Department of Allied Health Professions Radiologic Technology€¦ · of Radiologic Technologists...

Page 1 of 18 Rev. 12/22/2016 Mohave Community College Radiologic Technology Program 2017

Department of Allied Health Professions Radiologic Technology

Dear Radiologic Technology Program Applicant: Thank you for your interest in the Radiologic Technology Program at Mohave Community College. Please remember that this application is for the program itself. If you are not already enrolled at Mohave Community College, an application for admission to the College must be completed prior to this one. Information pertaining to Mohave Community College admissions is available at: https://jics.mohave.edu/ICS/Admissions_Apply_Online/. The program application process is your opportunity to present yourself for consideration into the Radiologic Technology Program. Your application will be evaluated in several categories. Each category will be weighed equally on a scale of 0-4.

The categories to be evaluated are: 1. Cover Letter 2. References 3. Job Shadow Experience 4. GPA for required prerequisite courses Other Requirements: 1. Official transcripts from other colleges/universities 2. Test of Essential Academic Skills (TEAS) Entrance Exam (HESI Admission

Assessment Exam to be used for 2017/2018) *Note any volunteer experience in health related areas

https://jics.mohave.edu/ICS/Admissions_Apply_Online/


Permission to take the national registry exam once a student has completed the program, may be denied if you have a felony conviction. Review for approval or denial by the American Registry of Radiologic Technologists (ARRT) is conducted on an individual basis. Convictions include criminal proceedings or military court-martials, such as: the conviction of a crime, including a felony, a gross misdemeanor, or a misdemeanor, with the sole exception of speeding and parking violations. Criminal proceedings where a finding or verdict of guilt is made or returned but the adjudication of guilt is withheld, deferred, or not entered or the sentence is suspended or stayed; or a criminal proceeding where the individual enters a plea of guilty or nolo contendere (no contest); [Interim] or where the individual enters into a pre-trial diversion activity; military court-martials that involve substance abuse, any sex-related infractions, or patient-related infractions. Offenses that occurred while a juvenile and that are processed through the juvenile court system are not required to be reported to the ARRT. All alcohol and/or drug-related violations must be reported. For additional information, contact The American Registry of Radiologic Technology, www.arrt.org. Equal Opportunity Policy Statement: Mohave Community College does not discriminate on the basis of race, color, ethnicity, national origin, gender, sex, age, religion, gender identity, gender expression, disability, or sexual orientation in its educational programs and activities or employment practices. Mohave Community College is committed to providing equal employment opportunity, educational opportunity, and advancement to individuals. The College does not discriminate on the basis of race, color, ethnicity, national origin, gender, sex, age, religion, gender identity, gender expression, disability, or sexual orientation in its educational programs and activities or employment practices. Discrimination includes harassment, which includes a wide range of abusive and humiliating verbal or physical behaviors that are directed against a particular person or persons because of one of the above named qualities. This includes creating a “hostile environment” where the conduct is sufficiently severe or pervasive to alter the conditions of the person’s employment or educational experience at the College. Members of the College community have a responsibility to report discrimination and those in supervisory roles are obligated to take action to correct it. Any person found to have violated this anti-discrimination policy will be subject to appropriate disciplinary action. For more information, call the Human Resources Office at 928-757-0835, 1971 Jagerson Ave., Kingman, AZ 86409 Completed applications must be delivered or post-marked by March 31, 2017, 4:00 p.m. (Arizona time). If you have questions or concerns, please contact the Radiologic Technology Department Secretary at 928-704-4180 or e-mail [email protected]. Sincerely, Richard Crabb, MPA, BS, RT(R)(MR) Director of Radiologic Technology

http://www.arrt.org/

mailto:[email protected]


Radiologic Technology Program

PERSONAL INFORMATION This form is required as part of the application packet. By the end of spring semester, all prerequisite classes or their approved equivalent, must be completed.

Personal Information

Last Name First Middle

Previous Last Name(s) MCC E-Mail Address MCC Student I.D. Physical Street Address City State Zip Mailing Address City State Zip Cell Phone Number Alternate Phone Number Emergency Contact Information

Name Relationship Physical Street Address City State Zip Cell Phone Number Alternate Phone Number

Student’s Signature Date


PROGRAM PREREQUISITES (See Chart Below) Applications are accepted January through March of each year. Therefore, if prerequisites are being completed at the time the application is submitted, this should be noted in the cover letter. Credits BIO 100 Biology Concepts 4* BIO 201 Anatomy & Physiology I 4 BIO 202 Anatomy & Physiology II 4 COM 121 Interpersonal Communications 3 ENG 101 English Composition I 3 HES 113 Medical Terminology 3 MAT 121 Intermediate Algebra 4 Total Prerequisites Credits 21-25*

• BIO 201, BIO 202 and MAT 121 must be completed with a grade equivalent to a 2.85 GPA or greater

• Credits completed for BIO 201, 202, and MAT 121 may not be more than five (5) years old • All other courses must have a minimum cumulative GPA of 2.5 * Depends upon BIO 100, BIO 181 vs. Biology Competency Exam.

APPLICATION STEPS 1. Download an application packet for the Radiologic Technology Program from the

Mohave Community College Radiologic Technology Program webpage at www.mohave.edu/radtech.

2. Review the application requirements. It is important to consult your advisor or the Director of the Radiologic Technology Program if you have questions.

3. Compile the requested material:

□ Personal Information: Completed, signed, and dated

□ Cover Letter: Introduces you to those who will review your application and states the purpose of your application, including why you want to be admitted into the program. Please note the following requirements:

• Between 100 and 200 words, no longer than one (1) page, printed in 12-

point Times New Roman font, double-spaced, with one (1) inch margins • A brief introduction • The title of the program for which you are applying • What you have included in your application • A conclusion • A signature

http://www.mohave.edu/radtech


□ References: References must be documented on the form provided. Letters of reference will not be accepted as substitutes for the form. Provide the form and an envelope to three (3) professional references. Your three (3) references need not be from the health professions, but should be someone who is familiar with your work style, skills, and personality (i.e., manager, supervisor, co-worker). We will not accept references from family members, former teachers, or neighbors as references. Each reference form submitted must be in an envelope which has been sealed by the referring party and shows their signature across the flap. Any evidence of tampering with the sealed reference will cause it to become invalid. All three (3) references must be included in your application packet in order for your application to be considered complete.

□ Successful Job Shadow Experience: Include the original job shadow form (which is available in the forms section of

the program handbook as well as on the MCC Radiologic Technology webpage, www.Mohave.edu/RadTech.) The form should be completed legibly, documenting the eight (8) hours spent in the diagnostic department of a hospital. This should have been done prior to the application becoming available (according to the directions available on the Radiologic Technology webpage and the Radiologic Technology Program Handbook). The applicant must successfully complete the job shadowing with a “good” report from the visited clinical site. If a “poor” report is obtained from the visited clinical site, the applicant then becomes ineligible for program acceptance.

□ Transcripts, evaluation of transfer courses, and/or waivers from institutions other than Mohave Community College:

• Official transcripts from all colleges and universities other than Mohave

Community College must be included. • Official transcripts from these colleges must be ordered by the student.

An official seal of the institution must be on the sealed envelope or the transcript will not be accepted.

• If you wish to receive a transfer of credit(s) for General Education courses required to apply to the Radiologic Technology Program from a college other than MCC, those transcripts must have been reviewed, and a determination must have been made, by the MCC Registrar’s Office (928.757.0878) prior to submitting your application.

• The Radiologic Technology Department cannot determine a transfer of credits.

• MCC Transcripts will be acquired by the Radiologic Technology Department at no cost to the applicant.

□ Test of Essential Academic Skills (TEAS) Entrance Exam


To schedule an appointment, contact any MCC Testing Center. A picture ID (valid driver’s license or MCC HigherOne card with a photo) is required for all testing. The cost is $60 for MCC students/$70 for non-MCC students. The fee for the TEAS test can be paid at www.jics.mohave.edu/ICS/Students by clicking the “Pay For a TEAS Test” link on the lower right side of the page once you are logged into your student account. An overall score of 58 or higher will be considered acceptable. Should students not achieve this score on their first attempt they may continue to take the TEAS test with no specific wait time in between tests and no limit on the number of times they may attempt to achieve the required score. Acquire and submit a copy of the report verifying a score of 58 or higher.

□ Volunteer Experience (Health Related Only): List only volunteer experiences that relate to the health professions. Remember to

include the name of a contact person where the volunteering occurred and the number of hours spent volunteering.

Please note: volunteer experience is not required, however, points are awarded based on volunteer hours completed.

4. Submit: Completed applications must be submitted by March 31, 2017, at 4:00

p.m. (Arizona time). The application must be in a sealed 9” x 12” envelope. Clearly written on the front should be: Radiologic Technology Program, your name, and address. Do not insert your application into any kind of binder or plastic cover.

Submit by mail or in person to: Mohave Community College

Radiologic Technology Department, Building 1100, Room 1115 3400 Highway 95

Bullhead City, AZ 86442 NOTE: Each packet will be date-stamped upon receipt. It is the applicant’s

responsibility to allow ample time for mailing. The order in which application packets are received will in no way influence the student selection process (unless they are submitted after the deadline).

SELECTION PROCESS

http://www.jics.mohave.edu/ICS/Students


1. After the spring semester final grades have been posted, the applications will be reviewed. All applicants will then be notified by mail of their status. Twenty (20) students will be chosen for potential admission into the program. All other candidates will receive written notice that they are no longer being considered for the program. Information regarding status will only be communicated by letter and will not be given over the telephone or via e-mail.

2. Once the data from the top 20 application packets has been reviewed, fourteen (14) candidates for the program will be selected. These candidates will then receive another letter congratulating them on having been selected to participate in the Radiologic Technology Program.

3. Within ten (10) business days from the date printed on that letter, applicants then must: a. Notify the Radiologic Technology Department Secretary in writing (e-mail is

acceptable) of their intent to ACCEPT or DECLINE admission to the Radiologic Technology Program. You are required to use your Mohave Community College student e-mail for this and all other correspondence with the College faculty and staff.

b. Bring a refundable $500.00 deposit in the form of a money order, personal check,

or cash to the Student Services Desk at any Mohave Community College campus. If you are unable to make it to campus, you may pay the deposit on your student account only if you have previously taken classes at MCC. This deposit is required to reserve your spot in the program and will be credited to your first semester course fees.

At the same time, you must present your driver’s license and Mohave Community College student identification number.

c. A copy of the receipt for your deposit must be faxed, e-mailed, mailed, or hand

delivered to:

FAX: 928.704.4185 (Attn: Radiologic Technology Department Secretary) OR E-MAIL to: [email protected] OR MAIL or HAND DELIVER to:

Mohave Community College Radiologic Technology Department, Building 1100, Room 1115

3400 Highway 95 Bullhead City, AZ 86442

Failure to respond within ten (10) business days from the date of the admittance letter will result in a default of your position in the program and another candidate will be chosen to fill the space.

mailto:[email protected]


If extenuating circumstances prevent you from accepting Mohave Community College’s invitation into the Radiologic Technology Program, we ask that you please notify the Radiologic Technology Department Secretary immediately so that an alternate candidate can be notified in a timely manner.

4. In the event you are not admitted into the program, it is recommended that you schedule

an advising appointment with the Director of the Radiologic Technology Program to discuss a new educational plan. Please call the Radiologic Technology Department Secretary to schedule an advising appointment at 928.704.4180.

5. In order to ensure fairness to all applicants, your timely response(s) are critically important in guaranteeing your place in the program. We must have an accurate name, address, telephone number, and Mohave Community College student e-mail address to ensure we can reach you.

6. The program typically receives more applicants than there are positions available. There

is no waiting list. If a student is not admitted into the program they will have the opportunity to reapply for the next year’s class.


VOLUNTEER EXPERIENCE (HEALTH RELATED)

Name of Institution, Facility

or Organization

Name of Person Acting as Your Direct Supervisor and

Their Phone Number

Responsibilities

Specific Months, Weeks, or Dates You Volunteered

Number of Hours Per Day

You Volunteered



REFERENCE FORM # 1 INSTRUCTIONS AND WAIVER for ____________________________________ (Applicant’s Name)

It is our responsibility to select students whose abilities, values, motives, and character give the greatest promise for success as a radiologic technologist. Therefore, your candid and honest responses to the questionnaire are very important. Please take the time to consider each of your responses carefully. The Radiologic Technology Department cannot require that applicants agree to waive their right to see their references. However, applicants may do so voluntarily. If the student waives their right, the reference you provide will not be shared with them at any point. Students wishing to have a copy of their completed reference form may ask their references to provide them with a copy, however copies will not be provided to applicants by the Radiologic Technology Department. The applicant should provide you with a Reference Form and an envelope for your completed questionnaire. Please return the completed form to the candidate, sealed in the envelope with your name written across the glued potion of the flap. Any evidence of tampering with the seal of the envelope will disqualify the candidate. These envelopes will be submitted with other application materials. We respectfully request your prompt action, as the applicant has a deadline for submitting materials. Thank you, The Radiologic Technology Department I DO or DO NOT waive my right to see this reference. (Please circle one)

Applicant’s Signature Date



Reference Form #1

Name of Applicant Date Please read each of the characteristics listed below carefully and respond as honestly as possible. 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 or Unknown.”

Applicant Characteristics to be Evaluated

Constantly

Often

Occasionally

Seldom

Never

N/A or

Unknown Is an effective team member Is an effective team leader Works well independently Is appropriately assertive Is self-motivated Displays initiative Prioritizes tasks appropriately Analyzes/ solves problems using critical thinking skills

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 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 in a healthcare situation

Please provide the following information:

Your name: __________________________________________________________ Your phone number: __________________________________

Length of time you worked with applicant: _________years _________months _________ weeks

What was the candidate’s position when you worked with them? ________________________________________________________________

Where was it that you worked with this candidate? _____________________________________________________________________________

What was your title when you worked with this candidate? ______________________________________________________________________

_________________________________________ _________________________________________ Your Signature Date signed



REFERENCE FORM #2 INSTRUCTIONS AND WAIVER for ____________________________________ (Applicant’s Name)





Reference Form #2



Constantly

Often

Occasionally

Seldom

Never

N/A or












REFERENCE FORM #3 INSTRUCTIONS AND WAIVER for ____________________________________ (Applicant’s Name)





Reference Form #3



Constantly

Often

Occasionally

Seldom

Never

N/A or











APPLICATION CHECKLIST *******************For applicant use only******************* This page is NOT to be included in your application packet

Your completed application should contain the following information in this order: Personal Information

Cover Letter

References in sealed envelopes

Successful Job Shadow Experience

Official transcripts from all colleges and universities other than Mohave Community College, if applicable

TEAS report (changing to HESI Admission Assessment Exam in 2017/2018)

Volunteer Experience (Health Related), if applicable

Selection Criteria: • Application • GPA • TEAS Entrance Exam (HESI Admission Assessment Exam) • Successful Job Shadow Experience

Remember: All documentation should be placed in a sealed 9” x 12” envelope with the name of the program, and address along with the name and address of the applicant indicated on the outside of the envelope:

Thank you for your interest in the Mohave Community College Radiologic Technology Program.

Your name Address Mohave Community College

Radiologic Technology Department Building 1100, Room 1115

3400 Highway 95 Bullhead City, AZ 86442


RADIOLOGIC TECHNOLOGY PROGRAM

2017 APPLICATION RUBRIC

Criterion 4 3 2 1 0 Points Awarded

COVER LETTER

• Correct format • Date & address • Signature • Clear • Concise • No spelling errors • Grammatically correct

• Correct format • Date & address • Signature • Decent in content • Concise • Minimal grammar &

spelling errors

• Correct format • Date & address • No signature • Limited content • Multiple grammar &

spelling errors

• Not the correct format • No date, address or

signature • Content confusing • Numerous errors

• No cover letter OR cover letter provided does not make sense and contains numerous errors

REFERENCES

The majority of characteristics checked are “constantly”

The majority of characteristics checked are “often”

The majority of characteristics checked are “occasionally” and/or one reference not professional

The majority of characteristics checked are “seldom” and/or two references not professional

The majority of characteristics checked are “never” and/or NO professional references included and/or references tampered with

JOB SHADOW EXPERIENCE

• Form included • Eight (8) hours • By deadline (December 31,

2016) • Totally completed • Followed directions • “Good” Clinical Site

Report

• Achieved 5 of out of 6 criteria

• Achieved 4 out of 6 criteria

• Achieved 3 out of 6 achieved criteria

• Achieved 1 or 2 out of 6 or no form included

• “Poor” Clinical Site Report

VOLUNTEER EXPERIENCE: HEALTH RELATED

Relevant experience in health related area(s) totaling >1000 hours within the last 3 years

2 points

Relevant experience in health related area(s) totaling >500 hours within the last 3 years

1.5 points

Limited experience in relevant health related area(s) totaling >200 hours within the last 3 years

1 point

Some experiences relevant to health related area(s) totaling >100 hours within the last 3 years

0.5 points

No work experience or < 100 hours in health related area(s) within the last 3 years

0 points


**FOR OFFICE USE ONLY**

Prerequisite GPA

4.0 to 3.75

3.74 to 3.5

3.49 to 3.1

3.0 to 2.85

Below 2.85

TOTAL POINTS EARNED

If Veteran, add additional 2 points. Added to TOTAL score:

GRAND TOTAL:

TEAS Actual Adjusted Individual Total Score:

For

_____________________________________________________________________________

Applicant Name

_____________________________________________________________________________ _________________________________

Name of Person Reviewing Application Date of Evaluation

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