ORANGE COUNTY COMMUNITY COLLEGE OFFICE OF ADMISSION
115 SOUTH STREET | MIDDLETOWN, NEW YORK 10940
This form must be filled out by students wishing to be considered for entry into the Occupational Therapy Assistant Program in
Fall 2012 Occupational Therapy Assistant Program Application
Fall 2012 and returned to the Admissions Office by February 1, 2012 for consideration.
Name (Please print legibly):_________________________________________________ Student ID#: A
Mailing Address:________________________________________________________________
City:_________________________State:_____Zip Code:________ Legal County of Residence:________________________
Phone Number:________________________ E-Mail:______________________________
Date of Birth:_________________
Have you ever been enrolled in a Health Professions program at an Associate’s degree level or higher either at SUNY Orange or
another college? Yes No Program:_______________________________
If yes, did you successfully complete the program? Yes No
Transcripts from all institutions will be reviewed as part of the admissions process. Please list all colleges previously attended:
____________________________________________________________________________________________________________
Academic Requirements:
Admissions Requirements
• High school diploma or GED.
• Eligible to take Freshman English I (ENG 101).
• Eligible to take Elementary Algebra (MAT 101) or have successfully completed Developmental Algebra (MAT 020)
• Completed Intro to Biology (BIO 110), Anatomy & Physiology I (BIO 111), or Anatomy & Physiology II (BIO 112), with a
grade of 2.0 or better; High School AP Biology (score of 3, 4, or 5) or a passing grade in the Biology CLEP examination
within 5 years (Spring 2007 semester or later).
• Students must attain a minimum cumulative GPA of 2.4.
Department Specific Requirements:
• Submit Occupational Therapy Pre-Admission Observation Report with essay. (15 hour min. with documentation).
• Attendance at an Occupational Therapy Assistant pre-admission orientation (includes interview with Dept Chair; problem
solving activity and discussion). At this orientation, students will receive and sign off on information pertaining to health
forms, drug testing, and criminal record policies. Orientation dates and observation forms are available online at
www.sunyorange.edu/admissions/healthforms.shtml.
Students will be considered for admission into this program based on the completion of all academic and department specific
requirements, cumulative GPA, credits completed towards the program (see reverse), problem solving skills, quality of
observation and essay, and seats available.
Students must meet all of the above admissions requirements to be considered for
admission into the program.
Selection Process
All Occupational Therapy Assistant Admissions Requirements must be completed before February 1
st
in order for a student to
be considered for acceptance into that program for the fall semester.
Student Certification and Signature (please check one of the following):
I have attended a pre-Admissions Orientation and completed my observation within 3 years of my planned program start date
(Fall 2009 semester or later).
I plan to attend/have attended a pre-Admissions Orientation this year. Include date attended/plan to attend (mo/yr)____________
My signature acknowledges that I have read and accept the admissions requirements listed above, and that all of the information
provided is accurate and complete.
Student Signature
Date:
For Office Use Only: Accept _________Alt_______ Checklist_______ Low Cum_______ No Deposit _____ Declined ____
Dept Chair/Designee Signature Date:
Admissions Signature Date:
