need to be completed by the first day of classes. Please do not submit the information below until
you are accepted. All the information below needs to be submitted to the MLT Program Coordinator.
Immunization records for the following Immunizations/vaccinations -
o MMR Documentation
Two (2) doses or proof of immunity by titer
o Chickenpox (Varicella)
Two (2) doses or proof of immunity by titer
Will NOT ACCEPT HISTORY OF CHICKENPOX
o Tetanus (TDAP)
One (1) dose taken less than 10 years ago
o Hepatitis B (Hep B)
Three (3) doses or proof of immunity by titer
o TB (tuberculosis) test - not due until end of August
Background Check The student is responsible for the additional fee.
Health Insurance — Students are required to hold health insurance during their enrollment at Manhattan Tech in the MLT
program
Home Computer and Internet Access - Students should have a reliable home computer with high-speed Internet access.
Failure to provide the items listed above may result in dismissal from the program.
Reapplication
Applicants who are not selected for admission are encouraged to submit a new MLT packet for the following year. Manhattan Area
Technical College Admissions Applications are good for three (3) years. Those not selected for admission are encouraged to talk
with an advisor about how to increase their admissions scores.
8 Revised 4/19/2019
Medical Laboratory Technology
Admissions Scoring Rubric
Applicant Information
Last Name: First Name: MI: MATC Student ID:
Since the Medical Laboratory Technology program is a selective admission program, the scoring rubric (located below) will be used to
determine the applicants selected. The completion of the MLT Admissions Application does not guarantee a position in the program.
Students that do not qualify for admission are encouraged to follow up with an advisor to see what they can do in order to improve their
score. Students with pre-requisites currently in progress will receive a score of zero for the line noting the pre-requisite in part A. Any
exception to the rubric below will be at the discretion of the MLT Program Coordinator. Interviews will be conducted by the MLT
Coordinator only if the applicant numbers exceed the total seat allotment for the program.
Part A - Prerequisite Math and Science Grades:
Points 2 3 4 Scores
Letter Grade for:
Anatomy and Physiology
C B A
Letter Grade for:
Microbiology with lab
C B A
Letter Grade for:
Chemistry I with lab
C B A
Letter Grade for:
Intermediate Algebra or Higher
C B A
GPA on all required courses (includes Public Speaking and
English Composition I)
2.5-2.9 3.0-3.4 3.5-4.0
Total of Section A
Part B Additional Points:
Points
2
3
4
Scores
BS in a Science Field of Study N/A N/A Yes
Years of Work Experience in Medical Field N/A 1+ Years N/A
Shadowed/Volunteered in a Clinical Laboratory Yes N/A N/A
Total of Section B
Total of Sections A and B
Part C – Interview with MLT Program Coordinator (Conducted only if applicant numbers exceed program capacity):
Points
0
1
2
Scores
Interviews will be conducted if there are more applicants
than program capacity
Doesn’t
Meet
Expectations
Partially
Meets
Expectations
Meets
Expectations
Total of Section C
Note Deadline: Your Manhattan Tech Admissions Application as well as the required Medical Laboratory Technology
Admissions Packet and the documents listed within must be received on or before the 1
st
business day in March to be
considered for admission into the program. Any packets completed after this date will be reviewed at the discretion
of the MLT Program Coordinator and based upon program capacity.
9 Revised 4/19/2019
Explanation of Immunization Requirements
All immunizations below need to be completed after acceptance into the MLT program.
Some series below take 6 months to complete so plan accordingly.
MMR (Measles/Rubeola, Mumps, & Rubella)
Options to meet this requirement:
1. Provide a copy of proof showing a positive IgG antibody titer for Measles/Rubeola, Mumps and Rubella.
a. If the titer results are POSITIVE, attach a copy of the lab results to the MLT admissions application.
b. If the titer results are NEGATIVE or EQUIVOCAL, you must get your MMR series. After the first shot, you
will be required to complete the second MMR after 28 days and submit proof to Manhattan Tech.
