Name BANNER ID @ Address

Please complete this form carefully. Incomplete or illegible applications will not be reviewed.
Phone number (home)
Zip ___________
Phone number (work)
Phone number (cell)
How did you hear about the program?
Please list 6 of the 9 required pre requisite courses.(see the bottom of page 2 of this application) All courses must
be completed with a grade of C or higher by May 30, 2014
Course name
Catalog Number
College where course was taken
Semester/Yr Taken
Intro to Biology
Please attach a copy of the transcript from each of the schools (including HCC) from which you have credits.
Official transcripts from these same schools must be on file and evaluated by the Advising office prior to June 1,
A printout from HCC that shows that courses completed outside HCC have been accepted as transfer credits must
be attached for the application to be considered.
Semester and Year you completed computer fundamentals course _________This must show up on transcript
OR Signature of the computer fundamentals proctor_______________________________________________
Indicating successful completion of the test.
Date you attended an OTA information session
Date you took OTA Admissions Essay Test _____________
A copy of the letter you received indicating your score on the Essay test must be attached.
This application must be postmarked no later than June 1, 2014 to be considered for September 2014 admission.
The Occupational Therapy Assistant program is open to students from outside the college as well as from the
student body currently attending HCC.
In order to apply for admission all students must first meet these BASIC REQUIREMENTS
Be admitted to the college (see college catalog for this process).
Have a Banner ID number.
Have transcripts from all previous schools sent to the HCC admissions office and evaluated by the
advising office ( 203-332-5215) so that they appear on the HCC transcript.
Take the placement test and place above developmental levels of both Math and English OR have
successfully completed Developmental Math and English courses.
Complete the computer fundamentals course with a C or higher or pass the computer
fundamentals test at HCC.
Successfully complete the OTA Clinical Writing test. You can schedule the test by calling 203-332-5019.
Earn a programmatic GPA of 3.0 or Please see the college catalog for courses applicable to the OTA
Attend a program information session within 12 months prior to the anticipated entrance date. Please see
the website for information session
Complete Biology 105 with a grade of B or higher and 5 more of the following 9 courses with a grade of C
or higher (Use the course elective codes in the HCC catalog to determine which courses fulfill these
requirements) If you are unsure about which courses transfer in to fulfill these requirements contact Mr.
Tracy Chavis at 332-5215
Biology 105 B or higher
English 101
English 102
Math 103 or higher
Psychology 111
Psychology elective (200 level)
Fine Arts
Social Science Elective
Biology 117
Complete both exploratory assignments with college level writing . You should contact the OTA program
director for approval of your volunteer/worksite experience. See attached for a full explanation of the
exploratory assignments.
Applications are ranked according to English 101 grades, programmatic GPA , writing scores and exploratory
assignments. Please be aware that completion of the basic requirements does not guarantee admissions. Students
who meet minimum requirements will be asked to a group interview conducted by the faculty .Final determination
will for acceptance will be made by the interviewers.
Exploratory Assignments
All applicants must successfully complete the following 2 exploratory assignments Evidence of completing these
assignments must be submitted using specific forms and guidelines in this packet.
Exploratory Assignment 1 : Review three online videos of OT treatment sessions and complete a
structured essay about one of the sessions
Exploratory Assignment 2: Twenty (20) hours of paid or volunteer experience working directly with
people with disabilities. These hours SHOULD NOT be completed in an Occupational Therapy
Department. The setting must be approved by the OTA Program Director prior to beginning the volunteer
Applications without completed documented exploratory assignments will be considered incomplete and will not be
Student Name
As an exploratory assignment for entrance into the program, you must write a paper describing your observation of
an Occupational Therapist using the guidelines below. You are to review the three videos at the AOTA website
Please DO NOT contact local Occupational Therapists for the assignment.
Write a review of one of the sessions on the website using the following outline. The essay must be a minimum of
2 pages typed double spaced 12 point ARIAL font with one inch margins
Your essay should cover the following information
Name of the patient
Diagnosis/disabling condition
Current challenges due to disabling condition
The overall goal of therapy for this patient
Describe three treatment interventions and how they will help the patient to become more functional
Student Name
These hours should be completed through a volunteer department or a work setting and can be completed with any
disabled population. They need not be done in an OT setting. Applicants are encouraged to go through the volunteer
department of the facility. Have the supervisor you work with fill out this form. Include the completed form in your
application packet. Please print legibly.
Facility Name:
Supervisor’s Name:
Job Title:
Phone Number: (
Area Code
Facility Address:
Street Address
Name of student volunteer/employee:
Start date of volunteer or work experience:
End date of volunteer or work experience:
Number of hours volunteered or worked:
Please list the duties of this volunteer/worker:
I certify that the above named volunteer/worker completed
hours of (volunteer) work at my facility.
Supervisor’s Signature
1. The OTA/student must be able to acquire a defined level of necessary information as
presented through educational experiences in pre-professional, professional, and
continuing education courses.
