Allied Health Programs Competitive Selection

Spring 2020, Summer 2020, and Fall 2020 Semesters Valid from July 1, 2019 – June 30, 2020

www.OFTC.edu | OFTC is a unit of the Technical College System of Georgia and an Equal Opportunity Institution.

This Page Intentionally Left Blank

Non-Discrimination Statement The Technical College System of Georgia and its constituent Technical Colleges do not discriminate on the basis of race, color, creed, national or ethnic origin, sex, religion, disability, age, political affiliation or belief, genetic information, disabled veteran, veteran of the Vietnam Era, spouse of military member or citizenship status (except in those special circumstances permitted or mandated by law). This nondiscrimination policy encompasses the operation of all technical college-administered programs, programs financed by the federal government includingany Workforce Innovation and Opportunity Act (WIOA) Title I financed programs, educational programs and activities, including admissions, scholarships and loans, student life, and athletics. It also encompasses the recruitment and employment of personnel and contracting for goods and services. The Technical College System and Technical Colleges shall promote the realization of equal opportunity through a positive continuing program of specific practices designed to ensure the full realization of equal opportunity. The following person(s) has been designated to handle inquiries regarding the nondiscrimination policies: ▪ TITLE IX Coordinator: Janet Smith, Office: South

Campus WRS 112, 478-274-7836, jrsmith@oftc.edu ▪ ADA/504 Coordinator: Saketta Brown, Office: South

Campus WRS 112, 478-274-7643 or 478-553-2124, sdbrown@oftc.edu

▪ EEOC Officer: Rosemary Selby, Office: North Campus 205, 478-553-2055, rselby@oftc.edu

The Technical College System and Technical Colleges shall promote the realization of equal opportunity through a positive continuing program of specific practices designed to ensure the full realization of equal opportunity.

College Accreditation Institutional Accreditation

Southern Association of Colleges and Schools Commission on Colleges Oconee Fall Line Technical College is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award Associate Degrees, Diplomas, and Technical Certificates of Credit. Contact the Commission on Colleges at 1866 Southern Lane, Decatur, GA 30033-4097 or call (404) 679-4500 for questions about the accreditation of Oconee Fall Line Technical College. The Commission is to be contacted only if there is evidence that appears to support Oconee Fall Line Technical College’s significant non-compliance with a requirement or standard. Normal inquiries about Oconee Fall Line Technical College, such as admission requirements, financial aid, educational programs, etc., should be addressed directly to the College at 1189 Deepstep Road, Sandersville, GA 31082 or call 877-399-8324.

Program Accreditation

Visit www.oftc.edu/about-oftc/institutional-effectiveness/program-accreditation/ for a complete list of program accreditations.

Gainful Employment For more information about our graduation rates, the media debt of students who complete a program, and other important information, visit www.OFTC.edu/gainfulemployment.

Admissions and Selection Process Admission to Oconee Fall Line Technical College and the competitive selection process are two separate processes; students are responsible for understandingboth. This document provides instructions for both college admission and competitive selection. Please read this entire document thoroughly.

OFTC Admissions Process

To be accepted into the College and qualify for selection, students must complete all OFTC admissions requirements: ▪ Submit a complete Application for Admission.

Applicants can apply online at oftc.edu & pay the non-refundable application fee of $25.

▪ Submit an official copy of your high school, ALL college/university, and/or GED transcripts to the Admissions Office. Applicants who have completed a minimum of 30 semester or 45 quarter hours at the degree level may submit official college transcripts in lieu of high school diploma or GED. Veterans must submit a copy of their DD214, Military Transcript, VA Application and/or Certificate of Eligibility.

▪ Schedule placement test or provide a copy of test results.

▪ Apply for Financial Aid. ▪ Register for Class and Attend New Student

Orientation. Acceptance into the college does not guarantee admission into an allied health program. The competitive selection process is a separate process that must be completed to gain entry into the student’s desired program.

Competitive Selection Process

All steps below must be completed before the competitive selection deadline published for each program. Deadlines are listed online on the Competitive Admissions Programs web page at www.oftc.edu (go to Admissions, click Competitive Admissions Programs) and on the Designated Courses and Deadlines section of this booklet. To be considered for selection in an allied health program, a student must: ▪ Successfully complete all designated courses and

additional curriculum/other requirements for selection (see the Designated Courses and Deadlines section

in this booklet for information specific to each program).

