PALM BEACH STATE COLLEGE – Lake Worth
Limited Access Office
4200 Congress Avenue, Lake Worth, FL 33461
PALM BEACH STATE
COLLEGE
Application Questions: (561) 868-3045
EMERGENCY MEDICAL TECHNICIAN
Web Site: www.palmbeachstate.edu/programs/ems
Spring 2016 (2016-2)
Your acceptance for selection MUST be viewed at
www.palmbeachstate.edu/pantherweb
under Limited Access Application Status.
(EMT)
ALL communication will be sent to your
my.palmbeachstate.edu e-mail account including requests for
missing information and all required acceptance documentation.
DEADLINE: November 20, 2015
An Equal Opportunity Institution
Program Information
PROGRAM BEGINS:
Night Class – January 6, 2016
C Shift – January 6, 2016
A Shift – January 7, 2016
B Shift – January 8, 2016
PROGRAM DESCRIPTION: This is a college credit (Applied Technology Diploma) program designed to instruct a person
to the level of Emergency Medical Technician-Basic. EMT-B’s serves as a link in the chain of the health care team. It is
recognized that the majority of pre-hospital emergency medical care will be provided by the EMT-B’s. This includes all skills
necessary for the individual to provide emergency care at a basic life support level with an ambulance service or other
emergency service agencies. The EMT-B Program is a prerequisite for the Paramedic Program as well as. Special admission
requirements are associated with this program.
PROGRAM LENGTH: Approximately 16 weeks, full college semester -11 college credits
PROGRAM SCHEDULE:
This program is on the Palm Beach County Firefighter shift schedule. http://www.pbcfr.org/shift_calendar.asp
Section
Lecture/Lab
Lab
Clinical
Schedule
Hours*
Mondays, Wednesdays and Thursday
Saturdays
Saturdays*
6 pm – 10 pm
9 am – 4 pm
Shift
A SHIFT
Section
Lecture/Lab
Clinical
Schedule
A Shift (except Sundays and College holidays)
B or C Shift (except Sundays and College holidays)
Hours
8:30am – 5:30pm*
10 hours**
Shift
B SHIFT
Section
Lecture/Lab
Clinical
Schedule
B Shift (except Sundays and College holidays)
A or C Shift (except Sundays and College holidays)
Hours
8:30am – 5:30pm*
10 hours**
Shift
C SHIFT
Section
Lecture/Lab
Clinical
Schedule
C Shift (except Sundays and College holidays)
A or B Shift (except Sundays and College holidays)
Hours
8:30am – 5:30pm*
10 hours**
Night Class
10 hours**
*Hours are subject to change in subsequent semesters. Clinical rotations (6 days in the semester) include a combination
of Hospital Facility and Fire Rescue field experience (**Fire Rescue starts at 7:30 am and Hospital starts at 8:30 am).
Further details of the schedule will be explained at the mandatory orientation (approximately 2 weeks before classes begin)*.
Page 1 of 7
Program Information
PROGRAM LOCATIONS:
Classes and labs will be held on the Lake Worth campus – 4200 Congress Avenue, Lake Worth, Florida 33461
Clinical sites will be designated per the Clinical Coordinator and are subject to change throughout the program.
PROGRAM COST:
Tuition and fees (FL resident) $ 1,173*
*These costs are approximate and subject to change.*
Fees include parking decal, Medical Accident Insurance and Liability Insurance assessed.
*Does not include textbooks, uniforms, and pre-screening costs (drug screening, med exam & criminal background).
FINANCIAL AID: At this point the program is NOT eligible for federal aid programs; however, there are scholarships
available through the Palm Beach State College Foundation. To apply for this foundation scholarship go online to:
http://www.palmbeachstate.edu/foundation If you have any scholarship questions please call (561)-868-3573.