2. The OTA/student must perceive, assimilate, and integrate information from a variety of
sources. These sources include lectures, conversations, printed materials, visual and
auditory media, clinical experiences, and hands-on demonstrations.
3. The OTA/student must demonstrate adequate functional use of visual, tactile, auditory
and other sensory and perceptual abilities, to enable such observations and information
acquisition necessary for academic and clinical performance.
1. The OTA/student must demonstrate critical thinking skills so that s/he can problem-solve
creatively, master abstract ideas, and synthesize information present in clinical settings
which may present ambiguities and ethical dilemmas.
2. The OTA/student must be able to measure, calculate, reason, analyze, process,
integrate, synthesize, apply and retain facts, concepts, and data related to the art and
science of health care.
3. The OTA/student must be able to comprehend three-dimensional relationships and
understand the spatial relationships of anatomic structures.
4. The OTA/student must be able to apply theoretical knowledge and current research
evidence to specific client populations and diagnoses, and justify the rationale for
medical and therapeutic interventions.
5. The OTA/student must develop a sense of socio-medical ethics, and recognize and
apply pertinent legal and ethical standards.
1. The successful OTA/student maintains a high level of alertness and responsiveness
during classroom and fieldwork situations.
2. The OTA/student must possess the ability to focus on a task for a prolonged period of
time to allow for successful learning to take place.
3. The OTA/student must be able to recall information and organize information in an
efficient and useful manner. This includes the ability to acquire, retain, and prioritize
informational data, conceptualize and integrate abstract information, apply theoretical
knowledge to specific client populations and justify a rationale for therapeutic
interventions, and problem-solve to create innovative and practical solutions.
1. Effective communication is critical for the OTA/student to build relationships with
patients, clinical supervisors, other professionals, and care givers, in his/her various
roles of learner, peer, colleague and professional.
2. The OTA/student must be able to gather, comprehend, utilize and disseminate
information effectively, efficiently, and in accordance with professional standards.
Students are required to communicate in the English language both verbally and in
writing at a level consistent with competent professional practice.
3. The OTA/student is expected to use grammar and vocabulary proficiently. The OTA
student must be able to elicit information, gather information, and describe findings
verbally and in writing (e.g. reports, treatment plans, progress notes, and discharge
summaries), that are comprehensible by clients, care-givers, professionals and nonprofessionals.
4. The OTA/student must have the ability to use computers, keyboards and accessories for
searching, recording, storing, and retrieving information as well as the ability to hand
write legibly in charts.
1. The OTA/student must be able to communicate accurately, sensitively and effectively
with clients and professionals from different cultural and social backgrounds. The OTA
student should be able to observe, recognize and understand non-verbal behavior. The
OTA student must be able to establish rapport with clients and communicate evaluation
and treatment information effectively, while adhering to principles of confidentiality.
1. The OTA/student must demonstrate emotional stability and be capable of developing
mature and effective interpersonal relationships with other peers, coworkers, clinical
supervisors, and other professionals.
2. The OTA/student must be able to tolerate physically and emotionally taxing workloads
and to function effectively under stress.
3. The OTA/student must be able to adapt to changing environments, display flexibility and
function in the face of real-world ambiguities.
4. The OTA/student must exhibit the ability and commitment to work with individuals in fastpaced, demanding settings.
5. The OTA/student must acknowledge and manage personal biases in order to meet the
needs of people from diverse cultures, age groups, and socioeconomic levels.
6. The OTA/student must be prepared to work with individuals who are severely medically
involved, injured or disabled; be limited by cognitive, emotional and functional
impairments; and exhibit extreme behavior that may elicit an aversive reaction. The
ability to successfully interact with such individuals without being judgmental or
prejudicial is critical to establishing a therapeutic relationship and maintaining one’s
professionalism as indicated in the OT code of ethics.
7. The OTA/student must demonstrate attributes of empathy, integrity, concern for others,
interpersonal skills, interest, and motivation
8. The OTA/student must possess the emotional wellbeing required for use of his/her
intellectual abilities, the exercise of care of patients, and the development of mature,
sensitive, and effective relationships with patients.
9. The OTA/student must be able to adapt to ever-changing environments, display
flexibility, and learn to function in the face of uncertainties and stresses which are
inherent in the educational process, as well as the clinical problems of many patients.
1. The OTA/student must possess sufficient motor abilities, including physical strength and
coordination to effectively operate and maintain equipment, safely handle, transfer, and
move clients, carry out medical procedures, perform evaluations, provide treatment
intervention with a variety of clients, and in multiple, non-isolated settings.
2. The OTA/student must demonstrate good gross and fine motor skills including but not
limited to, the ability to walk, balance, bend, climb, stoop, kneel, crouch, rotate body,
coordinate arms, and reach overhead.
3. The OTA/student are required to use multiple grasp and pinch patterns, including
dexterity for writing and keyboard function, and firm grasp for sustained hand/arm use as
in lifting, push/pull, twisting, transferring and carrying. Students must regularly lift and/or
move objects up to 10 pounds, occasionally lift and/or move objects at 25-50 pounds,
and infrequently lift/move objects at greater than 50 pounds.