▪ The Test of Essential Academic Skills (TEAS) is required to compete for any nursing program, Diagnostic Medical Sonography, and Radiologic Technology.

▪ When you are ready to compete for a seat in your desired program cohort, submit an Application for Allied Health Programs and Work Experience Credit Verification if applicable. Forms are available in this booklet and online on the Competitive Admissions Programs web page at www.oftc.edu (go to Admissions, click Competitive Admissions Programs). ADN Bridge Applicants must submit the Application for Allied Health Programs and Work Experience Credit Verification at the same time. Incomplete packets will not be accepted.

▪ Wait for notification from OFTC’s Admissions Office. Once selections are made, all applicants will be notified via mail of their acceptance or denial for admission into a competitive program. Please verify that Admissions has your current contact information on file.

Questions?

For questions about the admissions & competitive selection process, please contact the Admissions Office at 478-553-2064 or (478) 478-274-7837 or admissions@oftc.edu.

Allied Health Programs Guidelines Competitive Criteria

▪ Students can only apply to one program, one location per semester.

▪ All designated courses that must be completed prior to entering program courses.

▪ If designated core courses and additional curriculum/other requirements listed on pages 8 & 9 are not completed by the date listed under deadlines, the application will not be considered.

▪ Applications to compete must be completed by the documentation deadline listed on pages 8 and 9. Students without an application to compete on file in the Admissions Office will NOT be considered for competition. Applications to compete signify that you (1) have completed the designated courses, (2)

will finish the designated courses by the indicated deadline, and (3) understand the competitive process, including deadlines for all documentation to include work experience forms and official college transcripts.

▪ Drug screen and criminal background checks will be required prior to any clinical rotation. The student is responsible for the payment of the drug screen fee and criminal background check fee that will be assessed when students register for classes with such requirements.

▪ Students assigned to clinical rotations at sites with requirements in addition to those covered by OFTC fees will be personally responsible for the charges associated with clinical placement.

▪ If a student is not selected and would like to compete in the next selection cycle, the student must submit a new application to compete and any applicable work experience form each time.

▪ All newly accepted students will be required to attend an orientation session prior to the beginning of the program.

Competitive Programs Participating Programs

1. Associate Degree in Nursing Bridge 2. Diagnostic Medical Sonography 3. Practical Nursing 4. Radiologic Technology

▪ Only the designated courses (and comparable

transferred credit for those courses) listed on pages 9 and 10 will be used towards GPA ranking.

▪ Associate Degree in Nursing Bridge- A work experience form documenting at least one year’s experience working as either a Licensed Practical Nurse (LPN) or a Paramedic is required to compete for the ADN Bridge program. Work experience must be current by the term start date of the cohort for which you are competing. If a student has failed out of any RN program, the student will not be eligible for the Associate Degree in Nursing Bridge program unless the student completed an OFTC Practical Nursing program after the unsuccessful RN attempt.

▪ Practical Nursing-Completion of the Health Care Assistant Technical Certificate of Credit is required prior to competition for the Practical Nursing program.

All students accepted into the Practical Nursingcohort will be required to attend Math Boot Camp and a Program Orientation during the break prior to term of entry. Attendance at these events is mandatory, and dates will be listed in the student’s program acceptance letter. If a selected applicant does not attend both Orientation and Math Boot Camp, his/her slot will be forfeited. Current American Heart Association Basic Life Support/First Aid certification will be required on the first day of class. Certification must remain current throughout program.

▪ Radiologic Technology-Completion of the ImagingScience Technical Certificate of Credit is required prior to competition for the Radiologic Technology program.

Non-Competitive Programs Participating Programs

1. Computed Tomography (CT) 2. EMS Professions 3. Magnetic Resonance Imaging (MRI) 4. Medical Assisting 5. Pharmacy Technology 6. Pre-hospital EMS Operations 7. Respiratory Care

▪ If more students apply to compete than there are seats available, the competitive process will be followed with the exception of TEAS testing for all programs excluding Computed Tomography and Magnetic Resonance Imaging. All expiration policies apply regardless of whether or not a program is competitive.

