Personal Information: Student Name: EMPL # (student ID#) Last Four of Social Security #: School of Health and Human Services Health Program Application Florida State College at Jacksonville 4501 Capper Road, Room A224 Jacksonville, Florida 32218 Please Print In compliance with Florida State Statute 119.071(5), students should be aware that Florida State College at Jacksonville collects and uses social security numbers (SSNs) if specifically required by law to do so or if necessary for the performance of the College's duties and responsibilities. The College takes appropriate measures to secure SSNs from unauthorized access and does not release SSNs to other parties except as required to fulfill the College's duties and responsibilities. View full list of SSN collection purposes. Street Address: City, State, Zip FSCJ Email Home Phone: Cell Phone: Birthdate: Sex: Male Female Race: Black American Indian Alaskan Native White (Not Hispanic Origin) Asian Or Pacific Islander Hispanic Certification: I, certify that all information given in this application is true and accurate to the best of my knowledge. I understand that if I have falsified any information, I am subject to immediate dismissal from the School of Health and Human Services program for which I am selected. I understand that all correspondence regarding the program will be sent to my Florida State College at Jacksonville email account. All applicants will be notified of their status 2 to 3 weeks after deadline date. Signature: Date Participation in any health science program requires a medical history and physical examination, including a record of immunizations. For programs that have clinical training components, students must complete a background check and drug screening. Students selected for admission into a program will be provided with the necessary health and screening forms. Students who are unable to complete the clinical requirements after acceptance into selective access programs are not eligible for refunds of tuition and fees. Radiation Therapy Specialist
School of Health and Human Services Health Program Application Florida State College at Jacksonville 4501 Capper Road Jacksonville, Florida 32218 Thank you for your interest in the Radiation Therapy Specialist program at Florida State College at Jacksonville. Please read the instructions carefully and complete the application in its entirety. The application deadline for admission into the program is: Spring term September 15 Before submitting this application, the following must be completed: 1. Have an Associate degree.in Radiologic Technology or Nuclear Medicine Technology 2. Possess a current ARRT card. 3. Include the following with the Radiation Therapy Specialist Program Application: o Copy of ARRT Exam Scores o Unofficial Florida State College at Jacksonville Transcripts o Copy of current ARRT card o Proof of Associate degree o Copy of front and back of signed CPR card (through American Heart Association only) o Verification of healthcare experience, if applicable Submit Health Program Application by one of the following methods: 1) Email all documents to hcic@fscj.edu (Preferred method) 2) Hand deliver to the Health Career Information Center, North Campus, Building A Room 224. 3) Mail to 4501 Capper Rd, Room A224, Jacksonville, FL 32218 Direct all questions to the Health Career Information Center at 904-713-4545 Status notifications will be sent to your FSCJ email account only.
Florida State College Radiation Therapy Specialist Program (6153) Selection Criteria Date Name Student ID # How many years have you been an R.T.(R)? or a CNMT? Selection Criteria The first criterion is number of years in the field of radiography and/or Nuclear Medicine. Applicants with two or more years in-field experience are eligible for the selection process. If there are not enough applicants to fill the program, then the applicants with scores on the ARRT examination will be used. The maximum possible score is 50. What follows is an example. The top scores will be accepted until the class is filled. Example Your Scores (Provide copy) Radiation Protection 8.3 Radiaton Protection Equipment Operation & Maintenance 6.8 Equipment Operation & Maintenance Image Production & Evaluation 8.1 Image Production and Evaluation Radiographic Procedures 7.5 Radiographic Procedures Patient Care 9.7 Patient Care Total Points 39.4 Total Points
GENERAL PROFESSIONAL INFORMATION: The Radiation Therapist assists in the treatment of cancer patients. Working as part of a health care team, supervised by a radiation oncologist, the radiation therapist positions the patient for treatment, performs the necessary mathematical calculations to determine the radiation dosage and delivers the radiation treatments utilizing highly sophisticated equipment. In order to be considered for the Radiation Therapy Specialist program, the student must be registered with the American Registry of Radiologic Technologists (ARRT) as a radiologic technologist or nuclear medicine technologist and have earned a minimum of an Associate degree. Please refer to the American Registry of Radiologic Technologists (ARRT) eligibility requirements for January 2015. For more information concerning the program, call (904) 713-4545. The Program Director can arrange for you to tour the facilities, meet current students, or speak to faculty members or others working in the field. For Further Information... About the profession -contact: American Society of Radiologic Technologists 15000 Central Ave, SE Albuquerque, NM 87123-3917 www.asrt.org The American Registry of Radiologic Technologists 1255 Northland Dr St. Paul, MN 55120-1155 www.arrt.org About the college -contact: Registrar's Office, Florida State College at Jacksonville 501 State Street Jacksonville, FL 32202 About the program -contact: Radiation Therapy Specialist Program Florida State College at Jacksonville 4501 Capper Rd. Rm. A-224 Jacksonville, FL 32218 (904) 713-4545 hcic@fscj.edu