OR
2. Complete one series of MMR immunizations. One “series” of immunizations includes immunization for each
disease on separate dates at least 28 days a part.
Varicella (Chickenpox)
Options to meet this requirement:
1. Provide a copy of proof of positive IgG antibody titer for Varicella
a. If the titer results are POSITIVE, attach a copy of the lab results to the MLT admissions application.
b. If any of the titer results are NEGATIVE or EQUIVOCAL, you must get your first Varicella vaccination and
the second Varicella must be completed after 30 days and proof submitted to Manhattan Tech.
OR
2. Show proof of or complete one series of Varicella immunizations. One “series” of immunizations includes two
shots separated at least 30 days apart.
Tetanus/Diphtheria/Pertussis (Tdap)
Options to meet this requirement:
1. You must provide proof of Tdap vaccination, followed by a Tdap booster every 10 years.
Hepatitis B (Hep B)
Options to meet this requirement:
1. If you have not received the injections in the past, do not get a titer. Provide a copy of proof showing a
positive IgG antibody titer for Hep B.
a. If the titer results are POSITIVE, attach a copy of the lab results to the MLT admissions application.
b. If the titer results are NEGATIVE or EQUIVOCAL, you must get your Hep B Booster.
OR
1. Show proof of or complete one seriesof Hep B immunizations. You must obtain the first injection, then the
second injection is given 1 to 2 months after the first dose and the third injection is 4 to 6 months after the first
dose.
TB (tuberculosis) Test
1. Not due until August once accepted into program. Information will be given at orientation.
10 Revised 4/19/2019
This Page Intentionally
Left Blank.
1 Revised 4/19/19
Medical Laboratory Technology
Admissions Application
Program Information Form
Applicant Information
Last Name: First Name: MI: Date of Birth:
Street Address: Apt #:
City: State: Zip:
Cellular Phone: Have you ever been convicted of a felony? ____ Yes ____ No
MATC Email address: MATC Student ID:
Have you ever applied to this program before? No______ Yes______ If yes, when?
Please provide the following information for all courses:
Pre-Requisite Course Number College Grade
Anatomy and Physiology with lab
Microbiology with lab
Chemistry I with lab
English Composition I
Public Speaking
Intermediate Algebra or higher
Please check if any of the following apply to you. These are not required; however, they may strengthen your application. If you
indicate “yes” on any of the three categories listed above you are required to attach the appropriate documentation proving this
information to be true.
Additional Information Yes/No
I have a BS in a Science field of study.
I have at least 1 year of work experience in the medical field.
I have shadowed or volunteered in a clinical laboratory.
*Any packets completed after this date will be reviewed at the discretion of the MLT Program Coordinator and based upon program capacity
.
Due on or before the 1st business day in
March*. Please type or print legibly.
2 Revised 4/19/19
Medical Laboratory Technician
Physical and Environmental Requirements*
The following sensory and physical activities are essential functions of this position and are performed in excess of levels requirement for
ordinary movement.
1. Accommodation
7. Grasping
13. Reaching
2. Awkward position
8. Hearing
14. Repetitive movement
3. Color vision
9. Handling
15. Speaking
4. Depth perception
10. Lifting
16. Standing
5. Feeling
11. Mobility
17. Stooping
6. Fingering (manipulative finger movement)
12. Near visual acuity
18. Twisting
The following mental and communicative activities are essential to the performance of this position:
1. Ability to handle stress and emotions 9. Handling conflict
2. Ability to organize materials 10. Handling multiple priorities
3. Ability to remember procedures and instructions 11. Performing task during limited timeframe
4. Careful attention to detail 12. Positive attitude toward ill, handicapped and elderly
5. Concentrating on task 13. Public contact
6. Dealing with angry people 14. Reasoning-applying procedures
7. Dealing with diverse populations 15. Using diplomacy and tact
8. Fast reaction time.
An individual in this position will be required to carry or lift weights in this range:
10-25 pounds
An individual in this position will be exposed to:
1. Bloodborne pathogens
3. Chemical hazards
2. Physical hazards
4. Respiratory hazards
* Reference: Directory of Occupational titles, 4
th
Edition, Department of Labor, 1991. Additional information available upon request.
