Washtenaw Community College
Physical Therapist Assistant (APPTA)
Fall 2021 Entry (2021-22 Academic Year)
Application Deadline: Friday, January 8, 2021 at 5pm (or until all accepted and/or alternate seats are filled)
PROGRAM APPLICATION AND REQUIREMENTS CHECKLIST
Rev. 8/31/20 Health and 2
nd
Tier Admissions Office · Washtenaw Community College · 4800 East Huron River Drive, Ann Arbor, MI 48105
Phone: (734) 973-3596 or (734) 477-8998 · Fax: (734) 677-5408 · Email: healthadmissions@wccnet.edu · www.wccnet.edu
WCC Student ID: _________________________ Date: __________________
Last Name: _________________________ First Name: ________________________ Middle Name: __________________
Former/Previous Names: _______________________________________________________________________________
Street Address: _____________________________________________________________________ Apt: _____________
City: __________________________________________ State: ______ Zip: __________ County: ___________________
Home Phone: (_____)_______________ Cell Phone: (_____)_______________ Work Phone: (_____)_________________
WCC Email/netID: ___________________________________ Other Email: ______________________________________
REQUIRED CHECKLIST
All of the requirements below must be successfully completed before submitting an application to the program.
_
__ 1. Admission to WCC
An admission application to the school can be submitted on WCC’s website at
https://mywcc.force.com/OnlineApp/TX_SiteLogin?startURL=%2FOnlineApp%2FTargetX_Portal__PB
.
_
__ 2. Mandatory Advising Appointment & Signature
You must meet all “required” checklist items and have an advisor sign-off on this application packet before you will be
eligible to apply to the program. Appointments should be scheduled during the Fall 2020 semester. To ensure
availability of an appointment, we encourage students to schedule their appointment as soon as possible. Please
call (734) 677-5102 and press 0 to request your “Mandatory PTA Advising” appointment.
Date Completed: ______________________
Important COVID-19 Information: While on-campus operations are suspended due to the pandemic, appointments
will be scheduled remotely via telephone. In this case, your advisor’s signature will not be required on your
application. Your advisor will notify our office to confirm completion after your appointment.
_
__ 3. Program Prerequisite Courses
Please indicate how you met each requirement below.
___ a. Academic Math Level 3 or higher or MTH 160 (Basic Statistics) with a minimum grade of C/2.0
___ MTH 160 or equivalent course (provide details below). Grade will be used in GPA calculation.
___ Academic Math Level of 3 (provide details below if college level math course taken). If a level 3 or
higher level college math course (e.g. MTH 125, MTH 167, MTH 169, MTH 176, etc) was successfully
completed, the grade will be used in the GPA calculation for points. If level 3 or higher was established
base on test scores or remedial level courses (e.g. MTH 094, MTH 097, etc.), the score/grade will NOT
be used in the GPA calculation.
School
Subject
Course
Grade/GPA
Credits
WCC Equivalent (if transfer)
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PROGRAM APPLICATION AND REQUIREMENTS CHECKLIST continued for APPTA Fall 2021 (2021-22 Academic Year)
Rev. 8/31/20 Health and 2
nd
Tier Admissions Office · Washtenaw Community College · 4800 East Huron River Drive, Ann Arbor, MI 48105
Phone: (734) 973-3596 or (734) 477-8998 · Fax: (734) 677-5408 · Email: healthadmissions@wccnet.edu · www.wccnet.edu
___ b. HSC 101* (Healthcare Terminology) with a minimum grade of C/2.0
*HSC 124 (Medical Terminology) may be substituted.
School
Subject
Course
Grade/GPA
Credits
WCC Equivalent (if transfer)
___ c. ENG 111* (Composition I) with a minimum grade of C/2.0
*ENG 226 or other substitutions may be noted in DegreeWorks.
School
Subject
Course
Grade/GPA
Credits
WCC Equivalent (if transfer)
___ d. BIO 111* (Anatomy and Physiology Normal Structure and Function) with a minimum grade of B-/2.7
*Student’s may use multiple courses and labs to meet requirement. If taken between multiple schools, a
substitution must be submitted by the department.
