Fillable Physical Abilities Test Candidate Packet (Miami Dade College)

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Physical Abilities Test Candidate Packet (Miami Dade College)

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PHYSICAL ABILITIES TEST INFORMATION
Schedule
The Physical Abilities Test (PAT) is administered by appointment only. Please email us
at nac@mdc.edu to request your appointment date.
The Practice PAT is also administered by appointment.
Report 10 minutes before the scheduled time in front of Building 9.
Reporting Information
When reporting for the Physical Abilities Test, you MUST bring the following items:
Completed Physician’s Medical Consent Form (must be signed by a Physician)
Physical Ability Test Data Sheet
Signed Liability Waiver
Completed Visitor Entry Questionnaire
Government Issued Picture ID (i.e. Driver’s License)
Receipt of payment from the Bursar’s Office.
Location: North Campus, Building 1, Room 1154
Bursar’s Office Telephone Number: (305) 237-1287
Bursar's Office Email - northbursars@mdc.edu
Candidates may email the Bursar's Office to request Online payment. Please include
your payment form and your phone number in your email to the Bursar's Office
Bursar’s Office Hours: Mon—Thurs 8:00 A.M.—7:00 P.M.; Fri 8:00 A.M.—4:30 P.M.
Candidates will not be allowed to participate in the Practice PAT or PAT
wit
hout the aforementioned items.
N
o Exceptions.
Fees
All Physical Ability Test Fees are non-refundable and non-transferable.
$30—Ph
ysical Abilities Test
$45—Ph
ysical Abilities Test and Practice PAT
Test results are on a pass/fail basis and will be provided to candidates immediately following the
tes
t.
For more information on Physical Abilities Testing, please contact
The Assessment Center:
(305) 237-1476
nac@mdc.edu
REVISED: AUGUST 2021
Instructions
• Turn completed form into the BURSAR’S OFFICE.
o Location: North Campus, Building 1, Room 1154
o Telephone: (305) 237-1287
o Hours: Mon—Thurs 8:00 A.M.—7:00 P.M.; Fri 8:00 A.M.—4:30 P.M.
Please note: The Bursar’s office is closed on Saturdays.
• Bring a copy of the receipt of payment to your scheduled practice test and/or test.
Name :
_______________________________________________________
Date:
________________ (mm/dd/yyyy)
Last Four Digits of
SSN:
________________
Payment Type:
(Please Check One)
__________ Practice Test + Physical Ability Test ($45)
__________ Physical Ability Test Only ($30)
__________ Duplicate Test Results ($10.00)
__________ Duplicate Test Results (Electronic) $1
5.00
I, _____________________________________, understand the following:
• The Physical Abilities Test fee must be paid prior to arriving at the testing site.
• Payment may be made in cash, credit card or money order payable to Miami Dade College.
• All fees are non-refundable and non-transferable.
• Receipts are valid for thirty (30) days from payment date.
********** It will take up to 48 hrs. to receive your PAT Results***************
Candidate Signature: ________________________________________________________
Bursar’s Authorization to Collect Test Fee for
Physical Abilities Test
Payment Receipt #: ____________________________ Cashier: ______________________
For questions, contact
The Assessment Center (305) 237-1476 or nac@mdc.edu
ASSESSMENT CENTER
QUAL
O PER ATING
UNIT
FUND
CODE
ICS DEPT ID
CAMPUS
CENTER
GL CODE
N31201 DI15 301 4A22001 350090 1000 40920
PAYMENT FORM
PHYSICAL ABILITIES TEST
LAW ENFORCEMENT
THE ASSESSMENT CENTER
M iami Dade College
School of Justice
(305) 237-1476
nac@mdc.edu
Phone Number: ______________________________________________________
Email - Address: ______________________________________________________
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signature
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PHYSICIAN’S MEDICAL CONSENT FORM
TO PARTICIPATE IN BASIC PHYSICAL ABILITY TEST
Dear Physician:
RE:
Last Name: ______________________ First Name: ______________________ Mi.: ____
Last 4 Digits SSN: _____________________________ Agency: _________________________
This letter is to inform you of the above named applicant’s intention to participate in the
Pre-Academy Physical Ability Test. The primary goal of this test is to determine if the
applicant is capable of performing MINIMUM standards appropriate for Law Enforcement/
Corrections.
