Department of Health Professions Radiologic Technology Program

Dear Radiologic Technology Applicant: Department of Health Professions Radiologic Technology Program Thank you for your interest in the Health Professions programs at Missoula College (MC) of the University of Montana (UM). As you prepare your application for submission, there are a few items to consider. This is an internal program application for the Radiologic Technology program itself. The program application process is your opportunity to distinguish yourself as an applicant to the Radiologic Technology Program. Your application will be evaluated in three categories. Each category is weighted equally. The categories to be evaluated are: 1. Cover letter, work experience, and references 2. GPA from prerequisite courses 3. Interviews. Interviews will be conducted for the top 20 candidates. If you qualify for an interview, it will be scheduled for June 2018. If you are not already enrolled at Missoula College (or Bitterroot College), you must also do one of the following as applicable to your situation: If you are currently enrolled at the University of Montana-Missoula campus or were enrolled there less than 24 months ago, you must: o Complete the Intra-Campus File Transfer Form (https://www.umt.edu/registrar/pdf/intra%20campus%20transfer%20form.pdf) and o Submit the form to Admissions/New Student Services in Lommasson Center 101 or email it to Violet Hopkins (Violet.Hopkins@umontana.edu). If you attended University of Montana-Missoula campus over 24 months ago, you must: o Submit a Readmission Application (https://www.umt.edu/registrar/students/readmission%20information.php), selecting Missoula College as your campus. If neither of the above situations apply to you, you must: o Complete an application for admission to Missoula College (http://mc.umt.edu/new%20students/default.php). We hope this is helpful to you. Applications must be received by April 2, 2018 at 12:00 Noon. We are eager to evaluate your application and will provide feedback to you in a timely manner. If you have questions or concerns, please contact Cyndi Stary, Health Professions Administrative Associate, by email at Cyndi.Stary@mso.umt.edu or by phone at (406) 243-7846 for further information. Sincerely, Anne Delaney MBA, RT(R) Radiologic Technology Program Director

2018 Application for Radiologic Technology: Missoula This application is for students applying to the Radiologic Technology program starting August 2018. You must have completed, or will complete by the end of spring semester, all prerequisite classes or their approved equivalent. This application must be legible. If you are not currently enrolled at MC, please see the previous page. Personal Information Full Legal Name LAST FIRST MIDDLE Previous Names(s) LAST FIRST MIDDLE Missoula College Student ID# Permanent Mailing Address City State Zip Phone ( ) - Current Mailing Address City State Zip Phone ( ) - Current Email Address Permanent Email Address National Exam After graduation, students must pass a national exam in order to practice. If you have a felony or misdemeanor conviction, you may not be allowed to take the exam. If you have such a conviction, you must contact the American Registry of Radiologic Technologists (https://www.arrt.org/) in order to determine whether or not you will be allowed to sit for the national exam. Rural and Remote Clinical Placements The Program requires approximately 1,000 hours of clinical rotations, where students are placed in health care facilities to train under the supervision of a licensed Radiologic Technologist. Most placements are in Missoula, but students are also expected to travel to rural locations such as Polson, Hamilton, and Plains, MT. Travel and living expenses are the student s responsibility. In addition, it may be possible to assign a student to either Great Falls or Bozeman, MT for an entire 10 months of clinical training at one facility. If you would like to be considered for one of our remote clinical placements, please check one or both of these options: Great Falls Bozeman Applicant Signature Date 2