▪ EMS Professions students may begin core classes during any semester. However, the competitive application must be completed prior to program classes in the specified semester listed on pages 9 and 10.

▪ The following allied health programs begin each semester, and no competitive application is required: Health Care Assistant, Health Care Management, Imaging Science Assistant, and Nurse Aide.

▪ Computed Tomography (CT) - Prospective students must hold a current certification in good standing with: (1) American Registry of Radiologic Technologist (ARRT) as either a registered Radiologic Technologist or Radiation Therapist, (2) Nuclear Medicine Technology Certification Board

(NMTCB) as a registered nuclear medicine technologist, or (3) be a student in the final semester of the OFTC Radiologic Technology program. OFTC Radiologic Technology graduates/students will receive first option for available seats. However, if additional seats remain after OFTC graduates/students are accommodated, other credentialed professionals in good standing with ARRT or NMTCB will be placed on a first-come, first-served basis. Students enrolled in the Radiologic Technology program must complete the non-required course form to acknowledge that Financial Aid will not pay for CT classes until students are officially accepted into the Computed Tomography program.

▪ Magnetic Resonance Imaging (MRI) - Prospective students must hold a current certification in good standing with: (1) American Registry of Radiologic Technologist (ARRT) as either a registered Radiologic Technologist or Radiation Therapist, (2) American Registry for Diagnostic Medical Sonography (ARDMS) as a registered diagnostic medical sonographer, or (3) Nuclear Medicine Technology Certification Board (NMTCB) as a registered nuclear medicine technologist. OFTC Radiologic Technology graduates will receive first option for available seats. However, if additional seats remain after OFTC graduates are accommodated, other credentialed professionals in good standing with ARRT, ARDMS, or NMTCB will be placed on a first-come, first-served basis.

Designated Courses & Time Expiration ▪ Each program has designated courses that must be

completed in order for the student to compete (refer to the Designated Courses and Deadlines Section). The GPA is calculated using grades earned in the designated courses. ALHS, BIOL, CHEM, and PHYS courses must have been completed within the past five (5) years, and if these courses have been repeated, each grade within the previous five (5) years will be used in the GPA calculation. If the student has been continuously enrolled at OFTC, the five-year period will not apply. (If the student is a Pharmacy Technician Diploma graduate within the last five calendar years, please refer to the student handbook for explanation of credit for courses toward the Pharmacy Technician Degree). General education core courses, such as English, math, and

psychology do not expire. The highest attempt of these general education core courses will be used in the GPA calculation. The Registrar will calculate GPAs for all students. The GPA must be 3.0 or higher to be considered for the program.

▪ Transfer students must submit All final transcripts by the designated deadline listed on pages 9 & 10. Courses may be in progress at the application deadline only for students enrolled at OFTC.

Exemption Exam If a student elects to take an exemption test and passes the test for one of the required core classes for an allied health competitive program, then the exempted course will not be used for calculating the GPA for a competitive allied health program acceptance. Students may only exempt two courses in competitive allied health programs.

Competitive Program Entrance Tests ▪ Students competing for competitive programs must

complete the entrance test requirement specific to the desired program. The Test of Essential Academic Skills (TEAS) is a requirement for entry into any nursing program, Diagnostic Medical Sonography, and Radiologic Technology.

▪ These tests may be taken only three times per academic year (the academic year begins each fall semester). Students must wait 30 days before retesting. The test must be taken and scored prior to acceptance. The highest overall score will be used in the competitive process. The TEAS must be taken within the last 12 months and be current by the term start date of the cohort for which you are competing for the scores to be considered for admission purposes.

▪ A minimum TEAS scores of 59.5 must be attained for competition for Practical Nursing. A minimum TEAS score of 65 must be attained for competition for the Associate Degree in Nursing Bridge, Diagnostic Medical Sonography, and Radiologic Technology.

▪ Students should contact OFTC’s Assessment Center at either North or South campus to make an appointment to register. The $75 (TEAS) test fee must be paid in advance of the test. Fees are subject to change without notice.