The test will consist of a series of job-related physical performance tests that are designed
to measure balance, flexibility, muscular endurance and strength, anaerobic capacity, and fine
motor skills. These tests will require MAXIMUM effort and will include the following activities:
A. Exit vehicle
B. 220 yard run
C. Obstacle course
(40 inch Police barricade,
Hurdles 24/12/18 inches,
Pylon zig-zag, low crawl)
D. Dummy drag (150 lbs.) 100 ft.
distance
E. Obstacle course (repeat)
F. 220 yard run (repeat)
G. Revolver trigger pull (6 each hand)
H. Re-enter vehicle
PHYSICIAN PLEASE COMPLETE THE FOLLOWING SECTION
I have examined the above named applicant and evaluated his/her medical history. On the basic of
my evaluation, I recommend that:
____________________ Subject can participate without restrictions.
____________________ Participation is not advisable at this time.
Signature of Physician: ____________________________________ Date: ___________________
Office Address: _______
___________________________
Te
lephone
#:
_________
____________
___________________________________
___________________________________
If you have any further questions please contact me at (305) 237- 8292
Training Advisor Lloyd Mitchell
Physical Fitness Coordinator
Room # 8202-6
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signature
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LOCAL PHYSICIAN INFORMATION
Criminal Justice Testing Center for Law Enforcement & Correctional Officers
Notice to Applications: If you do not have your own physician – Medical Doctor (M.D.), or Doctor
of Osteopathy (D.O.), licensed in the State of Florida, you may choose to contact one of the
physicians listed on this page.
1. Call physician’s office for an appointment. The customary charge is $15 - $25.
2. When making an appointment, inform the physician that you are an applicant from Miami
Dade College, Criminal Justice Testing Center.
3. Request Physician to complete and sign the “PHYSICIAN’S STATEMENT FORM” on the
reverse side of this page.
Juan A Enriquez MD
Clinic Center
3800 West 12th Avenue
Hialeah, FL 33012
305-557-7777
Mon-Tues-Thurs 9:00 a.m. – 5:00 p.m.
Friday 9:00 a.m. – 3:00 p.m.
Family Medical Clinic (FMC)
9000 SW 137 Avenue
Miami, Florida 33186
305-603-7824
Mon-Thurs: 9 a.m.- 7p.m
Friday: 9:00 a.m. – 4:00 p.m.
Saturday: 9:00 a.m. – 3:00 p.m.
Urgent Family Care
5673 SW 137th Ave
Miami, FL 33183
(305) 385-3949
Dates: Monday-Friday
Hours: 8:00 a.m.-8:00 p.m.
JOB RELATED PHYSICAL ABILITY TEST
TESTING DATA SHEET
Law Enforcement Test Date: _________________
Corrections
Agency: __________________________________ Independent: ___________________________
Name: ___________________________________ Social Security #: _______________________
Address: _________________________________ City: _______________ Zip: __________
Phone: ______________________ Age: ___________ Height: ____________Weight: _________
Race: ______________ Male Female
I, __________________________________, in consideration of being allowed to take the job
related test, do hereby agree and a vow that I shall not hold liable the school of Justice should I
incur any injuries or disabilities. I have been orientated to the course, given the opportunity to view
a video tape of the course, and have had any questions satisfactorily answered regarding the test.