Pre-Program (Core) Requirements Program Core Requirements: Students apply in spring semester. If the student is completing the core requirements this spring, be sure to note this in the cover letter. Determination of accepted students will be made after final grades are received at the end of spring semester. Applicants will be notified of official acceptance in June. *Applicants must prove competence with computer technology in one of the following three ways: Have acceptable transfer credit for CAPP 120 Introduction to Computers Pass the challenge exam for CAPP 120 Take and pass CAPP 120 Missoula Campus Course Subject Course Title Credits M 115 or M 121 Probability and Linear Math or College Algebra (**MAT 100 is acceptable in cases where a student began prerequisites prior to Fall 2008.) 3 BIOH 201 & 202N Human Anatomy and Physiology I 4 (Lecture and Lab) WRIT 121 or WRIT 101 Technical Writing or College Writing I SCN 175 Integrated Science 3 AHMS 144 Medical Terminology 3 3 Total Credits 16 BIOH 201N, Human Anatomy and Physiology I Lecture, and BIOH 202N, Human Anatomy and Physiology I Lab, must be completed with a minimum grade of B (3.0). All other coursework must have a cumulative minimum GPA of 2.75. Students may take BIOH 211, Human Anatomy and Physiology II Lecture, and BIOH 212N, Human Anatomy and Physiology Lab, during the first semester of the program. Students must receive a minimum grade of B in BIOH 211N and 212N to continue in the program. Submission Date: April 2, 2018 at 12:00 Noon 3

Application Steps 1. Obtain an application packet for the Radiologic Technology program. A link to the application packet is accessible: a. on the Radiologic Technology program homepage (http://mc.umt.edu/health/radiology) by clicking on the Applications tab; and b. via the Missoula College Health Professions applications webpage (http://mc.umt.edu/health/applications/). 2. Review the application requirements for the Missoula College Radiologic Technology because each program is unique in its admission and acceptance requirements. a. Program requirements are also listed in the current University of Montana catalog under the Missoula College Department of Health Professions (http://catalog.umt.edu/collegesschools-programs/missoula-college/health-professions/aas-radiologictechnology/#requirementstext). b. It is important to consult your advisor or the program director if you have questions. 3. Compile the requested material: Cover letter: Your cover letter is the most important part of your application. It introduces you to the selection committee and explains why you want to be accepted into the program. It is very important that your letter meets these requirements: a. The cover letter should be between 200 and 300 words, no longer than 1 page, printed in 12-point font, single-spaced, with one-inch margins. b. Introduction c. Why you are interested in the field of diagnostic imaging d. Personal characteristics that make you a good candidate e. Conclusion Please use a formal letter format, with complete thoughts and your signature. Include your current address and phone number. Application form (program): completed, signed and dated. Application form (MC UM Missoula): completed, signed and dated, if not already enrolled. Work Experience Form: Please include both paid work and any volunteering you have done. Job Shadowing Form: o A maximum of four hours should be allotted for shadowing a staff technologist. o Shadowing could have occurred in any hospital and is not limited to hospitals in Missoula. o The required job shadow form is included in this application. Document your participation (hours, institutions and name of the radiographer you shadowed) on the Medical Work Experience section of the application and include the completed job shadow form in the packet. 4

References Included in this packet are three copies of the two-page Reference Form. Please inform your recommenders to use the Reference Form, and letters of recommendation are highly encouraged as well. o Please provide three professional references. You are strongly encouraged to use professional references rather than family, friends, or former teachers. o Provide the Reference Form and an envelope to each of your 3 recommenders. o Each Reference Form and letter submitted by you must be in the envelope sealed by the recommender with their signature across the envelope flap. Any evidence of tampering with the sealed reference will cause it to become void. Transcripts, evaluation of transfer courses and/or waivers must include: a. Official paper transcripts from all colleges and universities attended outside of University of Montana-Missoula, Missoula College, and Bitterroot College, if applicable. 1. You can check to see if your college/university allows ordering of transcripts via the National Student Clearinghouse (http://www.studentclearinghouse.org/). 2. Once on the website, click on the orange Order-Track-Verify button, then select Order or Track a Transcript. 3. From there, you can click on the Select school drop-down menu to see if your school(s) show on the list. If not listed, you will have to go to that school s own website for transcript ordering instructions. b. An unofficial transcript of courses currently in progress c. Form: Course Waiver, Transfer and Substitution completed (if applicable). Please submit a copy only of the original document. 4. Submit the completed application by April 2, 2018 on or before 12:00 Noon. The application must be in a sealed 9 by 12 envelope with the following written on the outside of the envelope: o Radiologic Technology Missoula ; o your name; o mailing address; o phone number; and o email address Submit by mail or in person to: Cyndi Stary, Health Professions Missoula College, Room 441 1205 East Broadway Missoula, MT 59802 NOTE: Each packet will be date-stamped upon receipt, and applicant contact information entered on a spreadsheet for further notification. It is the applicant s responsibility to allow ample time for mailing, etc. 5

Selection Process 1. Applications will be read and ALL applicants will be notified of the status, either scheduled for an interview or not selected as soon as possible after final grades for the semester have been posted. Therefore, final acceptance letters are sent out only after semester final grades are known and interviews have been conducted. Information regarding status will only be communicated by letter and will not be given by telephone or email. 2. Accepted applicants must notify MC in writing of the intent to ACCEPT or DECLINE admission to the Radiologic Technology program within ten (10) business days of receipt of the acceptance letter. Failure to do so will result in another candidate being chosen to fill the space Please email Cyndi Stary, copying Anne Delaney, with your decision. o Cyndi Stary, Health Professions Admin. Assoc.: Cyndi.Stary@mso.umt.edu o Anne Delaney, Program Director: Anne.Delaney@mso.umt.edu You are required to use your MC-UM email address (if you have one) for this and any other correspondence with the MC College faculty and staff. 3. Once you have notified MC of your decision to accept a slot in the Radiologic Technology Program, you must register for courses on Cyberbear within ten (10) business days. If you have not registered in the above timeframe, we will not save your place. If after accepting, circumstances prevent you from attending, please immediately notify Cyndi Stary or Anne Delaney, via email, so an alternate candidate can be notified in a timely manner. 4. In the event you are not accepted into the program, you may schedule an advising appointment to discuss why and formulate a plan B. Please contact Maryann Dunbar to schedule an advising appointment. This is necessary to assure financial aid and class availability. IMPORTANT NOTES: In order to ensure fairness to all applicants a spreadsheet with the dates of application, notifications, etc. will be maintained. Therefore, your timely response(s) are critically important in guaranteeing your place in the program. We must have an accurate name, address and telephone number to ensure we reach you. Currently, the program has more applicants than there are positions available. There is no waiting list, students compete with all who are applying to the Radiologic Technology Program. Students not accepted into the program after two admission attempts should request advice from career counseling regarding their educational options. 6

Non-Medical Work Experience Form General Work Experience (this section would include pertinent life experience ) Name and address of facility Job Title Job Responsibility Dates and hours/week of employment Supervisor s name and current phone number Medical Work Experience (Paid or Voluntary) Name and address of facility CNA or Job Title Job Responsibility Dates and similar hours/week of credential employment Supervisor s name and current phone number 7

Job Shadow Documentation Name of Institution and City Name of Technologist shadowed and current phone number of Radiology Department. Date of Shadow Experience Number of Hours 8

Job Shadow Form YOU MUST HAVE THIS FORM WITH YOU WHEN JOB SHADOWING OR YOU WILL BE ASKED TO LEAVE THE FACILITY AND TO SCHEDULE ANOTHER APPOINTMENT. Please complete the following questions while performing your Job Shadow observations. Maintain this form for inclusion in your application for the Radiologic Technology Program. Your application will be considered incomplete without the inclusion of this form. Student s name: Date of observation: Facility where observation took place: Time observation took place (arrival to departure): Total number of hours of observation: Signature of a Registered Radiographic Technologist who was present during observations: Please report on three DIFFERENT TYPES of exams that you observe during your time Job Shadowing. Exam Type #1: Technologist(s) involved in exam: Gross anatomy visualized on final images: Exam Room: Were any special preparations, adaptations, equipment, devices, and/or accommodations used by the technologist or the patient, and for what specific purpose? What is the reason this exam was ordered/why is the exam being done? Exam Type #2: Technologist(s) involved in exam: Gross anatomy visualized on final images: Exam Room: Were any special preparations, adaptations, equipment, devices, and/or accommodations used by the technologist or the patient, and for what specific purpose? What is the reason this exam was ordered/why is the exam being done? 9

Exam Type #3: Technologist(s) involved in exam: Gross anatomy visualized on final images: Exam Room: Were any special preparations, adaptations, equipment, devices, and/or accommodations used by the technologist or the patient, and for what specific purpose? What is the reason this exam was ordered/why is the exam being done? What is the difference between CR and Dr in a Radiology Department? 10

Reference Form (page 1 of 2) (APPLICANT PRINTED NAME) is applying to the Missoula College Department of Health Professions Radiologic Technology Program. The University of Montana cannot require that applicants waive their right to see their references. However, applicants may do so voluntarily. If the applicant waives their right, the recommender s response will not be shared with the applicant at any point. As the applicant, I do waive my right to see this reference. Applicant Signature Date If you wish to have a copy of your completed reference form, ask your recommender to provide you with a copy. Copies will not be provided to applicants by Missoula College. Request to Recommender: The need for healthcare professionals is great. However, due to the availability of clinical sites, we are limited in the number of students we are able to accept into each program. Therefore, it is our responsibility to select students whose abilities, values, motives, and character give the greatest promise for success. Your candid, honest responses to the questions we ask are important to all concerned. We ask therefore, that you take the time to consider each response carefully. And, we request your prompt attention as the applicant has a deadline to submit materials. The applicant will provide an envelope for your reply. Please return the envelope to the applicant sealed and with your name written across the glued portion of the flap. Any evidence of tampering with the seal of the envelope will disqualify the applicant. The applicant will then submit the sealed/signed envelope with other application materials. Thank you. Date: Name and Title of Reference: Please provide the following information: Institution Name and Address: Phone Number (we may contact you further): How long have you known the applicant and in what capacity? 11

Name of Applicant: (Reference Form, page 2) Please read the following and respond as honestly as possible. A single response will cause neither denial nor assurance of admission to a program. We are asking that you respond by comparing the applicant with others having similar backgrounds, responsibilities, and capacities. If you are unable to evaluate in some area, please check N/A. Applicant Characteristics to be Evaluated: 10% Outstanding 25% Above average 50% Average Lower 50% Below average N/A Unknown Interacts well with co-workers, employers, others Is an effective team member Is an effective team leader Works well independently Is appropriately assertive Is self-motivated Displays initiative and creativity Prioritizes tasks appropriately Analyzes and solves problems Requests assistance appropriately Accomplishes tasks in a timely manner Able to function with safety for self and others Effectively communicates orally Has clear written communication Language is professional Is present when expected.reliable Dress and personal care are appropriate Responds positively to criticism Exhibits ethical behavior consistently Interacts respectfully with diverse individuals Demonstrates kindness and compassion Able to laugh at him/herself Exhibits qualities you would like to have in someone taking care of you Additional Information: Please feel free to add descriptions or give examples that will illustrate the above. Use additional paper if needed. In order to help us evaluate this recommendation form, please answer the following: The evaluation characteristics were clear and easy to rate Yes No The evaluation form allows a fair picture of the applicant Yes No The evaluation process took an acceptable amount of time Yes No 12

Application Checklist (for student use only) Your complete application should contain the following items in this order and be received no later than Noon on Monday, April 2, 2018: Cover Letter Application form (program), completed, signed and dated Application form (MC UM), completed, signed and dated, if not already enrolled Work Experience Form References (three references in envelopes with reference signature across sealed flap) Transcripts (official) from all schools attended If applicable, Course Transfer, Waiver and Substitution Form (please submit a copy only) Completed Job Shadow Form Submission Requirement: All information should be sealed in 9 by 12 envelope with the following information printed clearly on the outside of the envelope and received by Noon on Monday, April 2, 2018. Program applying to Applicant Name Address Phone Number Email Address Submit by mail or in person to: Cyndi Stary, Health Professions Missoula College, Room 441 1205 East Broadway Missoula, MT 59802 NOTE: Each packet will be date-stamped upon receipt, and applicant contact information entered on a spreadsheet for further notification. It is the applicant s responsibility to allow ample time for mailing, etc. Thank you for your interest in the Missoula College Radiologic Technology Program. 17