Physical Therapist Assistant Program Checklist
APPLICATION SUBMITTED
College of Southern Idaho
College of Western Idaho
North Idaho College
APPLICATION INSTRUCTIONS & CHECKLIST
Applicants must meet the admission requirements of a degree-seeking student at one of the colleges listed above
before they are eligible to proceed with the application process for admission to the PTA program. If an applicant
plans to attend the PTA program at a location other than the one in which they are currently enrolled as a degreeseeking student, then they must submit an application to that college.
Students who plan to attend the PTA program at LCSC will need to complete an application to North Idaho
College, which can be found online at https://web.nic.edu/admissions/applyonline/screen01.php.
You must read and follow all steps to ensure a complete application. Only complete applications will be reviewed.
Applications for the spring 2013 program start will be accepted August 23, 2012 through the application deadline
November 15th, 2012. No applications will be accepted after the deadline.
STEP 1: COMPLETE ITEMS PRIOR TO PROGRAM APPLICATION SUBMISSION
It is STRONGLY RECOMMENDED that you complete these steps at least a couple of months prior to the Physical Therapist
Assistant Program deadline to ensure your transcripts have been received and that your coursework has been evaluated in
time to submit this application for the Physical Therapist Assistant Program.
Check to verify you have already completed these steps:
OFFICIAL HIGH SCHOOL TRANSCRIPT/ GED:
Official High School transcripts or GED scores must be submitted to the admissions office of the college
you will be attending for the PTA program by the application deadline to be considered for the PTA
program.
COLLEGE TRANSCRIPTS:
ALL official college and military transcripts must be received in the admissions office of the college you
will be attending for the PTA program. Only courses that appear on official transcripts at the application
deadline will be used to determine points for admission.
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PHYSICAL THERAPIST ASSISTANT CHECKLIST & APPLICATION
PREPARE PROGRAM APPLICATION SUBMISSION MATERIALS
Assemble the following materials:
REQUIRED MATERIALS
APPLICATION TO THE PTA PROGRAM:
This application must be completed and submitted by the time the application is due to be considered for
the PTA program. Only complete applications will be accepted.
LETTERS OF RECOMMENDATION:
A total of three letters of recommendation and/or PTA Reference Forms are allowable for acquiring points
on the PTA Application. Healthcare references are desired but not required. These letters/forms will be
used as character references. They must be submitted in a sealed envelope with the application packet.
PROOF OF 50 HOURS OF OBSERVATION TIME:
Please submit proof of completion of observation or experience in physical therapy hours. You will need a
minimum of 50 hours of observation/experience time. The Physical Therapist Assistant Observation Form
can be found on the website for the program. If you have been employed in a physical therapy setting,
please submit some form of documentation of hours worked.
APPLICATION LETTER/LETTER OF INTEREST:
This is a one page letter of interest written by the applicant explaining their interest and knowledge
concerning the Physical Therapist Assistant profession.
OPTIONAL MATERIALS: While not required, this is a competitive program. These materials count toward your ranking
points.
HEALTHCARE CERTIFICATIONS
Include copies of CURRENT Healthcare Certifications (CNA, CMA, EMT, etc.). Expired or lapsed
certifications will not be accepted.
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PHYSICAL THERAPIST ASSISTANT CHECKLIST & APPLICATION
Physical Therapist Assistant Program Checklist & Application
This form is used to apply for admission to the Physical Therapist Assistant Program. Candidates not admitted to
the spring cohort may be placed on an alternate list for admission in the event an opening occurs in that same
cohort. If not admitted, applicants must reapply each year.
CONSORTIUM PROGRAM - (AAS) PHYSICAL THERAPIST ASSISTANT APPLICATION
LAST NAME
FIRST NAME
ADDRESS
M.I.
CITY
STUDENT #
STATE
PHONE NUMBER (INCLUDING AREA CODE)
ZIP
EMAIL
OTHER PREVIOUSLY USED NAMES
STEP 2: VERIFY COMPLETION OF PREREQUISITES
Disqualified from applying if not currently enrolled nor completed w/ a “C” or better as per official transcripts on-file
2 Points = Completed with a “C” OR currently enrolled as per official transcripts on-file
3 Points = Completed with a “B” as per official transcripts on-file
4 Points = Completed with an “A” as per official transcripts on-file
These courses must be completed prior to the beginning of PTAE 101
PREREQUISITE
SCHOOL
YEAR
COURSE # AND TITLE
(if taken elsewhere)
Credit
Hours
Grade
BIOL 227 – Human Anatomy & Physiology I
CAOT 179 – Medical Terminology
MATH 123 – Contemporary Math or a higher
ENGL 101 – English Composition
STEP 3: VERIFY COMPLETION OF COREQUISITES
0 Points = Not Currently Enrolled nor Completed w/ a “C” or better as per official transcripts on-file
2 Points = Completed with a “C” OR currently enrolled as per official transcripts on-file
3 Points = Completed with a “B” as per official transcripts on-file
4 Points = Completed with an “A” as per official transcripts on-file
COREREQUISITE
SCHOOL
YEAR
BIOL 228 – Human Anatomy & Physiology II
COMM 101 – Introduction to Speech
Communication
PSYC 101 – Introduction to Psychology
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PHYSICAL THERAPIST ASSISTANT CHECKLIST & APPLICATION
COURSE # AND TITLE
(if taken elsewhere)
Credit
Hours
Grade
STEP 4: LIST FOLLOW UP/EMERGENCY CONTACT INFORMATION
Provide contact information for two people who will always know where you are located. REQUIRED
NAME
RELATIONSHIP
PHONE NUMBER
STEP 5: SIGN THIS APPLICATION
I certify that all the information provided in this application is true and correct to the best of my knowledge. I understand that
falsification of information is cause for denial of admission/expulsion. Illegal use, possession, and/or misuse of drugs or a
felony conviction may prevent me from obtaining a Physical Therapist Assistant degree.
STUDENT SIGNATURE
DATE
STEP 6: SUBMIT THIS APPLICATION
Together with this application, submit all of the materials required in one large sealed envelope prior to November 15th,
2012 @ 5:00pm for consideration. Write your name and "PTA Consortium Program Application" on the envelope. Your
application materials can be hand-delivered or mailed to:
North Idaho College
Admissions Office
1000 W Garden Ave
Coeur d’Alene ID 83814
NO ADDITIONAL MATERIALS WILL BE ACCEPTED TOWARD YOUR APPLICATION AFTER NOVEMBER 15, 2012, 5:00 p.m.
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PHYSICAL THERAPIST ASSISTANT CHECKLIST & APPLICATION