Bonus Points ▪ With the exception of the ADN Bridge, bonus points

may be earned through documented, program-specific, paid work experience. One (1) bonus point for every three (3) months of work experience will be awarded with a maximum of five (5) bonus points for consecutive work experience. Only work experience from the past five years will be considered for bonus points. Work experience will be evaluated by program faculty.

▪ Bonus points may be awarded for completing designated courses at HGTC, STC and OFTC. One (1) point will be awarded for each designated course completed, with a maximum of three (3) bonus points possible.

▪ Bonus points may be awarded to Diagnostic Medical Sonography applicants who are a Registered Radiologic Technologist or Registered Radiation Therapist through ARRT or a Nuclear Medicine Technologist through ARRT or NMTCB.

Competitive Selection Process Following the successful completion (which means a grade of “C” or higher) of all designated courses, students will enter into a competitive process for determining eligibility to progress into occupational program courses. The formula used for the competitive process is: Formula (Designated courses GPA x 50%) + (TEAS x 50%) + possible bonus points = Total Score

▪ All students’ total scores will be ranked from the highest to the lowest. Students with the highest total scores, a GPA of at least 3.0 and the required minimum TEAS score (see “Entrance Test” section) will be accepted. The total number of students accepted is based on the number of available openings. If all seats are not filled through the competitive admissions requirements, consideration may be given to students who did not make the required GPA or TEAS cut scores based on the number of available seats.

▪ In the event of a total score tie, the student with the highest GPA will be selected.

Residency Requirements for Graduation In order to graduate from most Oconee Fall Line Technical College allied health programs, the student must complete a minimum of fifty percent (50%) of the course work of a particular program of study at OFTC. See the OFTC Handbook.

Re-entering or Transfer Students

▪ Students who have been unsuccessful or have withdrawn from an Allied Health program at HGTC, STC, OFTC, or another TCSG school and desire to re-enroll must compete for re-entry.

Re-entry to first semester

▪ Students who wish to reenroll in the first term of a program must follow the same guidelines listed above. TEAS scores already on file in the admissions office will be used in calculating the total score using the formula above as long as the former TEAS test was taken within the last 12 months AND is current by the term start date of the cohort for which you are competing . Students must resubmit Work Experience Credit Verification forms. Students previously in programs that did not require TEAS scores must take the exam to be considered for reentry into a competitive program.

▪ Students wishing to transfer into the Associate Degree in Nursing Bridge program must compete and, if selected, will be placed in first semester (RNSG) program classes.

Re-entry to other semesters

▪ All students applying for reentry into other semesters must first meet OFTC’s first-term entry requirements. If ALHS, BIOL, CHEM, and PHYS courses have been repeated, each grade within the previous five (5) years will be used in the GPA calculation. The highest attempt of other designated core courses will be used in the GPA calculation. Student will be ranked from the highest to the lowest based on the normal

competitive process. Students with the highest ranking will be accepted, up to the maximum of available openings. This option is only available if vacant slots exist in the advanced program cohort for the semester student needs to re-enter.

▪ There are no advanced placement slots for transfer into the ADN Bridge program.

▪ Students transferring into the Practical Nursing program will be required to successfully complete the applicable ATI (Assessment Technologies Institute) exam(s) with a score of a level 2 or higher as well as a skills-based exam at 100% with OFTC faculty prior to being allowed to compete for an advanced slot. Students are allowed one attempt on the ATI and skills-based exams. Successful completion of the ATI exam is required before the skills-based exam is administered. The $35 fee (subject to change without notice) for the ATI exam must be paid with a credit card by the student during the testing process.

Appeals ▪ Applicants who feel that they were unjustly

denied admission have the right to appeal any decision regarding acceptance to Oconee Fall Line Technical College. Appeals should be made in writing to the Dean for Student Affairs at the student’s campus within three (3) business days of receiving notification of their admission status. The written document must include specific details supporting the appeal. A further appeal may be made to the Vice President for Student Affairs. This appeal also must be made in writing to the Vice President within three (3) business days of receiving notification of the Dean for Student Affairs' decision. The decision of the Vice President is final.