4. The OTA/student must have a comfort level and the safety awareness to avoid
negatively impacting patient care when dealing with hazardous conditions s/he may be
exposed to on the job. These include but are not limited to the following: wet or humid
internal environments; proximity to moving mechanical parts, fumes or airborne particles,
hazardous materials, body fluids and blood borne pathogens; risk of electrical shock,
objects of hot/cold temperature, or vibration.
Students who seek information regarding academic accommodations should make an
appointment with Ms. Lynn Langella, Director of Disabilities Services at 332-5018.
American Occupational Therapy Association (1997), Educating College Students With
Disabilities, AOTA, Bethesda, MD.
American Occupational Therapy Association (1996). Reference Manual of the Official
Documents of the American Occupational Therapy Association, AOTA, Bethesda, MD.
Wells, S.A. & Hanebrink, S. (1998), A Guide to Reasonable Accommodation for Practitioners
with Disabilities: Fieldwork to Employment. AOTA, Bethesda, MD.
The OTA student is required to meet criteria outside of the academic requirements.. These are
the non-academic skills required of students and are reflective of the essential skills needed to
complete the OTA program and in preparation for national certification testing and
The student is expected to enter the program with the ability to meet all of the requirements.
It is not the responsibility of the faculty to teach these skills to students.
Students will be monitored by the faculty throughout the course of the program to ensure that
they are meeting the non-academic essentials. Those students failing to meet these requirements
will be asked to counsel with a faculty and could be dismissed from the program. In some cases
of egregious behavior that threatens the safety of a patient, faculty or peer, a student could be
immediately dismissed from the program for failure to meet the non-academic essentials.
Failure to fully and consistently meet non-academic essential requirements will result in the
inability to register for Level II Fieldwork. Students who cannot meet these requirements will be
referred to the program director as soon as possible in the course of their studies to determine if
a referral to a different course of study is appropriate.
I certify that I have read the essentials and believe I am capable of meeting all of them . I am
willing to participate in evaluations of these skills as part of my classroom and fieldwork
experiences. I have read the above statements and understand my responsibilities and the
consequences of not meeting the non-academic essentials
Print Name:
Make sure your application is complete.
Completed applications must be postmarked by June 1th prior to the September start date for which the student is
applying. All supporting documentation must be included in the applicant’s packet. The packet should be sent
directly to the program director in one envelope. Students are encouraged to obtain a postal receipt when mailing
their application package.
A completed application includes the following:
___ Student information cover sheet correctly and fully filled out.
___Copy of e mail from program acknowledging successful completion of the OTA admissions essay
___ Unofficial copies of transcripts from all schools attended must be attached to this application
___Official copies of transcripts must be evaluated and on file in the Advising Office (It is the
student responsibility to make sure the evaluation is complete and on file)
___ Signed Acknowledgement of Non Academic Essential Requirements
___ Documentation of volunteer/paid hours working with people with disabilities
___ Report of Observation of an OT
Of special note:
Incomplete or illegible applications will not be reviewed.
Students who have failed out of another nursing or allied health program are generally not accepted into
the program but will be considered for admission on a case by case basis under very special circumstances
Recommendations from the prior program faculty will be required.
Applications submitted past June 1 will be considered on a space available basis.
Each applicant who meets all the criteria and submits a complete, legible, satisfactory application will be
invited to complete a formal interview with the admission committee and demonstrate the skills, behaviors
and attitudes outlined in the interview standards. Applicants who do not pass the interview may not reapply
to the program in subsequent semesters.
Applicants will be ranked according to G.P.A., number of program courses already completed OTA
clinical writing test score and, in case of tie ranking, the postmark of the application packet.
In order to be eligible apply for early admission, students must have a programmatic GPA of 3.0 and have
completed six (6) of the nine(9) non-OTA courses including English101,English 102 and Bio 105 with a B
or higher .
A grade of C or higher in Biology 105 is required for admission to Biology 117, however due to the
rigorous coursework based on the basic biology, a grade of B or better is highly recommended
Any attempt to falsify information in any part of the application process will render the applicant
ineligible for program admission for the current or any subsequent semester.
Completion of pre requisite requirements does not guarantee admission. Admission is selective and
Students will be notified of their admissions status via e mail by June 30,2014. The office will NOT have
decisions on status before then. Please do not call . Students will be contacted and must schedule an
interview within 10 days of receipt of this e-mail.
Students who have passed the interview and are accepted into the program must attend all three days of a
mandatory summer orientation in order to begin the program. This session is held in August and specific
dates will be available by July 1, 2014.
Graduates of the program must sit for the national certification examination before becoming licensed to
practice Occupational Therapy .Students who have been convicted of a felony may not be eligible to take
the national certification exam.
It is possible that students may have to wait up to 1 year after finishing their academic work to be placed in
an appropriate fieldwork setting . Placements are made through the college and cannot be arranged by the
individual student.