APPLICATION AND ADMISSION: Students are accepted into this program every spring term. Application is a two-step process. You must first make general application to Florida State College at Jacksonville (FSCJ). This can be done at any FSCJ campus, and there will be a one-time $25 fee. After applying to FSCJ, you may then apply specifically to the Radiation Therapy Specialist Program (application is included in this document). This limited access program is open to applicants regardless of race, religious affiliation, sex or age. Applicants must meet the Florida State College at Jacksonville admissions eligibility requirements (See college catalog for information) and have completed a minimum of an Associate degree in order to be considered for program admission. All applicants should contact a campus admissions office to see if they meet all admissions requirements. Application deadline is midnight, September 15 for admission to the program for the following spring term. Applications may be accepted after the deadline should the class not be filled. Applicants will be required to have a drug screen and background check performed prior to entrance into the program. COURSES: All radiation therapy courses must be taken in sequence or with the permission of the Program Director. Students must achieve a "C" average in all the radiation therapy courses prior to graduation from the program. No radiation therapy course may be repeated more than twice. Any withdrawals or reenrollments must be approved by the Program Director. DENIAL OR REQUIRED WITHDRAWAL: The Radiation Therapy Specialist Program reserves the right to deny admission or require withdrawal of any student who, in the judgment of the department, gives evidence of being unable to perform the responsibilities and tasks required of the radiation therapy profession. Students must be able to demonstrate ability to communicate, ambulate and perform fine motor coordination; have adequate vision and auditory perception. In accordance with Chapter 486.125 of the Florida Statutes, the Radiation Therapy Specialist Program reserves the right to deny or delay admission, or require withdrawal of any student, who in the judgment of the department, gives evidence of "being unable to practice radiation therapy with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals or any other type of material, or as a result of any mental or physical condition." Helpful Phone Numbers Academic Advising/Counseling 904-766-6761 Admissions/Registration 904-766-6700 Bookstore 904-766-6631 Financial Aid/Veterans Affairs 904-766-6700 Health Career Information Center 904-713-4545
SUBMISSION OF APPLICATION Complete Radiation Therapy applications must contain the following items. Incomplete applications will not be processed. 1. Completed Radiation Therapy Specialist Application Form 2. Transcript printed from Campus Solutions (go to www.fscj.edu. At top of the page, click on login to MyFSCJ, login and click on the my Records tab at the top of the page, click on Transcript and click on Printable Version.) 3. Copy of current CPR certification card: The American Heart Association s Basic Life Support for Healthcare Providers. FSCJ's HED 0300 Basic Life Support will fulfill this requirement. Students must keep their certification current through the expected date of graduation. NOTE: The Radiation Therapy Specialist Program is unable to provide applicants with copies of any documentation in their files. Please make and retain copies for your future use prior to submitting them to the program. Submit Health Program Application by one of the following methods: 1) Email all documents to hcic@fscj.edu (Preferred method) 2) Hand deliver to the Health Career Information Center, North Campus, Building A Room 224. 3) Mail to 4501 Capper Rd, Room A224, Jacksonville, FL 32218 Candidates will be notified by FSCJ email of their status after all completed applications have been reviewed. Information concerning a student's status will not be given over the telephone. ESTIMATED EXPENSE: (These Figures Are Approximate and Subject to Change) TUITION Florida resident: Georgia Resident: Non-Florida/Georgia resident: $104.88 per credit hour $216.55 per credit hour $401.27 per credit hour OTHER EXPENSES Application fees for ARRT exam $200.00 Background check $50.00 College application fee $25.00 Drug screen $60.00 FSCJ name tag $8.00 Graduation fees $25.00 Physical exam (est. cost) $125.00 Textbooks (est. cost) $600.00 Uniforms and shoes (est. costs) $125.00