Definitions
Accommodation: Adjustment of lens of eye to bring an object into sharp focus. The factor is required when doing near-point work at varying distances from the eye.
Awkward: Unusual, unaligned position. Twisting or bending at the waist, back and/or neck.
Color vision: Ability to identify and distinguish colors.
Depth perception: Three-dimensional vision. Ability to judge distances and spatial relationships so as to see objects where and as they actually are.
Feeling: Perceiving attributes of objects such as size, shape, temperature or texture by means of receptors in skin, particularly those of finger tips.
Fingering (manipulative finger movements): Using primarily fingers to perform action rather than the whole arm or hand (example: typing, transfer of instruments)
Grasping: Clutching with fingers or arms and maintaining hold.
Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.
Hearing: The power to perceive sound with no less than a 40 decibel loss at 500 Hz, 1,000, Hx and 2, 000 Hz with or without correction . Ability to make fine
discrimination in sound.
Handling: Seizing, holding, grasping, turning, or otherwise working with hand or hands.
Lifting: Moving objects from a lower to higher position or moving objects along a horizontal level, but from position to position.
Mobility: Capable of moving.
Near Visual Acuity: Clarity of vision at 20 inches or less.
Reaching: Stretching of arms and/or legs.
Repetitive movement: Tediously repeating movement.
Speaking: Expressing or exchanging ideas by means of the spoken word.
Standing: Supporting oneself on the feet in an erect position especially for a prolonged period of time.
Stooping: Bending the body forward and downward by bending at the waist.
Twisting: Turning at the hips, waist or neck.
I have read and understand the essential functions for the Medical Laboratory Technology program. I am currently able to meet all requirements of
the essential functions necessary for success in the field of laboratory medicine. I will immediately notify the MLT program coordinator if my
physical capabilities and behavioral skills deteriorate. If at any time the essential functions are not met, your candidacy in the program will be
reviewed.
Name: ______________________________________________ Signature: _____________________________________ Date: ________________
3 Revised 4/19/19
Medical Laboratory Technology Packet
Student Certification and Checklist Form
Please carefully read and initial next to each line item indicating that you have fully completed or met the requirements for admittance
into the Medical Laboratory Technology program.
Checklist for Complete Application
Initials
I have completed an Admissions Application to Manhattan Area Technical College. If
separated from Manhattan Tech for 3 years or more, a new college application is required.
Official transcripts from colleges/universities and high school have been submitted to
Manhattan Tech.
I have completed all the prerequisite courses required and achieved a grade of “C” or
higher OR currently in progress with the prerequisite course(s).
I have completed all pre-application requirements listed in the application information and
instructions.
I certify that I do not have any conduct or criminal violations from Manhattan Tech or any
other college attended and/or I understand that the Admissions Committee will verify.
I acknowledge that I have to turn in my immunization records verifying the required
immunizations upon acceptance into the MLT program
I have attached all the documents required in the order specified below.
Please attach all required documentation as well as Dental Hygiene Packet in the order below:
1) Program information pagePage 1
2) Medical Laboratory Technology Physical and Environmental Requirements Form Page 2
3) Student Certification and Checklist pagePage 3
4) If applicable, additional documentation for the program information page
I certify, under penalty of disciplinary action up to and including automatic withdrawal from the MLT program, that all of the information
is complete and accurate. I agree to supply the MLT program with supporting documentation related to my application, if I am requested
to do so. I further understand that submitting this application does not guarantee admission to the MLT program. Additionally, I
acknowledge incomplete packets will not be considered.
______________________________________________ ________________________________
Student Signature Date
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