▪ If a student has been extended two offers of acceptance into a specific allied health program at HGTC, STC, and/or OFTC and does not complete the program, the student will be denied admittance into the program. Students who have extenuating circumstances may appeal via the admissions appeal process.

Designated Courses and Deadlines Associate Degrees

Program Designated CoreCourses

Additional Curriculum/Other Requirements

Term of Entry Deadlines

Associate Degree in BIOL 2113 ENGL 1101 One of the following courses: HIST 2111, Fall 2020 (North Campus) April 1, 2020-All Nursing Bridge BIOL 2113L ENGL 1102 HIST 2112, POLS 1101, SOCI 1101 required documents

BIOL 2114 ENGL 2130 BIOL 2114L MATH 1111 And LPN unrestricted license number or April 29, 2020-All BIOL 2117 or paramedic unrestricted certification required classes BIOL 2117L MATH 1103

PSYC 1101 number And Work Experience form documenting at least one year of work experience as either a License Practical Nurse (LPN) or Paramedic. And Current CPR Card will be required on first day of class

completed & official transcripts received

Diagnostic Medical ENGL 1101 BIOL 2113 Fall 2020 (South Campus) June 3, 2020 Sonography ENGL 2130 BIOL 2113L

MATH 1111 BIOL 2114 MATH 1127 BIOL 2114L PSYC 1101 PHYS 1110

PHYS 1110L Pharmacy Technology ENGL 1101 ALHS 1040 One of the following: Fall 2020 (South Campus) June 3, 2020

ENGL 2130 ALHS 1090 ENGL 1102 MATH 1111 BIOL 2113 HIST 2111 or BIOL 2113 L POLS 1101 MATH 1103 BIOL 2114 SOCI 1101 PSYC 1101 COLL 1060

BIOL 2114 L

Radiologic ENGL 1101 BIOL2113 *Completion of the Imaging Science Spring 2020 (South Campus) November 6, 2019 Technology ENGL 2130

MATH 1111 BIOL 2113L BIOL 2114

Assistant Technical Certificate of Credit is required prior to competition.

or BIOL 2114L MATH 1103 IMSA 1100 COLL 1060 RADT 1010 PSYC 1101 ALHS 1090

Respiratory Care ENGL 1101 BIOL 2114L n/a Fall 2020 (South Campus) June 3, 2020 ENGL 2130 BIOL 2117 MATH 1111 BIOL 2117L COLL 1060 CHEM 1151 BIOL 2113 CHEM 1151L BIOL 2113L PSYC 1101 BIOL 2114

Diplomas

Program Designated Core Courses

Additional Curriculum/ Other Requirements

Term of Entry Deadlines

EMS Professions n/a n/a Fall 2020 (South Campus) June 3, 2020 Medical Assisting ENGL 1010

MATH 1012 PSYC 1010

COLL 1060 ALHS 1011 ALHS 1090

n/a Spring 2020 (South Campus)

Fall 2020 (South Campus)

November 6, 2019

June 3, 2020 Pharmacy Technology ENGL 1010

MATH 1012 PSYC 1010 COLL 1060

ALHS 1011 ALHS 1040 ALHS 1090

n/a Fall 2020 (South Campus) June 3, 2020

Practical Nursing ENGL 1010 PSYC 1010 MATH 1012 COLL 1060 ALHS 1011

ALHS 1040 ALHS 1090 ALHS 1060 NAST 1100 or current

*Completion of the Health Care Assistant Technical Certificate of Credit is required prior to competition

Spring 2020 (South Campus)

Fall 2020 (North & South Campus)

November 6, 2019

June 3, 2020

Program Designated CoreCourses

Additional Curriculum/Other Requirements

Term of Entry Deadlines

Georgia Nurse Aide Registry

Program Orientation & Math Boot Camp upon each acceptance into cohort. Current Basic Life Support /First Aid Certification required first day of class

Technical Certificates of Credit

Program Designated CoreCourses

Additional Curriculum/Other Requirements

Term of Entry Deadlines

Computed n/a Current certification in good standing with: Summer 2020 (South March 4, 2020 Tomography (CT) (1) ARRT as either a registered

Radiologic Technologist or Radiation Therapist, or (2) NMTCB as a registered nuclear medicine technologist.

