FALL Quarter 2019 Entry
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1 OCCUPATIONAL THERAPY ASSISTANT PROGRAM Enrollment Application for FALL Quarter 2019 Entry NAME: STUDENT I.D. #: DATE: ADDRESS: TELEPHONE NUMBER: ADDRESS: CITY: STATE: ZIP CODE: The College application fee must be paid to apply. Have you paid? Yes No Have you applied to the Bates OTA Program previously? Yes No If yes, what year? What was the reason you did not attend or complete the program? Have you previously attended another OTA Program? Yes No If yes, school name: Date of attendance: What was the reason you did not complete the program? The completed enrollment application (original forms only) must include: 1. The cover page with all information provided in the upper box, including student I.D. number. 2. The OTA Foundation Coursework Planning form completed by student. 3. The Statement of Understanding Regarding Program Requirements form completed and signed by student. 4. The two Documentation of 15 Hours of Experience in an OT Setting with two different populations of clients completed by and signed by an OT practitioner from each practice setting. 5. The Personal Statement about OT completed by student. 6. The Letter of Recommendation Form completed and signed by an instructor or employer. OTA PROGRAM ENROLLMENT APPLICATIONS WILL BE ACCEPTED January 8, 2019 to April 19, 2019 Mail the completed OTA program Enrollment Application with original forms to: Bates Technical College 1101 South Yakima Ave. Tacoma, WA 98405
2 OTA ENROLLMENT APPLICATION INFORMATION Fall quarter 2019 entry The accepts 20 students each Fall quarter on a firstcome, first-serve basis. This means the first 20 applicants who submit a complete enrollment application as outlined in the enrollment application packet will be placed on the enrollment list for Fall Quarter 2019, pending meeting the requirements outlined. Those who are working on prerequisites (foundation courses) can apply but need to fill out the conditional enrollment form (mentioned below) with a plan and contract outlined as specified. Enrollment application deadline The OTA enrollment applications will be accepted between January 8, 2019 and April 19, Submit the original forms via the US mail to the address on the enrollment application. It is recommended you keep a copy of the application for your records. All applicants who submit a completed OTA enrollment application by April 19, 2018 will receive notification of probable placement on the enrollment list for Fall Quarter 2019 by April 30, Once the enrollment list is full, applicants will be notified about placement on a wait list. Applicants who are not considered for enrollment in the OTA program Fall Quarter 2019, can reapply for enrollment for Fall Quarter Those not meeting requirements will be notified by or phone. Applications must be complete Applications that are illegible or inaccurate will not be considered (i.e., if an address is illegible or inaccurate and causes your notification letter of placement to be returned, your acceptance status will change). Include all required documents before submitting the application. Incomplete applications will not be considered. A student identification number must be on the application. Conditional enrollment Students can request conditional enrollment on the enrollment application (referred to above). To request conditional enrollment, you must have completed one quarter of an OTA foundation (prerequisites) course and be able to complete the remainder of OTA foundation courses by the end of Summer quarter. Each foundation course must be completed with a grade of 3.0 or better. The Course Planning form (below) in the OTA application will help with planning courses for conditional enrollment. Applicants who meet the OTA application requirements and qualify for conditional enrollment are allowed entry based on the condition that each foundation course is completed prior to Fall Quarter 2019 with a grade of 3.0 or better. Other entry requirements After students receive notification of placement on the OTA enrollment list, instructions to submit documentation regarding the entry requirements (immunizations, background check, dental and health clearance, proof of insurance) will be provided in May of 2019.
