2/11/14
Patrick Henry Community College
Application for Emergency Medical Services Program
Application Period is February 24 th – March 31 st , 2014
Admission Requirements :
The following requirements must be met before you can be considered for admission into the EMT-
Intermediate program. Interested students should contact the EMS/ Paramedic Office (656-0328 or 656-0248) for academic advising.
1.
Admission to the College
You must be admitted to PHCC before you can be considered for admission to the
EMT-I program. ADMISSION TO THE COLLEGE DOES NOT GUARANTEE
2.
3.
4.
5.
ADMISSION TO THE EMS PROGRAM.
Graduation from high school or GED
Applicants must have a grade point average of 2.0 or better to be considered. Students who graduated from high school with less than an overall “C” average or have a college
GPA of less than 2.0 must establish a minimum 2.0 cumulative grade point average in graded (A, B, C, D, F) college level courses.
Transcripts
You must provide transcripts from your high school and from any other colleges that you have attended. You will need to contact these schools and ask that a copy of your transcripts to sent to the PHCC EMS/ Paramedic Office or bring them to the office in a sealed envelope from the school.
High School Courses
In order to be admitted to the EMS program, you must have at least a “C” average in the following high school courses.
_____________________________________________________
HIGH SCHOOL REQUIREMENTS or PHCC EQUIVALENT_
One college prep level science BIO101 or BIO102 i.e. (Biology, Chemistry, Physics, or
H.S. Anatomy & Physiology)
6.
7.
8.
Placement Test Scores
You must complete the Virginia Placement Test. If scores indicate, the applicant will be required to successfully complete developmental courses before being considered for admission to the EMS program. Students must place out of or successfully complete ENF 1 or 2 and MTE 1 and 2 . A student may be concurrently enrolled in
ENF 3/ ENG 111 and EMS courses.
Application Form
You will need to complete the EMS application form during the specified application period.
Currently certified as Virginia or Nationally Registered Emergency Medical Technician
–
Basic (if you are testing for EMT prior to August 9 th , please complete additional form attached to the application)

2/11/14
PATRICK HENRY COMMUNITY COLLEGE
Application to the Emergency Medical Services Program
Application Period 2/24/14 thru 3/31/14
1. Please complete the following information.
2. After completing the application, attach copies of a. your high school transcript or GED scores b. transcripts from any college you have attended other than PHCC. (You are responsible for going to the Counseling Office and obtaining copies of your transcripts from colleges other than PHCC before submitting your program application ) *We DO NOT NEED
PHCC transcripts. c. copy of current Virginia or Nationally Registered EMT-B certification
3. You should take the Virginia Placement Test prior to the end of the application period. It is best to do it before since your application may not be considered without that information.
4. Turn in completed application with transcripts and copies of certifications to the
EMS/Paramedic Office in Philpott Hall, Paramedic Office P-126.
5. Please attach a copy of any other current EMS related certifications.
After the application, transcripts, and placement test scores have been reviewed, you will be contacted by the EMS/ Paramedic office. For information about the application process or for questions about the application please contact Kari Whitney, EMS Program Director kwhitney@patrickhenry.edu
Office: (276) 656-0328 Fax: (276) 656-0261.
Intended educational track:
EMT- Intermediate (evenings)
EMT- Paramedic (1 st year evenings/ 2 nd year optional evenings or 1 day/week)
Intermediate- Paramedic (evenings)
Intermediate- Paramedic (1 day/week)
Certificate Degree
Name : SS#: EMPLID :
Address: City: State : Zip Code :
Cell Phone: Home Phone: Work Phone : Email :
Date of High School Graduation or GED Completion :
Name of High School you attended:
Please list present certifications and expiration dates:
BLS/HCP exp.
ACLS exp. PALS exp.
PEPP exp. ITLS exp.
AMLS exp.
exp.
Are you presently associated with a licensed Virginia EMS agency?
Yes No
If yes, please identify which one :

2/11/14
PATRICK HENRY COMMUNITY COLLEGE
Application to the Emergency Medical Services Program
Application Period 2/24/14 thru 3/31/14
th
Course Location:
Course Instructor:
Course Begin Date: End Date:
Practical Test Date: Test Site:
I, , verify the above named student has proven to be competent thus far in the EMT curriculum and endorse this student for acceptance into the EMS Program at Patrick Henry
Community College pending certification as an EMT prior to August 15 th , 2014.
Education Coordinator Certification #: Date:
You may contact me for further information about this student.
Email:
Phone:
I would rather not be contacted.
Comments: