APPLICATION FOR Health Career Programs

Health Career Programs at MCCq Dental Assistantq Occupational Therapy Assistantq Radiation Therapyq Radiographyq Respiratory Careq MCC/Hartford Hospital Surgical Technology

Admissions: 860-512-3210

Financial Aid: 860-512-3380 ma-finaid@manchestercc.edu

STEM Division Office: 860-512-2704

Mail the completed application to: STEM Division Office, MS #17 Attention: Surgical Technology Program Director Manchester Community College P.O. Box 1046, Manchester, CT 06045-1046

Or drop off completed application: STEM Division Office, LRC A237

IMPORTANT DATES:Application Deadline: February 1, 2020

Financial Aid: Priority deadline to be eligible for maximum grant aid is May 15 for fall; October 1 for spring.

Info Sessions: Applicants must register for a mandatory information session. Go to www.manchestercc.edu/surgical-technology.

PR/07/19

www.manchestercc.edu

Banner ID @ ___________________________________________

Net ID _______________________ @ student.commnet.edu

2020-21 Application Process for Surgical TechnologyComplete the Health Career Programs Application and sign, date and submit to the STEM Division office, LRC A237. Applications can be placed in the drop box outside if the office is closed. Deadline for the 2020-21 academic year is February 1, 2020.

July 2019/PR

QUESTIONS: Contact Terry Kennedy, CST, MAT, Surgical Technology Program Director, 860-512-2734, email tkennedy@manchestercc.edu

Consideration for admission to the MCC/Hartford Hospital Surgical Technology program follows a sequential application and selective admission process. The Surgical Technology applicant may not advance in the process if the prior step has not been completed.

Complete the following required non-core Surgical Technology courses (34 credits) or their equivalent, if transferring, and demonstrate a minimum GPA of 2.5 in all courses completed: • BIO* 211: Anatomy and Physiology I• BIO* 212: Anatomy and Physiology II • BIO* 235: Microbiology • CHE* 111: Concepts of Chemistry • COM* 172: Interpersonal Communications or COM* 173: Effective Speaking• ENG* 101: English Composition• MAT* 109: Quantitative Literacy or higher• PSY* 111: General Psychology I • Elective: Any one course from Gen Ed — The Arts• Elective: Any one course 2

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EIGHT STEPS REQUIRED TO COMPLETE SURGICAL TECHNOLOGY APPLICATION PROCESS

• BIO* 211: Anatomy and Physiology I• BIO* 212: Anatomy and Physiology II • BIO* 235: Microbiology • CHE* 111: Concepts of Chemistry • COM* 172: Interpersonal

Communications or COM* 173: Effective Speaking

• ENG* 101: English Composition• MAT* 109: Quantitative Literacy or

higher• PSY* 111: General Psychology I • Elective: Any one course from

Gen Ed — The Arts• Elective: Any one course

Attend Surgical Technology information session before the application deadline of February 1, 2020.

Submit the required applications by February 1, 2020. MCC Application for Admission: Applications are available at the Admissions office,

SSC L156, or online at www.manchestercc.edu/admissions. Health Career Programs Application: Applications are available at www.

manchestercc.edu/surgtech and must include official copies of transcripts. Hard copies of official transcripts should be attached to the application. If the institution does not issue hard copies, then electronic copies can be sent by email directly to Terry Kennedy, Program Director, at tkennedy@manchestercc.edu.

Pass a program entrance exam with minimum score of 70%.

Pass an in-person interview with an oral and written component. After completing steps 1-5, a maximum of 10 students will be offered admission, based

on the Surgical Technology Interview Committee decision. Students offered admission to the program are required to complete steps 6-8.

2. Attend Surgical Technology program orientation.

Pass background check (paperwork provided at Surgical Technology program orientation).

Demonstrate that program’s physical standards are met through submission of current physical examination/immunization records (form provided at Surgical Technology program orientation).

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Health Career ProgramsApplication

Please complete this application and sign, date and submit to the STEM Division offce, LRC A237. Applications can be placed in the drop box outside if the offce is closed. APPLICATION DEADLINE for the 2020-21 academic year is February 1, 2020.

PROGRAM SELECTION

Please indicate the program for which you are applying. Use a separate application for each program to which you wish to apply. Program prerequisites and application requirements vary by program. It is the student ’s responsibility to meet all program prerequisites and to complete all application requirements.

n Dental Assistant certifcate program (applications will be accepted until class is flled)

n Occupational Therapy Assistant associate degree program

n Radiation Therapy associate degree program

n Radiography associate degree program

n Respiratory Care associate degree program

n Surgical Technology associate degree program

APPLICANT INFORMATION

Name Banner ID

Street Address (including apt/unit #)

City State Zip

Home Phone Number Cell Phone Number

Email Date Attended Information Session

HIGH SCHOOL INFORMATION

High School Attended High School Address/City/State

Date of Graduation GED n Yes n No

COLLEGE INFORMATION

College Attended Degree Earned Date of Graduation

College Attended Degree Earned Date of Graduation

College Attended Degree Earned Date of Graduation

REQUIRED

If I am selected for a program interview, I agree to be available for an in-person interview at the designated time. n Yes, I agree.

I certify that my answers are true and complete to the best of my knowledge. Signature Date

www.manchestercc.edu/health July 2019/PR