_________________________ _____________________________
Date Signature
Retest Test
Test Score: _____________________________/ _________________ Evaluation: Pass/ Fail
Test administrator’s Initials: (1) ____________ (2) ______________
Comments and Observations: ________________________________________________________
________________________________________________________________________________
Training Advisor Lloyd Mi chell
Physical Fitness Coordinator
t
NOTE: PHOTO I.D. MUST BE PRESENTED UPON REQUEST
Miami Dade College Assessment Center
11380 N.W. 27TH Avenue RM 8324
Miami, FL 33147
(305) 237-1476
NAC@MDC.EDU
INTRODUCTION
The Physical Ability test you are about to take requires a maximum effort. The time it takes to
complete the test be recorded as your test effort. Pacing yourself will be important for the
successful completion of the test.
FLUIDS:
Consume plenty of fluids 2-3 days prior to testing. Consume a light meal 2-3 hours prior to testing.
YOUR BEST EFFORT IS ENCOURAGED!
PACE YOURSELF AND GOOD LUCK!
The Physical Abilities Test (PAT) is held every other Friday at 9 AM. On MDC North Campus
grounds. The cost is $30 and must be PRE-PAID at the Bursar’s Office before the test
The PAT measures specific physical abilities through participation in a series of tasks which are
listed as follows:
1. Exit vehicle
2. 220 yard run
3. Obstacle course:
a. 40 inch barricade climb
b. 24 inch, 12 inch, and 18 inch hurdles
c. Serpentine ( 9 cones)
d. Low
crawl
4. Dummy drag (150 lbs.) for 100 yards
5. Repeat obstacle course
6. Repeat 220 yard run
7. Open trunk
8. Trigger Pull using “Dry-fire- Safe gun” (6 finger pulls with each hand)
9. Enter trunk and replace the “Dry-fire- Safe gun” and a police radio / re-enter vehice
The test is conducted in a continuous manner resulting in a total composite score.
EVALUATION:
Above course must be completed in a time of 6 minutes 4 seconds or less.
PASS or FAIL
MDC Assessment Center Visitor Entry Questionnaire
Updated as of
8/2/2021
The safety of our employees, students, and visitors remain the Assessment Centers (AC) overriding priority. To
prevent the spread of COVID-19 and reduce the potential risk of exposure to our employees and visitors, we are
conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures
to protect you and everyone in the facilities in accordance with CDC guidelines. Thank you for your cooperation.
Reason for visit: Person(s) You Are Meeting With:
Email Address:
Self-Declaration by Visitor
1
Have you returned from any country outside of the US within the last 14 days?
Yes No
2
Have you had close contact with or cared for someone diagnosed with COVID-19 within the last
14 days?
Yes No
3
Have you been in close contact with anyone who has traveled within the last 14 days to any
country outside of the US?
Yes No
4
Have you experienced any cold or flu-like symptoms in the last 14 days (to include fever, cough,
sore throat, respiratory illness, difficulty breathing)?
Yes No
If the answer is “yes” to any of the questions, we will postpone your appointment for 14 days.
Signature (visitor): _________________________________________ Date: ________________
Any questions should be directed to knewness@mdc.edu.
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I, _________________________, do hereby agree to release Miami Dade College, The School
of Justice Department, The Assessment Center, and all employees thereof, from any and all
claims and liability for personal injury or damages arising from my activities while performing
the Law Enforcement Physical Ability Test on the premises of Miami Dade College, North
Campus.
By my execution here of this ______ day of ______________ , 2021, I hereby certify I have read
and understand the above agreement.
______________________________________________ _________________
Signature Date
______________________________________________
Name (Printed)
Address
City, State, Zip
___________________ _______________________
Last Four Digits of SSN Primary Phone Number
LIABILITY WAIVER
PHYSICAL ABILITIES TEST
LAW ENFORCEMENT
THE ASSESSMENT CENTER
Miami Dade College
School of Justice
(305) 237-8012
nac@mdc.edu
In case of emergency, please contact:
____________________________________
_____________________________________
Name of Contact Person
Phone number of Contact Person
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Completed 18 February 2022

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