School
Subject
Course
Grade/GPA
Credits
WCC Equivalent (if transfer)
___ 4. Minimum Cumulative Program Prerequisite GPA of 2.8
Calculation of MTH Prereq Course, HSC 101/124, BIO 111, & ENG 111
Cumulative Prerequisite GPA: _________________________
_
__ 5. Program Application and Requirements Checklist (this form, pages 1-4)
_
__ 6. Additional Information Form (pages 5-6)
_
__ 7. Abilities Statement (page 7)
___ 8. Due to COVID-19, WCC is waiving the requirement for applicants to complete 20 Hours of Observations in a
physical therapy setting with a minimum of 3 hours in at least 3 different types of physical therapy settings. A
determination of requirements for future applicants will be made base on CDC and official Public Health
recommendations at the time the Fall 2022 application packet is prepared (early Fall 2021).
_
__ 9. Residency Verification
The student’s residency status may be updated accordingly based on the documentation submitted. Please include a
copy of the front and back of your Driver’s License or State ID Card.
OPTIONAL CHECKLIST
The items below are not required to apply to the program. However, by successfully completing and/or meeting these items
by the application deadline, you can earn additional points which could give you a more competitive edge.
_
__ 1. Military or Veteran Status
Submit appropriate documentation to verify status if currently serving or DD-214.
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PROGRAM APPLICATION AND REQUIREMENTS CHECKLIST continued for APPTA Fall 2021 (2021-22 Academic Year)
Rev. 8/31/20 Health and 2
nd
Tier Admissions Office · Washtenaw Community College · 4800 East Huron River Drive, Ann Arbor, MI 48105
Phone: (734) 973-3596 or (734) 477-8998 · Fax: (734) 677-5408 · Email: healthadmissions@wccnet.edu · www.wccnet.edu
_
__ 2. Alternate Candidate Status
Students who made alternate candidate status and did not make admission to the program based on a previous
application will be awarded additional points. Semester(s) given Alternate status: ____________________________
_
__ 3. Experience
Students can be awarded points for one (1) of the items below (sections a or b). For additional information, see the
Experience Form (included in packet) and Point Scales found on WCC’s Health and 2
nd
Tier Admissions at
https://www.wccnet.edu/start-now/degree/2nd-tier/.
_
__ a. Employment Experience
Submit completed Experience Form (page 8) or veterans must submit Form DD-214.
___ b. High School Health Science Technology Program with grade of C/2.0* (minimum of 1 year)
*Articulated credit is only accepted with grade of B/3.0 or better.
Submit high school transcript along with clarification documentation if necessary.
Please read the statements listed below. By signing this form, I acknowledge that I have completely read and
understand the statements below.
1. I have successfully completed all required checklist items and I have included all documentation needed to verify
these requirements.
2
. I have met with an advisor and discussed the admission/program requirements along with WCC’s competitive
admission process.
3
. I have discussed a plan for meeting any necessary requirements with my advisor including my next steps should I not
get accepted.
4
. I understand my advisor will help guide me through this selection process. However, I understand that if I hav
e
c
ompleted multiple courses which would satisfy any single requirement above, I take full responsibility for making the
final selection of the course I wish to use towards my application which may affect my application points.
S
tudent’s Printed Name: _______________________________________________ Student ID: ___________________
*Student’s Signature: __________________________________________________ Date: ________________________
*An electronic signature will be recognized ONLY IF this document is submitted directly from the students WCC email address.
Student Notes:
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PROGRAM APPLICATION AND REQUIREMENTS CHECKLIST continued for APPTA Fall 2021 (2021-22 Academic Year)
Rev. 8/31/20 Health and 2
nd
Tier Admissions Office · Washtenaw Community College · 4800 East Huron River Drive, Ann Arbor, MI 48105
Phone: (734) 973-3596 or (734) 477-8998 · Fax: (734) 677-5408 · Email: healthadmissions@wccnet.edu · www.wccnet.edu
TO BE COMPLETED BY ADVISOR
A
dvisor’s Printed Name: _______________________________________________ Extension: ___________________
I
have met with this student and reviewed their application with them. The student appears to meet all minimum admission
requirements for the program.
