Valencia College
Health Sciences Program Application
Technical Certificate in
Paramedic Technology
*For admission consideration, you must submit this application with all required documentation and have all of
your grades posted to your Valencia transcript by the application deadline.
Date of application:
__For entry into: ____________(semester/year) VID# (Required)
Name (Last)
(First)
Home Address
_______ (Middle)__ _________________
____City, State, Zip ______________________________
Phone Number: mobile: (____)_____________Work: (_____)____________ Home: (
Atlas E-mail:
)_______________
__________________@mail.valenciacollege.edu
(Admission Decisions will be sent to your Atlas email 3-4 weeks after the application deadline)
Male ____ Female ____
Date of Birth ________________
If you have applied to other limited access Health Sciences programs at Valencia in the past 12 months, indicate
which ones: ____________________________________________________________________________
Have you previously attended a Paramedic program? If so, please list name(s) of institution(s) and dates
attended: ______________________________________________________________
Have you attended a Health Sciences Information Session? ____Yes
____No
Have you satisfied all requirements on the Admission Criteria and Checklist in the current EMS Program
Guide, which includes the requirements for the Paramedic Program? ____Yes ____No
Are you a U.S. citizen or permanent resident?
____Yes
____No
Please list all colleges/universities/postsecondary institutions you have attended:
__________________________________________________________________________________________
If you have attended other institutions outside of Valencia, have all of your official transcripts from these
institutions been submitted to Valencia and posted to your Valencia record? (Check unofficial transcript in Atlas.)
_____Yes _____ No (Your application will be ineligible if you are missing transcripts.)
What is your overall college GPA, including all transfer work? __________
Do you hold a current Florida EMT certification?
____Yes ____No (Must attach copy of current certification)
Do you have work experience as an EMT? ____Yes ____No
Name of Place of Employment__________________ Dates of Employment_____________________
If yes, indicate amount of time: _____ 6 to 11 Months
_____ 12 Months or more
1
(Must attach letter from supervisor or HR on company letterhead indicating full-time or part-time status, job title,
and dates employed)
INSTRUCTIONS:
All official transcripts must be submitted to Valencia and evaluated by the application
deadline, including any AP/IB/CLEP official score reports (must be requested from collegeboard.org for
AP/CLEP or ibo.org for IB). Check unofficial academic transcript (Login to Atlas – Courses tab,
Registration, Transcripts) to verify that transcripts have been received and evaluated by Valencia. Your
application will be ineligible if you are missing any transcripts.
-Enter grades for courses completed with a minimum grade of “C” (for Humanities, highest grade should
be entered).
-Enter AP/IB/CLEP as the grade, if applicable. You must submit official scores and we cannot accept
scores from other school transcripts.
-Enter “R” as the grade if you are currently registered in a course.
-If you have not taken a course, please enter “No” or leave blank.
-Any blank spaces will be assumed to be courses not taken; therefore, please fill out chart carefully and
completely. If you are unsure about a course, enter it just in case and it will be reviewed.
* BSC 1084, the Prerequisite for Admission, may be in progress at the time of program application, but must be completed
with a minimum grade of C by the program start date.
**BSC2093C and BSC2094C may substitute for BSC 1084 and will satisfy the requirements for two Elective credits and for
three credits in General Education Science or Math. BSC 2094C may be in progress at the time of application and must be
completed with a minimum grade of C by the program start date.
Valencia
Course prefix/
number
Course
prefix/
Number
Credits
Course Title
(if different)
3
**BSC 2093C
4
**Human Anatomy & Physiology I
4
**Human Anatomy & Physiology II
ENC 1101
3
Freshman Composition I
SPC 1608
3
Fundamentals of Speech
POS 2041
3
U.S. Government
3
General Psychology
PSY 2012
Humanities
3
Math or Science
3
Elective
SLS 1122
2
Must be
SLS 1122
3
Semester
& Year
Taken
Name of
Institution
attended
*Essentials of Human Structure
and Functions
*BSC 1084
**BSC 2094C
Grade
Any course that meets Gen. Ed.
Humanities req. (highest grade)
Any course that meets the Gen Ed Math
or science requirement (highest grade)
Elective
New Student Experience
2
EMERGENCY MEDICAL SERVICES
CORE PERFORMANCE STANDARDS FOR ADMISSION AND PROGRESSION
Emergency Medical Services is a practice discipline with cognitive, sensory, affective, and psychomotor
performance requirements. Based on these requirements the following list of "Core Performance Standards" has been
developed. Each standard has an example of an activity or activities, which a student will be required to perform while
enrolled in the Emergency Medical Services Program. These standards are a part of the Emergency Medical Services
courses and of the role expectation of an Emergency Medical Services professional.