3 COURSEWORK PLANNING FORM **Needed for Conditional Enrollment** NAME: STUDENT I.D. NUMBER: DATE: Complete this form by checking all boxes that apply to you and by providing the required information about coursework. More than one column may be applicable. I submitted my official transcripts to the Registration Office to transfer course credits from another college. Complete column 1 on this form for each course Include a copy of the credit acceptance letter from Bates Registration office I have completed one or more OTA foundation courses at Bates. Complete column 2 on this form Include a copy of your unofficial Bates transcript for any Bates course you have already completed. Each foundation course grade must be 3.0 or better I plan to take or I am in the process of taking one or more OTA foundation courses at Bates. Complete column 3 on this form To be considered for conditional enrollment, you must have successfully completed at least one foundation course and be able to complete the remainder of foundation courses at Bates by winter quarter 1 COURSE TRANSFERRED FROM ANOTHER COLLEGE 2 COURSE COMPLETED AT BATES or other College 3 PLANNING TO COMPLETE COURSE AT BATES or Other College Math (Foundation courses grade must be 3.0 or better) Math 100+ level 5 credits Transferring MATH (Foundation courses grade must be 3.0 or better) Math 100+ level 5 credits Completed MATH Qtr/Yr: (Foundation courses grade must be 3.0 or better) Math 100+ level 5 credits Plan to take MATH Qtr/Yr: English English Composition 5 credits Transferring ENGL&101 English Composition 5 credits Completed ENGL&101 Qtr/Yr: English Composition 5 credits Plan to take ENGL& 101 Qtr/Yr: A & P Anatomy & Physiology with lab 5 credits Transferring BIOL& 175 or Transferring BIOL& 241 and 242 (both required) Anatomy & Physiology with lab 5 credits Completed BIOL& 175 Qtr/Yr: or Completed BIOL& 241/242 Qtr/Yr: Anatomy & Physiology with lab 5 credits Plan to take BIOL& 175 Qtr/Yr: or Taking BIOL& 241 Qtr/Yr: and plan to take BIOL& 242 Qtr/Yr: Medical Term Medical Terminology 2 credits Transferring: Medical Terminology 2 credits Completed BIOL 170 or Completed MEDSU 101 Qtr/Yr: Qtr/Yr: Medical Terminology 2 credits Plan to take BIOL& 170 Qtr/Yr Lifespan Lifespan Psychology* 5 credits Transferring PSYC& 200 Lifespan Psychology* 5 credits Completed PSYC& 200 Qtr/Yr: Lifespan Psychology* 5 credits Plan to take PSYC& 200 Qtr/Yr: *PSYC 100 is a pre-requisite to Lifespan Psych and does not have to meet the 3.0 grade requirement
4 STATEMENT OF UNDERSTANDING OF THE OTA PROGRAM REQUIREMENTS NAME: STUDENT I.D. NUMBER: Read each statement below and check the boxes and sign the form to indicate your understanding of and your agreement with the Bates requirements. I understand that incomplete grades are not given in the OTA program at Bates and that students are required to pass every OTA foundation course with a 3.0 or better to enter the OTA program and pass every OTA core course with a 2.0 or better to remain in the OTA program. I understand that the OTA core courses are sequenced and that if a student does not successfully complete a course, the student cannot continue in the OTA program until the course is retaken and successfully passed one year later when it is offered. I understand that Bates OTA students must pay for and complete a national criminal background check and be in compliance with the Child and Adult Abuse Information Act. I understand that if I was ever convicted of a felony, that it is my responsible to request a review of a charge of a felony, regardless of whether it was reduced to a misdemeanor or dismissed, expunged, etc., with the National Board Certification for OT at so that I will be eligible to take the national board OTA certification exam. I understand that OTA students must purchase and wear a uniform specified by the OTA program and follow dress code and a professional code of conduct outlined in the OTA Program Student Handbook. I understand that I must be able to meet the essential functions for students in the outlined below. I understand I can request special accommodations through the college Disability Support Services Office. I understand that if I cannot meet these requirements, I should discuss this with the OTA program director. I understand that my inability as a student to meet the requirements outlined in the Essential Functions for at Bates could impact my continuation in the program. Essential Functions for at Bates: Lift while standing light to moderate less than 50 pounds frequent Lift while sitting light under 25 pounds frequent Lift with assistance heavy over 50 pounds (patient transfer, etc) frequent Pushing heavy over 50 pounds frequent Pulling heavy over 50 pounds frequent Reaching (full extension elbow flexion) at shoulder level occasional/frequent Reaching (full extension elbow flexion) above shoulder level occasional/frequent Standing for extended periods frequent Sitting for prolonged periods of time frequent (60 minutes) Walking (moderate distances within clinical environment) frequent Carrying light to moderate less than 50 pounds occasional Bending occasional/frequent Stooping occasional/frequent Kneeling occasional Turning frequently Hand manipulation (hand controls, simple grasping, power grasping, fine manipulation) frequent Foot controls occasional Visual requirements ability to observe alarms, indicators, measuring devices, patients and the public. Ability to recognize and respond to safety issues. Auditory requirements ability to hear and understand instructions from an instructor, supervisor or health care professionals. Ability to hear safety alarms and respond appropriately. Critical thinking ability to interpret data, prioritize, problem solve, integrate information and make decisions, and exercise good judgement Behavior ability to work in stressful situations, multi-task, handle problems in a professional manner, conduct self in professional and ethical manner and work collaboratively with others. Interpersonal develop empathic relationships with patients and others, tolerate physically close contact with others, work with individuals of varying abilities, ages, socioeconomic, ethnic and cultural backgrounds, accept feedback and appropriately modify behaviors in response to feedback Student's signature: Date:
