Pta application

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Dear Prospective Physical Therapist Assistant Student:
You have indicated an interest in an Associate in Applied Science degree for a career
as a Physical Therapist Assistant. I invite you to apply for admission. I have attached
the necessary application forms and instructions.
Please return your application as early as possible and follow all directions carefully.
It is your responsibility to see that all application material has been received. Please
notify me of your interest in the program as soon as possible so that I can best advise
you.
Applicants may schedule an informational interview with the Physical Therapist
Assistant Program Director. If you have any questions regarding the entrance
requirements or would like to schedule an interview, please contact Doug Smith at
970-542-3226 or by e-mail at doug.smith@morgancc.edu. You may fax forms to
Doug at 970-542-3115 or mail them to the address below.
We hope to hear from you soon.
Sincerely,
Doug Smith, PTA, BS
Director, Physical Therapist Assistant Program
Morgan Community College
920 Barlow Road
Fort Morgan, CO 80701

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MORGAN COMMUNITY COLLEGE
PHYSICAL THERAPIST ASSISTANT PROGRAM
APPLICATION FOR ADMISSION
TODAY’S DATE: _______________________________
NAME _____________________________________________________________________
First Name Middle Initial Last Name
MAILING ADDRESS: _______________________________________________________
__________________________ _______________ ________________
City State Zip Code
PHONE: _________________ _____________________ ______________________
Home Work Emergency
CELL PHONE: _______________________E-MAIL: ________________________________
BIRTHDAY______________________GENDER______________ETHNICITY____________
PREVIOUS COLLEGES ATTENDED:
SCHOOL CITY & STATE COURSES DEGREE DATES
Other information:

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2011 Admission Requirements…
 Score 61 or more on Elementary Algebra Accuplacer, or pass MAT 107 or higher.
 Score 95 or more on Sentence Skills/English Accuplacer or pass ENG 090 or higher.
 Score 80 or more on Reading Accuplacer or pass REA 090 or higher.
 Work or observe 100 hours in a PT setting.
 Provide three recommendations (employer, instructor, and non-relative character references).
 Interview with PTA Program Director and submit an application and copies of all transcripts.
(Official transcripts must be received by the Registrar before Fall semester of Year One).
 Meet with Health Occupations Advisor Gwen Steffen at (970) 542-3224 for information on
required medical/clinical documents (immunizations, TB test, Professional CPR card,
criminal background check, drug screen, liability insurance, and clinical ID badge).
 In addition to all the above requirements, the two prerequisite courses must be completed
or in progress before the student is considered an “eligible applicant” for Fall enrollment
into the MCC PTA Program. (However, they must be completed with a grade of C or better
before Fall semester begins.)
Important Notes:
 Students are admitted to the program each Fall in the order in which they become “eligible
applicants” - until seats are filled. Other “eligible applicants” will be placed on a wait list.
 A grade of “C” or better must be achieved in all required courses each semester in order to progress
to the next semester of the program.
 Comprehensive exams must be passed each year.
 The graduate is awarded an Associate of Applied Science Degree for Physical Therapist Assistant.
 Medicare now requires PTA’s to pass licensure.
 Please make contact with the Program Director, Doug Smith, PTA, BS as early as possible
by phone (970) 542-3226, fax (970) 542-3115, or email: doug.smith@morgancc.edu.

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Graduation Requirements…
PREREQUISITES (6 Credits)
BIO 201 Anatomy & Physiology I 4
HPR 178 Medical Terminology 2
(Prerequisites must be completed before Fall semester of Year One.)
Year One
FALL (17 Credits)
BIO 202 Anatomy & Physiology II 4
HPR 117 Anatomical Kinesiology 3
PTA 110 Basic Patient Care Skills in PT 5
PTA 115 Principles & Practices of PT 2
ENG 121 English Composition I 3
SPRING (14 Credits)
PTA 120 Modalities in PT 5
PTA 140 Clinical Kinesiology 5
BIO 216 Pathophysiology 4
Year Two
SUMMER (7 Credits)
PTA 280 PTA Internship I 4
PSY 101 General Psychology 3
FALL (16 Credits)
PTA 230 Orthopedic Assessment & Management Techniques 5
PTA 240 Neurologic Assessment & Management Techniques 5
COM 125 Interpersonal Communication 3
PSY 235 Human Growth & Development 3
SPRING (12 Credits)
PTA 281 Internship II 5
PTA 282 Internship III 5
PTA 278 Seminar 2
Total Credits 72
(Includes the 6 credits of prerequisite courses)

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PHYSICAL THERAPY ASSISTANT PROGRAM
PHYSICAL THERAPY SETTING VISITATION/VOLUNTEER REPORT
Note to the clinician: As part of the admission process for the Physical Therapist Assistant program at
Morgan Community College, each prospective student is to spend time observing, volunteering, or
working in a physical therapy setting (100 TOTAL Hours). During this time, the student will hopefully
be able to interact with a physical therapist or physical therapist assistant and gain a better understanding
of the Physical Therapy profession and the roles and responsibilities of PT’s and PTA’s. We know your
schedule is busy, and your help is greatly appreciated. When the individual has completed his/her
visitation you may return this form through the student or mail it directly to:
Doug Smith, Director
Physical Therapy Assistant Program
` 920 Barlow Road
If you have questions regarding the PTA program or our admission procedures please, contact Doug by
phone (970) 542-3226, fax (970) 542-3115, or e-mail: doug.smith@morgancc.edu.
Name of applicant: ____________________________________________________________
Name of supervising clinician: _____________________________________________________
Name of clinic: _________________________________________________________ _
Address: ______________________________________________________________________
1. Student was punctual with his/her appointments. ___Yes ___No
2. Student was dressed appropriately. ___Yes ___No (explain)
3. Student's behavior was appropriate. ___Yes ___No (explain)
4. Student's interest appeared ______ ______ ______ ________ ______
Low Fair Average Very Good Exceptional
5. Number of hours the student spent in your setting: ______________________
6. Any additional comments:
Signature: ______________________________________ Date: .

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EVALUATION OF APPLICANT FOR ADMISSION
I, (applicant's name, printed) request that you complete this
evaluation of me and send it to the address indicated. I understand that your candid evaluation of me
is being sought and I have indicated below whether or not the form will remain confidential.
“I hereby waive my right of access to your confidential recommendation and understand the
recommendation will be held in confidence.”
Applicant's Signature: Date: ___________
(Absence of a signature indicates that the applicant has the right to see this information.)
1. How long and in what capacity have you known the applicant?
.
.
2. Please rate the following qualities for this individual, using a scale of “1” to “5”, with “5”
being the highest rank. If unable to rank, mark “UTR”.
Ability to learn Dependability Personality
Responsible attitude Leadership Interpersonal Relations
Maturity/Judgment
3. Check the phrase that best summarizes your recommendation of this applicant.
A superior applicant in all respects
I strongly recommend this applicant
I recommend this applicant with average confidence
I recommend this applicant with some reservations
I do not recommend this applicant
4. Please comment:
.
.
Signature: Occupation: .
Please return form to: Doug Smith, Director
Physical Therapist Assistant Program
920 Barlow Road

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Applicant's Signature: Date: __________
.
.
Maturity/Judgment
8. Please comment:
.
.
___________________________________________________________________________
Signature: Occupation: .
920 Barlow Road

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Applicant's Signature: Date: ___________
.
.
Maturity/Judgment
12. Please comment:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________.
Signature: Occupation: ___________________________
920 Barlow Road

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