For the purpose of the Emergency Medical Services Program, a “qualified individual with a disability is one who,
with or without reasonable accommodations or modifications, meets the essential eligibility requirements for participation
in the program." The Division of Allied Health at Valencia makes no preadmission inquiries concerning an applicant’s
disability status. Information related to an applicant’s disabilities is not a part of the information reviewed by the
Admission Committee.
These Performance Standards should be used to assist students in determining whether accommodations or
modifications are necessary for the student to meet program requirements. A student who identifies potential difficulties
with meeting the Performance Standards should communicate his/her concerns to an advisor in the Office for Students
with Disabilities. The student has the responsibility to identify and document the disability and to request reasonable and
appropriate adjustments. Determination is made on an individual basis as to whether any accommodations or
modifications can be reasonably made.
Issue
Standard
_____________
___________________________________
Some Examples of Necessary Activities
(not all inclusive)
____________________________________
Critical Thinking
Critical thinking ability sufficient for clinical
judgment
Identify cause-effect relationships in clinical
situations. Develop patient treatment plans
Interpersonal
Interpersonal abilities sufficient to interact
with individuals, families, and groups from a
variety of social, emotional, cultural, and
intellectual backgrounds
Establish rapport with patients/clients and colleagues
Communication
Communication abilities sufficient for interaction with others in verbal and written form
Explain treatment procedures, initiate health teaching,
document and interpret treatment strategies and
patient/client responses
Mobility
Physical abilities sufficient to move from
room to room, maneuver in small spaces,
and navigate stairwells
Moves around in patient's rooms, homes, ambulances,
work spaces, and treatment areas, administer
medications, lift a minimum of 100 pounds
Motor Skills
Gross and fine motor abilities sufficient to
provide safe and effective emergency care
Calibrate and use equipment; position patients/clients
Hearing
Auditory ability sufficient to monitor and
assess health needs
Hears monitor alarm, emergency signals, auscultatory
sounds, cries for help
Visual
Visual ability sufficient for observation and
assessment necessary in emergency care
Observes patient/client responses
Tactile
Tactile ability sufficient for physical
assessment
Perform palpation, functions of physical examination
and/or those related to therapeutic intervention, e.g.,
insertions of an intravenous catheter
I have read and understand the above performance standards necessary to be a competent Paramedic (see
3
previous page). ____________________________________________________Signature
For admission consideration, you must submit this application with any required documentation and have all of
your grades posted to your Valencia transcript by the Paramedic Program application deadline.
DECLARATION
I have reviewed all admission requirements and expectations in the Valencia Paramedic Technology Program Guide. I
understand that it is fraudulent to misrepresent any information on this application and I affirm that all information on this
application is true. I understand that, if admitted to this program, I must submit to a criminal background check,
fingerprinting and drug screening; document immunizations and other requirements for clinical participation; and be free
of offenses that would disqualify me from the program. I have read and understand the performance standards necessary
to be a competent Paramedic.
______________________________________________
Signature
___________________
Date
HOW TO SUBMIT APPLICATION:
A non-refundable Health Sciences Program Application fee of $15 must be submitted to the Business Office
http://valenciacollege.edu/businessoffice with each application.
By mail:
Please mail the application together with a check or money order payable to Valencia College to the
address listed below. Do not send separately.
Valencia College
Business Office 4-6
PO Box 4913
Orlando, FL 32802
In-person:
Please make payment by credit card, debit card, cash, check, or money order (a check or money order must
be payable to Valencia College) to the West Campus Business Office in the Student Services Building
(SSB), Room 101 before turning in your application to the Health Sciences Advising Office on the West
Campus in Building 1, Room 130.
OR
Please make payment to the Business Office on any Valencia campus and request that the Business Office
staff forward your Health Sciences Program Application and application fee receipt to the Health Sciences
Advising Office on West Campus (mail code: 4-30).
ADMISSION DECISIONS:
All admission decisions will be sent to your Valencia ATLAS EMAIL account from
HealthScienceApplications@valenciacollege.edu approximately 3 to 4 weeks after the
application deadline. Admission decisions will NOT be sent via postal mail.
4