PTA Military Bridge Program Application Name * Required First Last Address * Required Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands PhoneAlternate PhoneEmail * Required Enter Email Confirm Email Alternate Email Semester to start coursesSelect oneFallSpringSummerYear to start courses Military StatusSelect oneActiveReserveHonorable DischargeHiddenMilitary StatusSelect oneActiveReserveHonorable DischargeDate of Honorable Discharge Year completed phase 2 training * Required(Army/Navy, Coast Guard) or CCAF Journeyman (USAF) Answer the following questionsI have completed the online application to Lake Superior College.. * Required Agree (If you have not, you should do that step first. Apply now)I understand that my ability to start taking courses at LSC is dependent on results of placement testing, if necessary. * Required Agree I understand that I need to request my Joint Services Transcript (Army/Navy, Coast Guard) or CCAF Transcript (USAF) be sent to Lake Superior College. * Required Agree I understand that I am not eligible for the PTA Program until I have completed at least 6 months’ of work experience as a PT Specialist/PT Tech after Phase 2 military training. * Required Agree I understand that Phase 2 training does not count toward the 6 month work experience requirement. * Required Agree I understand I need to obtain a recommendation from a PT who supervised me for at least 6 months during the required work experience period. The recommendation must be on the specific form required by the LSC PTA Military Bridge Program and must be sent directly from the supervising P.T. to Jane Worley at ptamilitarybridge@lsc.edu * Required Agree I understand my supervising P.T. also needs need to complete a Skills Documentation Log form and send it as part of my program application to Jane Worley * Required Agree I understand that if my military training occurred prior to January 2006, I must petition acceptance of these earlier training dates through the LSC petition process and that the result of such a petition is not guaranteed. * Required Agree If honorably discharged I must submit my DD-214 form to Lake Superior College. * Required Agree I understand I am responsible for securing needed financial aid for this program and that the LSC Financial Aid office can be contacted with questions at (218) 733-7601. * Required Agree I understand I will be required to complete two online orientations; one is for the college (SOAR) and one is for the PTA program (administered through eLearning). * Required Agree I have read the program eligibility requirements and attest that the information provided as part of my application to the college and program is complete and accurate. * Required Agree I understand that in order to graduate from the program, I will be required to pass a comprehensive final exam similar in difficulty level to the National Physical Therapy Examination; this will occur during my final semester in the program as part of PTA 2780. I will be given more than one attempt to pass this final exam, but requiring a re-take will most likely delay graduation from the program. The current first-time pass rate for this comprehensive final exam is 40-60%. Each attempt on the exam must be supervised by an approved exam proctor; this will likely require travel and/or time off from work and supervisors may not be used as exam proctors. * Required Agree I understand that if I earn a grade of D, F, or FN (failure for non-attendance) in any technical program course (i.e., PTA 2680, 2682, 2780), I will be considered to be in PTA Program Academic Probation status, and will be moved to the bottom of the priority list for the current academic year for seats in technical program courses. Student who formally withdraw from the course prior to the withdrawal deadline will not be penalized for the first withdrawal from any course. * Required Agree I understand that graduates of accredited PTA programs are qualified to sit for the National Physical Therapy Examination (NPTE). Passing the NPTE is a requirement in all 50 states. 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. Students/graduates may find information about licensure requirements in the state in which they want to practice through the web site for the Federation for State Boards of Physical Therapy (www. fsbpt.org) * Required Agree Captcha