A
dvisor’s Signature: __________________________________________________ Date: ________________________
A
dvisor Notes:
SUBMITTING APPLICATIONS
Applications and all documentation can be submitted in one of the ways listed below. Applications must be received by
WCC’s Health and 2
nd
Tier Admissions Office on or prior to the application deadline. To confirm receipt, an email is sent to
the students WCC email approximately 1-2 business days after an application is received.
D
uring the COVID-19 crisis, WCC is operating in a remote capacity with on-campus operations suspended. Please be aware
there will be a delay in receipt of any documents submitted by mail or fax. In-coming mail and faxes are collected from WCC’s
main campus 1-2 times per week.
T
he preferred method of submitting an application is by email directly from the student’s WCC email. It’s recommended that
applicants complete the fillable fields and attach their completed packet along with all supporting documentation. Students
can scan or take pictures of their documentation.
E
mail: Send to healthadmissions@wccnet.edu
Preferred
Fax*: (734) 677-5408 (Attn: Health & Second Tier)
Mail**: Health & Second Tier Admissions, Washtenaw Community College, 4800 E Huron River Dr, Ann Arbor, MI 48105
In-person: Submit to Student Connection (2
nd
floor, Student Center) May not be an option depending on status of
COVID-19 crisis
*
We recommend calling to confirm legibility of documents if faxing. If requested, original or legible emailed documents must
be submitted to complete your application.
**We recommend tracking your application if sending by mail.
S
tudents with questions or concerns regarding WCC’s competitive admission process or submitting an application
to the program should contact the Health and Second Tier Admissions Office at (734) 973-3596, (734) 477-8998, or
healthadmissions@wccnet.edu
.
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Washtenaw Community College
Physical Therapist Assistant (APPTA)
Fall 2021 Entry (2021-22 Academic Year)
ADDITIONAL INFORMATION FORM
Rev. 8/31/20 Health and 2
nd
Tier Admissions Office · Washtenaw Community College · 4800 East Huron River Drive, Ann Arbor, MI 48105
Phone: (734) 973-3596 or (734) 477-8998 · Fax: (734) 677-5408 · Email: healthadmissions@wccnet.edu · www.wccnet.edu
Additional information is provided below that is important and pertains to the program. Please carefully read all statements.
1. The requirements outlined in this packet are based on the academic year/semester indicated above. Admission
requirements/criteria are reviewed annually and subject to change. You are expected to meet all admission requirements
for each semester you apply, and if offered admission, you must meet all program requirements of the catalog term in
which you first begin the program.
a. Program applications are semester specific and only valid for the semester in which you applied. If your
application is closed for any reason and wish to be reconsidered for admission to the program, you will need to
meet current admission requirements and submit a new application to a future semester.
b. Each year, approximately 20 students are accepted to the program for a Fall semester start. This is a full-time
program and no part-time option is available.
2. This program utilizes WCC’s Competitive Admission Process for determining admission to the program. Please read the
Admission to High Demand Programs policy and reviewed WCC’s Point Scales document on WCC’s websites below.
The Point Scales document includes details on how items are calculated and awarded towards the program application.
Admission to High Demand Programs: https://www.wccnet.edu/about/policies/2005.php
Point Scales: https://www.wccnet.edu/start-now/degree/2nd-tier/
3. Please read and review WCC’s website below for details on program requirements and continuing eligibility requirements
along with additional important information found on the department’s website.
Physical Therapist Assistant (APPTA) Degree Requirements:
https://www.wccnet.edu/learn/departments/alhd/programs/appta/
Physical Therapist Assistant (department website): https://www.wccnet.edu/learn/departments/alhd/physical-therapist/
4. WCC sends all communications regarding application and admission statuses directly to your WCC student
email address. It is extremely important that you check your WCC email on a regular basis so you do not
jeopardize your status. Please be aware that WCC assumes any information sent to your WCC email has been
received and reviewed. It is also important to keep your contact information current in the College system (including
addresses, emails, phone number). If WCC is unable to contact you regarding your application and/or you do not
respond to any contacts made by WCC, your application be closed. Contact information can be update online through
your WCC Gateway account by clicking on MyWCC and then Personal Information, at Student Connection (2
nd
floor,
Student Center), or by calling (734) 973-3543.
5. Residency status is a factor when determining application points. For information on WCC’s policies and procedures
regarding residency or to learn of additional documentation that can be submitted to verify residency, please visit WCC’s
website below.