5 DOCUMENTATION OF OBSERVATION OF OCCUPATIONAL THERAPY STUDENT: STUDENT I.D. NUMBER: Students are required to provide documentation of at least 15 hours of observation, job shadow or work experience in an occupational therapy setting. The 15 hours should take place with two different populations of clients that are seen by OT practitioners. For instance, if you can observe at Multicare Health Systems in adult rehab and also in outpatient pediatrics, that fulfills the Observation requirement. If you can observe in two different settings with two different types of clients, the Observation requirement is also fulfilled. Documentation of the hours must be verified by the occupational therapist or the occupational therapy assistant in the facility where the experience took place. The student is responsible for making a copy of this form for each facility. The student is responsible ensuring the form is accurate, legible, and complete and for submitting the form(s) with the enrollment application during the application period. Students seeking a place to fulfill the 15 hours of observation can contact local occupational therapists or occupational therapy assistants in skilled nursing facilities, hospitals, rehab centers, school districts, psychiatric treatment centers, hand therapy clinics, and pediatric clinics and ask about observing OT services. ****Students should be well-groomed and should dress professionally for the observations (collared shirt, slacks, flat or low-heeled shoes that cover the foot, low-profile accessories, no hats, and no sunglasses). The student has obtained hours of observation, job shadow, or work experience in an occupational therapy setting with an OTR or COTA. Please provide any Comments: Name of facility _ Department Address _ Contact phone number Name of OT practitioner _ Title Signature of OT practitioner _ Date Thank you for providing an opportunity for a student to learn about occupational therapy! If you have questions or comments to share, feel free to contact the OTA program at
6 DOCUMENTATION OF OBSERVATION OF OCCUPATIONAL THERAPY STUDENT: STUDENT I.D. NUMBER: Students are required to provide documentation of at least 15 hours of observation, job shadow or work experience in an occupational therapy setting. The 15 hours should take place with two different populations of clients that are seen by OT practitioners. For instance, if you can observe at Multicare Health Systems in adult rehab and also in outpatient pediatrics, that fulfills the Observation requirement. If you can observe in two different settings with two different types of clients, the Observation requirement is also fulfilled. Documentation of the hours must be verified by the occupational therapist or the occupational therapy assistant in the facility where the experience took place. The student is responsible for making a copy of this form for each facility. The student is responsible ensuring the form is accurate, legible, and complete and for submitting the form(s) with the enrollment application during the application period. Students seeking a place to fulfill the 15 hours of observation can contact local occupational therapists or occupational therapy assistants in skilled nursing facilities, hospitals, rehab centers, school districts, psychiatric treatment centers, hand therapy clinics, and pediatric clinics and ask about observing OT services. ****Students should be well-groomed and should dress professionally for the observations (collared shirt, slacks, flat or low-heeled shoes that cover the foot, low-profile accessories, no hats, and no sunglasses). The student has obtained hours of observation, job shadow, or work experience in an occupational therapy setting with an OTR or COTA. Please provide any Comments: Name of facility _ Department Address _ Contact phone number Name of OT practitioner _ Title Signature of OT practitioner _ Date Thank you for providing an opportunity for a student to learn about occupational therapy! If you have questions or comments to share, feel free to contact the OTA program at
7 PERSONAL ESSAY ABOUT OCCUPATIONAL THERAPY Write your own personal essay which includes the following content: your understanding and breadth of knowledge about occupational therapy your experience with individuals with limited physical, mental, emotional, and or social abilities characteristics you possess that ensure your success as a healthcare professional why you are pursuing a career as an occupational therapy assistant and why Bates? The personal essay should be included in the application and must: 1) be typed in 12 font 2) be between words 3) include your printed full name 4) include your student identification number 5) be a signed and dated original A complete and acceptable essay must score at least 8 out of 10 points to meet the minimum requirement for this application. Scoring is based on: Personal Essay Understanding of the profession (settings, clients, etc.) Addresses all content stated above Writing is organized and clear Grammar and spelling has basic and adequate knowledge addresses all content areas logical and organized; ideas are connected & understood somewhat lacking basic knowledge; inadequate no more than two areas are addressed Ideas are loosely connected and difficult to understand more than half of essay reflects lack of knowledge or misunderstanding failed to address content area listed above poorly connected and disorganized, unable to understand message free of errors no more than two errors more than two errors Completeness met all instructions met at least 4 of 5 instructions met 3 or less of 5 instructions
8 LETTER OF RECOMMENDATION Applicants are required to obtain a current letter of recommendation from your current or former college instructor OR from your current or former employer, supervisor, or a coworker. The person who writes your letter of recommendation has known you for at least six months and 1) can attest to your potential for success as a healthcare professional and 2) can attest to your potential for success in a training program for OT assistants. It is prudent and respectful for you to provide a self-addressed, stamped envelope for your reference to return the letter directly to you. You MUST include the original letter of recommendation in the application submission by April 19, So give your reference person plenty of time to write a terrific letter. Include the letter of recommendation in the application packet. Instructions to the person writing the letter of recommendation: The applicant to the Bates Occupational Therapy Assistant program has requested that you write a letter of recommendation addressing the following: How long you have known the applicant and in what role. In what role or capacity you have known the applicant Addresses the applicant s qualities and potential for success as a student in a career training program for occupational therapy assistants. Addresses the applicant s qualities and potential for success as a future health care professional. Please date the letter, include your contact information (name, address, telephone number, , etc), then sign and date the letter. Please return the letter of recommendation directly to the applicant for inclusion in the application packet.
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