(Fees and other expenses are subject to change without notice.) STUDENTS WHO ARE ACCEPTED TO THE RADIATION THERAPY SPECIALIST PROGRAM: Students are notified of their acceptance into the program by FSCJ email. Accepted students will receive an acceptance letter, and the necessary form(s) for a background check. Students must confirm acceptance of their seat in writing (e-mail) by the deadline specified in the acceptance letter. If the student does not accept the seat by the deadline, the seat will be offered to another candidate. Students must submit a current Student Health Certificate (completed by a physician), Student Health Form (completed by the student) and Hepatitis B Vaccine Statement. Official forms will be sent to the student. Students who receive letters of acceptance are given a specified period of time to formally accept the seat. A time line and guidelines for accepting the seat are included with the acceptance letter. If the student does not accept the seat by the deadline, the seat will be offered to another candidate. Students are required to attend mandatory general and Radiation Therapy Specialist Program orientation sessions to be held on FSCJ's North campus prior to the program's start date. The time, date and location of the session will be provided in the acceptance letter. It is highly recommended that students attend Anatomy and Physiology and Math boot camp to be held on FSCJ s North campus prior to the program s start date. The time, date and location of the session will be provided in the acceptance letter. Students must submit a current Student Health Certificate (completed by a physician), Student Health Form (completed by the student) and Hepatitis B Vaccine Statement. Official forms will be sent to the student. Students are strongly encouraged to carry medical insurance while enrolled in the Radiation Therapy Specialist Program. The student is responsible for any and all costs related to their medical needs while enrolled in the program. Questions about any information contained in this package should be addressed to the Health Career Information Center at (904) 713-4545.
Spring Term: Radiation Therapy Specialist Program Degree Introduction to Radiation Therapy (RAT 1001) Radiation Biology and Safety (RAT 2241) Oncology I (RAT 2242) Radiation Physics (RAT2614) Clinical Education B (RAT 2832) Summer Term: Patient Care in Radiation Therapy (RAT 2123) Oncology II (RAT 2243) Clinical Education C (RAT 2833) Dosimetry and Treatment Planning (RAT 2651) Fall Term: Clinical Education D (RAT 2834) Seminar: Registry Review (RAT 2061) 6 credits 18 credits 6 credits 15 credits 7 credits 10 credits Total: 43 credit hours If you have a record 1. You will be required to pre-apply to the American Registry of Radiologic Technologists (ARRT) for them to determine if you will be eligible to sit for the certification examination upon completion of the program. Contact them at (651) 687-0048 from 9am 5pm CST (11am 7 pm EST), or download the pre-application form by going to www.arrt.org (on the left side of their homepage, point to Ethics, click on Pre-application process then click preapplication ). 2. A copy will be sent to our clinical affiliates, and they will determine if they will allow you in their facility. Students are not denied admission to the program based on their background results, however: 1. If the ARRT deems the student ineligible, the student will not be permitted to sit for the credentialing examination. 2. If any of our clinical affiliates denies the student clinical space, the student will be unable to complete the requirements of the program, and therefore be ineligible to sit for the ARRT credentialing examination. Transcripts Please do not send official transcripts with this application. The only transcript accepted with this application is the unofficial one printed from campus solutions. The program faculty does not have the
authority to grant transfer credit. If the credits do not show up on the Connections unofficial transcript, it will not be counted. Applications received with an official transcript only will be discarded without notifying the student. Official transcripts are to be sent to the college registrar. Highlight the courses that you are counting. This will ensure that you and the program faculty come up with the same score. Do not include a check for payment of any kind. All fees are to be paid to Florida State College, not the program. Due to poor print quality, faxes are not accepted. Do not fax anything. Faxes will be immediately discarded. Scanned and emailed are accepted or delivered originals. If you have any direct patient care experience, please include a letter from your employer on letterhead to include the number of years you have been with them and a brief description of your duties. Thank you for your interest in the Florida State College Radiation Therapy Specialist Program. If you have any questions or problems with the application process, please call (904) 713-4545. Return the application along with any documents to: 1) Email all documents to hcic@fscj.edu (Preferred method) 2) Hand deliver to the Health Career Information Center, North Campus, Building A Room 224. 3) Mail to 4501 Capper Rd, Room A224, Jacksonville, FL 32218