Campus)

Magnetic Resonance n/a Current certification in good standing with: Fall 2020 (South Campus) June 3, 2020 Imaging (MRI) (1) ARRT as either a registered

Radiologic Technologist or Radiation Therapist, (2) ARDMS as a registered diagnostic medical sonographer, or (3) NMTCB as a registered nuclear medicine technologist.

Pre-hospital EMSOperations

n/a n/a Fall 2020 (South Campus) June 3, 2020

Application for Allied Health Programs

Oconee Fall Line Technical College is a unit of the Technical College System of Georgia and an Equal Opportunity Institution | www.OFTC.edu Updated 9.3.19

Students can only apply to one program, one location per semester. Check the program and term for which you are applying. Programs marked with asterisk may become competitive if the number of competitors exceeds available seats.

COMPETITIVE PROGRAMS: NON-COMPETITIVE PROGRAMS: Associate Degree in Nursing Bridge (ADN)

Fall 2020—North Campus (Sandersville) Computed Tomography (CT)

Summer 2020—South Campus (Dublin) Pharmacy Technology Degree*

Fall 2020—South Campus (Dublin) Diagnostic Medical Sonography

Fall 2020—South Campus (Dublin) EMS Professions*

Fall 2020—South Campus (Dublin)

Pharmacy Technology Diploma* Fall 2020—South Campus (Dublin)

Practical Nursing

Spring 2020—South Campus (Dublin) Fall 2020—North Campus (Sandersville) Fall 2020—South Campus (Dublin)

Magnetic Resonance Imaging (MRI) Fall 2020—South Campus (Dublin)

Pre-hospital EMS Operations* Fall 2020—South Campus (Dublin)

Radiologic Technology Spring 2020—South Campus (Dublin)

Medical Assisting*

Spring 2020—South Campus (Dublin) Fall 2020—South Campus (Dublin)

Respiratory Care* Fall 2020—South Campus (Dublin))

Full Legal Name _____________________________________________________ Student ID No. 900_____________________

(Last) (First) (Middle)

Previous Names (if any) ______________________ County _____________________ Last 4 digits of SS# ______________________ Home Phone ______________________ Work Phone _______________________ Cell Phone_____________________________ Mailing Address____________________________________________________________________________________________

(Street or Box) (City) (State) (Zip)

Email Address_____________________________ Circle highest level of education completed: GED 12 13 14 15 Bachelor

YOUR STUDENT STATUS Please check the description that applies to you:

______ 1. First time applicant. If you are a first time applicant to OFTC, you must submit an application for admission to OFTC and pay a $25.00 fee. All

final transcripts showing completion of designated courses must be received by the posted deadline. ______ 2. Current student at OFTC. I will complete all designated courses by the end of the current term. ______ 3. Former OFTC student, HGTC student, or STC student re-applying for admission, who has completed all designated courses. ______ 4. Applicant who is transferring all designated classes from another college(s). ______ 5. Re-entry: (Allowed for all programs except ADN), Circle Semester: 1st 2nd 3rd 4th

WORK EXPERIENCE FORMS Have you submitted work experience documentation and taken the TEAS exam? TEAS is

required to compete for any nursing program, Diagnostic Medical Sonography, and Radiologic Technology. You must resubmit work

experience documentation every time you compete.

Yes No, but plan to do so by the posted deadline. I have no related work experience.

REQUIRED FOR ADN APPLICANTS: Unrestricted LPN License or Unrestricted Paramedic Certification Number_______________________________ Have you previously been admitted to an RN Program? _____Yes _____No If “yes,” please provide college name, dates, and reason for withdrawal: _______________________________________________________________

I understand that the Admissions office of OFTC will notify me by mail whether or not I am admitted to the program. I understand that I am responsible for submitting all transcripts, TEAS scores, and work experience credit documentation by the required deadline to compete for my chosen program. _______________________________________ ______________________________________

Student’s Signature Date

The Technical College System of Georgia and its constituent technical colleges do not discriminate on the basis of race, color, creed, national or ethnic origin, gender, religion, disability, age, political affiliation or belief, genetic information, disabled veteran, veteran of the Vietnam Era, or citizenship status (except in those special circumstances permitted or mandated by law). This nondiscrimination policy encompasses the operation of all educational programs and activities, including admissions policies, scholarship and loan programs, athletic and other Technical College System and College-administered programs, including any Workforce Investment Act of 1998 (WIA) Title I financed programs. It also encompasses the employment of personnel and contracting for goods and services. For more information, contact: TITLE IX Coordinator Janet Smith, Office: South Campus WRS 112, 478-274-7836 jrsmith@oftc.edu, ADA/504 Coordinator Saketta Brown, Office: South Campus WRS 112, 478-274-7643, sdbrown@oftc.edu, EEOC Officer Rosemary Selby, Office: North Campus 205, 478-553-2055, rselby@oftc.edu

Send completed form to one of the following: North Campus –1189 Deepstep Road, Sandersville, GA 31082, Phone: 478-553-2064, Fax: 800-373-4783, Email: admissions@oftc.edu South Campus – 560 Pinehill Road, Dublin, GA 31021, Phone: 478-274-7837, Fax: 800-373-4783, Email: admissions@oftc.edu

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_____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________

______________________________________________________ ______________________________________________

______________________________________________________ ______________________________________________

______________________________________________________ ______________________________________________

______________________________________________________ ______________________________________________

Work Experience Credit Verification IMPORTANT: Use a separate form for each employer. NOTE: This form is REQUIRED for ADN students and OPTIONAL for other Allied Health programs as credit.

Students can only apply to one program, one location per semester. Check the program and term for which you are applying. Programs marked with asterisk may become competitive if the number of competitors exceeds available seats.

COMPETITIVE PROGRAMS: NON COMPETITIVE PROGRAMS: � Associate Degree in Nursing Bridge (ADN)

� Fall 2020—North Campus (Sandersville) � Computed Tomography (CT)

� Summer 2020—South Campus (Dublin) � Pharmacy Technology Degree*

� Fall 2020—South Campus (Dublin) � Diagnostic Medical Sonography

� Fall 2020—South Campus (Dublin) � EMS Professions*

� Fall 2020—South Campus (Dublin) � Pharmacy Technology Diploma*

� Fall 2020—South Campus (Dublin) � Practical Nursing

� Spring 2020—South Campus (Dublin) � Fall 2020—North Campus (Sandersville) � Fall 2020—South Campus (Dublin)

� Magnetic Resonance Imaging (MRI) � Fall 2020—South Campus (Dublin)

� Pre-hospital EMS Operations* � Fall 2020—South Campus (Dublin)

� Radiologic Technology � Spring 2020—South Campus (Dublin)

� Medical Assisting* � Spring 2020—South Campus (Dublin) � Fall 2020—South Campus (Dublin)

� Respiratory Care* � Fall 2020—South Campus (Dublin))

Student’s Name________________________________________ Student ID 900____________________

I certify that the above named person has been employed by this facility as a paid employee within the last five years. For Allied Health students (does not include ADN students): “Bonus” points equaling one point for each quarter (3 months) of work experience directly related to the program of study will be awarded, up to a maximum of 5 (five) bonus points.

Employer, please list major duties and dates (month/year) of employment for each position held. If the individual is still employed, please write “still employed” as the end date. Additional space is provided in the event the employee held more than one position in the company.)

(1) HIRE DATE / END DATE: _________________________ POSITION/JOB TITLE:____________________________________ Duties:_______________________________________________________________________________________________________________

(2) HIRE DATE / END DATE: _________________________ POSITION/JOB TITLE:____________________________________ Duties:_______________________________________________________________________________________________________________

Name of Person completing this form (Please print) Position/Job Title

Signature of Person Completing this form) Business Address

Date City State Zip

Name of Business Phone

Send completed form to one of the following: North Campus –1189 Deepstep Road, Sandersville, GA 31082, Phone: 478-553-2064, Fax: 800-373-4783, Email: admissions@oftc.edu South Campus – 560 Pinehill Road, Dublin, GA 31021, Phone: 478-274-7837, Fax: 800-373-4783, Email: admissions@oftc.edu

Oconee Fall Line Technical College is a unit of the Technical College System of Georgia and an Equal Opportunity Institution | www.OFTC.edu 6.24.19