PTA Program Application Step 1 of 5 20% Student InformationWe will attempt to contact you about your program application through one or more of the contact methods you provide. If we are unable to reach you, this may result in your inability to start the program.Full Legal Name * Required First Last Preferred NamePreferred Name Requests Students may request that their “Preferred Name” be different from their legal name of record in the system. If you enter a preferred name, it will appear on class lists and adjust your email address to reflect your preferred name.PronounsStudent ID or Star ID * RequiredPhone Number * RequiredMay we contact you using the phone number listed if we have questions about your application?YesNoPreferred Email Address * Required Alternate Email Address Address Street Address City State / Province / Region ZIP / Postal Code This application must be complete for consideration for program admission. Before applying to the ALLIED HEALTH PROGRAM please review your Degree Audit Report (DARS) for the following information. (How to read your report). Required Pre-Program Course Status (as of today's date)Note: These courses must be completed before starting the program. All Pre-Program courses, with a minimum cumulative GPA of 3.0 or better (excluding BIOL 1005). ALTH 1410 Medical Terminology (1 semester credit or equivalent)MEDICAL TERMINOLOGY: Credits * RequiredSelect one1234When taken * RequiredWhere taken * RequiredCourse grade * RequiredCommentsBIOL 1005 Cell Biology (1 semester credit)CELL BIOLOGY: Credits * RequiredSelect one1234When taken * RequiredWhere taken * RequiredCourse grade * RequiredCommentsBIOL 1140 Human Anatomy/Physiology I (4 semester credits or equivalent)ANATOMY/PHYSIOLOGY I: Credits * RequiredSelect one1234When taken * RequiredWhere taken * RequiredCourse grade * RequiredCommentsENGL 1106 College Composition I (3 semester credits or equivalent)COLLEGE COMPOSITION I: Credits * RequiredSelect one1234When taken * RequiredWhere taken * RequiredCourse grade * RequiredComments Observational Experience Pre-requisiteThe PTA program at Lake Superior College requires that students complete a total of 40 hours of observation or volunteer work in at least two (2) different physical therapy settings prior to starting the program. Priority is given to those who have this volunteer work completed by March 1. There is no requirement as to how the 40 hours must be divided between these two (or more) facilities. Complete the required Volunteer Work Verification Form. Students are not “program-ready” until all 40 hours of volunteer work have been documented. Upload Work Verification FormIf you're done with your volunteer hours, please take a photo of your form or scan it now. Optional: mail your form to PTA Program, 2101 Trinity Road, Duluth, MN 55811.Max. file size: 50 MB.I have read and understand the statement above regarding the observational experience pre-requisite. * Required I agree Essay QuestionsDescribe the qualities and attributes you possess that will make you a good physical therapist assistant. Answer relative to your volunteer work, past experience in health care, and/or past life experience. * RequiredExplain why this fall is a good time for you to enter the full-time technical PTA program. Also, discuss your level of commitment to completing the two-year program. * Required Year you wish to start courses * RequiredThis form is due by March 1 of the year in which you intend to start the technical PTA courses. Forms received after March 1 will be considered if all positions in the program are not filled. By submitting this application, I agree to the followingThis application is valid only for the Fall Semester for which I have applied. If necessary, it will be my responsibility to reapply for a future term. * Required Yes I have been accepted for admission at Lake Superior College or I am a current degree seeking student. * RequiredYesNoNot an admitted student? Please pause your application to this program and apply to the college. Remember to come back to this page to apply after you are admitted to the college. Please note that Lake Superior College does not require transcripts to be admitted, you will need to make sure to have your official transcripts sent to the admissions department if you have any transfer courses for this program.I have declared Physical Therapist Assistant Program as my academic program of interest when I applied to Lake Superior College or by working with a Lake Superior College advisor. * Required Agree I have reviewed and met the pre-program English/reading, and math requirements as outlined on the program guide. * Required Agree Status of pre-program courses * RequiredCompleted all pre-program coursesCurrently finishing final pre-program coursesI understand I can apply with pre-program requirements in-progress. Priority will be given to students who have pre-program requirements completed and apply by the application deadline. * Required Agree I understand that if information is missing from my file, or the application is incomplete, I will NOT be admitted into the program. * Required Agree I understand that any falsification of information will result in disqualification of my application. * Required Agree I understand that program acceptance will be sent to my preferred email address listed on this application. * Required Agree I will not register for Physical Therapist Assistant Program courses until I have received official acceptance in the program. * Required Agree There will be a required orientation for the PTA Program. The program orientation is completed after formal program acceptance. * Required Agree Program space is limited and applicants may be placed on a waiting list for formal program acceptance. Program acceptance is a separate process from Lake Superior College acceptance. General education (non-PTA) courses required for the program may be taken prior to formal program acceptance. * Required Agree Graduates of accredited PTA Programs are qualified to sit for the National Physical Therapy Examination (NPTE). Passing the NPTE is a requirement for state licensure in all 50 states. However, licensure in any particular state is controlled by the state licensing board in that state and other factors, such as background studies and criminal history, may affect a graduate’s ability to obtain licensure. * Required Agree