Residency: https://www.wccnet.edu/afford/cost/residency.php
6. Official transcripts must be submitted before any transfer credit can post to your WCC record and/or count towards
application requirements. Information regarding transfer credit can be found on WCC’s website below:
Transfer Credit: https://www.wccnet.edu/start-now/degree/transfer-to-wcc.php
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ADDITIONAL INFORMATION FORM continued for APPTA Fall 2021 (2021-22 Academic Year)
Rev. 8/31/20 Health and 2
nd
Tier Admissions Office · Washtenaw Community College · 4800 East Huron River Drive, Ann Arbor, MI 48105
Phone: (734) 973-3596 or (734) 477-8998 · Fax: (734) 677-5408 · Email: healthadmissions@wccnet.edu · www.wccnet.edu
a. All defined courses plus any substitutions approved by the department prior to the application deadline will be
used to meet prerequisites requirements. If a course is not clearly stated on your transcript and/or the course
cannot be determined an equivalent based on the course description, you must provide a course syllabus for
further review. Also, please be aware that if two (2) or more transfer courses are completed to meet the
equivalent of one (1) of WCC’s required courses, you must meet the minimum grade requirement in each
course (grades are not averaged between the two courses). WCC is not responsible for your application
be
ing delayed due to lack of clarification or approval of a substitution.
7
. Upon acceptance to the program, the Entrance Requirements below must be successfully completed to be eligible t
o
b
egin the program. Students who fail to comply or meet these requirements will forfeit their seat in the program.
a
. Mandatory attendance at two (2) new student orientation sessions. Details will be included in the program
acceptance and alternate candidate letters.
b
. Obtain a criminal background check from the college-designated vendor and submit completed health records.
Specific details and deadlines will be included in the program acceptance and alternate candidate letters and/or
provided at the first mandatory orientation.
c. Su
ccessful completion of WCC’s ROLL (Ready for Online Learning) course in Blackboard or verify completion of
a computer course equivalent to WCC’s CIS 100 (Introduction to Computer Productivity Apps) or CIS 110
(Introduction to Computer Information Systems).
d
. In order to participate in the required Clinical Education experiences, reliable transportation is required. Clinica
l
e
ducation sites may require travel of up to about one hour’s drive.
8. If there are not enough applicants to fill all accepted and/or alternate seats by the initial application deadline, the
a
pplication will remain open until all seats are filled. In this event, WCC’s Application Extension Process will be
utilized. Students who do not meet admission requirements but who expect to meet all requirements by the end of th
e
W
inter 2021 semester are encouraged to submit their incomplete application to be considered for a seat on a conditional
basis. In this case, all applicants (complete or incomplete) who submit an application after the initial application deadline
will be considered for a position based on the date the application was received. If multiple applications are received in a
single day, the applicants position is chosen based on a lottery. As soon as all seats are filled, the application will clos
e.
T
he application will be removed from WCC’s website and will no longer be collected.
By
signing this form, I acknowledge that I have completely read and understand the statements above.
S
tudent’s Printed Name: _______________________________________________ Student ID: ___________________
*S
tudent’s Signature: __________________________________________________ Date: ________________________
*An electronic signature will be recognized ONLY IF this document is submitted directly from the students WCC email
address.
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Washtenaw Community College
Physical Therapist Assistant (APPTA)
Fall 2021 Entry (2021-22 Academic Year)
ABILITIES STATEMENT
Rev. 8/31/20 Health and 2
nd
Tier Admissions Office · Washtenaw Community College · 4800 East Huron River Drive, Ann Arbor, MI 48105
Phone: (734) 973-3596 or (734) 477-8998 · Fax: (734) 677-5408 · Email: healthadmissions@wccnet.edu · www.wccnet.edu
A
dmission into the Physical Therapist Assistant program is contingent upon students declaring that they have specific physical
and cognitive abilities. These requirements are detailed below. WCC reserves the right to request that students successfully
demonstrate the specific cognitive and physical abilities related to the PTA program.
Ab
ilities Necessary for Attainment of Competencies in the PTA Program
The student MUST be able to:
1. Speak clearly in order to verbally communicate with patients, families, health care team members, peers, and faculty.
2. Stand and walk for six (6) to ten (10) hour per day.
3. Bend, squat, kneel, and climb stairs.
4. Possess sufficient strength to push/pull objects more than 50 pounds and to transfer objects of more than 100 pounds.
5. Perform CPR, i.e. move above patient to compress chest and manually ventilate patient.
6. Work with arms fully extended overhead.
7. Possess manual dexterity, i.e. use hands for grasping, pushing, pulling, and other fine motor manipulation, including
legible writing and typing.
8. Demonstrate eye-hand coordination and arm-hand steadiness for manipulation of equipment, i.e. goniometers.
9. Possess tactile ability to differentiate changes in sensation as part of the patient assessment.
10. Possess auditory acuity to note slight changes in the patient’s condition, i.e. lung sounds, vital signs, etc.
11. Possess auditory acuity to hear patient’s calls for assistance without facing the patient.
12. Possess auditory acuity to interpret various equipment signals and alarms and use the telephone.
13. Possess visual acuity to read and distinguish colors, to read handwritten orders and other handwritten or printed patient
data, i.e. medical records, equipment instructions.
14. Possess visual acuity to clearly see and read electronic monitors and scales in order to correctly interpret data.
15. Concentrate on details with moderate amount of interruptions and background noises, such as patient requests, IV
pumps/alarms, etc.
16. Attend to tasks/functions for periods up to 60 minutes in length and to attend to tasks/functions for periods exceeding 60
m
inutes in length.
17. Possess sufficient emotional control to exercise independent judgment and discretion to ensure patient safety.
18. Understand and relate to specific ideas, concepts, and theories generated and simultaneously discussed.
19. Possess ability to read and understand written and spoken English for effective verbal and written communication with
patients, family members, and health care providers.
20. Remember tasks and assignments given to self and others over both short and long periods of time.
I
HAVE READ THESE STATEMENTS AND BELIEVE I MEET THE ABOVE REQUIREMENTS.
P
rinted Name: ___________________________________________________ Student ID: _______________________
*Signature: ______________________________________________________ Date: ____________________________
*An electronic signature will be recognized ONLY IF this document is submitted directly from the students WCC email address.
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Washtenaw Community College
Physical Therapist Assistant (APPTA)
Fall 2021 Entry (2021-22 Academic Year)
EXPERIENCE FORM
Rev. 8/31/20 Health and 2
nd
Tier Admissions Office · Washtenaw Community College · 4800 East Huron River Drive, Ann Arbor, MI 48105
Phone: (734) 973-3596 or (734) 477-8998 · Fax: (734) 677-5408 · Email: healthadmissions@wccnet.edu · www.wccnet.edu
Students can be awarded additional points towards their program application for direct patient care employment experience
in a hospital or health care facility/agency if completed within 8 years of the application deadline. This form needs to be
attached to any experience submitted and a separate form must be submitted for each employer/organization.
To be completed by student:
Students Name (printed): ___________________________________________ WCC Student ID: ____________________
Please check one (1):
I am/was employed full-time (30 hrs or more per week). Employer must complete section below.
I am/was employed part-time (15 hrs or more per week, less than 30 hrs). Employer must complete section below.
*Students Signature: ______________________________________________________ Date: _________________
*An electronic signature will be recognized ONLY IF this document is submitted directly from the official email address of the
employer/organization below.
To be completed by employer/supervisor:
Employer/Organization Name: ___________________________________________________________________________
Street Address: _____________________________________________________________ Suite/Apt: ________________
City: _______________________________________________________ State: ___________ Zip: _________________
DATES OF EMPLOYMENT: From (date): _____________ To (date): _____________ Check here if still employed
The above student is/was employed for ______________________ hours per week between the dates listed above.
Job Duties/Services Performed:
Supervisor’s Name: ______________________________________ -Tape business card here-
Job Title: _______________________________________________
Phone Number: _________________________________________
*Signature: _____________________________________________
Date: __________________________________________________
*If completing and submitting electronically, an electronic signature will be recognized ONLY IF this document is submitted directly from
the official email address of the employer/organization. Please send to healthadmissions@wccnet.edu. If a paper form is completed,
please attach a business card or statement on organization letterhead to verify the information.
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