MANDATORY ORIENTATION:
All accepted students are required to attend one of the following Mandatory Orientations:
EMT Mandatory Orientations
December 1, 2015
December 2, 2015
PSD108
At 6 pm
PSD108
At 9 am
Page 2 of 7
EMT Program Application
Requirements for Consideration for Selection
Requirements
forConsideration
Considerationforfor
Selection
quirements for
Selection
The following criteria determine eligibility for placement into the selection pool. Meeting the criteria for selection does not
guarantee admission to the EMT-B Program. Final selection will be based on the applicant pool. These criteria below
supersede any other information.
All documentation must be on file at the Palm Beach State College Admissions Office, Lake Worth by November
20, 2015.
1.
APPLICATION
 First-time Palm Beach State College Students: Submit a completed Palm Beach State general credit application at
http://www.palmbeachstate.edu/admissions and pay the appropriate fee by the deadline date. New students will be
assessed a $40 nonrefundable fee. International (F-1/M-1) students will be assessed a $75 nonrefundable application fee.
Be sure to insert your current and active email address where requested; is specific regarding your program of study. Once
submitted, a confirmation page with conditions of admission will be sent to the e-mail address provided in the college
application. Print the confirmation page and follow the instructions within. Applicants must also submit the program
application contained in this packet and submit to the Admissions office.
 Non first-time Palm Beach State College Students: Must complete the program application in this packet and submit
to the Admissions office.
2.
ACADEMIC HIGH SCHOOL DIPLOMA OR GED
Transcripts must be official (transcripts are considered official if sent directly to Palm Beach State College from the previous institution or
are hand-delivered in a sealed envelope sealed by the issuing institution) and mailed directly from the previous institution to the
Palm Beach State College Admissions Office proving a standard high school diploma, GED, or validated foreign
equivalent. All applicants – new, current, and college transfer students - must have their official high school or GED
transcript on file at Palm Beach State College. You may download the transcript request form from our website at
http://www.palmbeachstate.edu/admissions/transcript-request.aspx. Students who received a Florida GED can request
their scores using the downloaded form at http://www.palmbeachstate.edu/admissions/transcript-request.aspx.
3. PROOF OF AGE
All students must be at least 18 years of age on or before the start of the program.
4. PROGRAM INFORMATION SESSION
All students are encouraged to attend one of the following information sessions:
 October 5, 2015 at 2:00 pm at PSD108
or
 November 4, 2015 at 6:00 pm at PSD108
5. AMERICAN HEART ASSOCIATION CPR CERTIFICATION
All applicants must provide documentation of completion of a current American Heart Association (BLS for Healthcare
Provider) course. Call the Public Safety Corporate Continuing Education office at 561-868-3775 for CPR classes held at
Palm Beach State College or by Web on Panther Web at: http://www.palmbeachstate.edu/cce/health/healthcourses.aspx (CPR Course ID# is EMO 0123).
6.
COLLEGE TRANSCRIPTS
Official college transcripts (transcripts are considered official if sent directly to Palm Beach State College from the previous institution or
are hand-delivered in a sealed envelope sealed by the issuing institution) from ALL post-secondary institutions attended must be
submitted. You may download the transcript request form from out website at
http://www.palmbeachstate.edu/admissions/transcript-request.aspx. All post-secondary records from out of the country
must be submitted with a commercial evaluation. If you have attended college, we still require proof of a standard high
school diploma, GED or validated foreign equivalent. Commercial evaluation of foreign transcripts must be conducted
by approved evaluators listed at http://www.palmbeachstate.edu/admissions/transcript-request.aspx.
Page 3 of 7
EMT Program Application
Requirements for Consideration for Selection (continued from previous page)
7. PLACEMENT TEST
Applicants (unless exempt, see below) must take the I/O Solutions NFSI Test (National Firefighter Selection Inventory
–Form 3 Test) within two years of application deadline date and score at least a 75% in order to be eligible for
consideration for selection. Additional Information about this test and study guides can be found at
www.publicsafetyrecruitment.com. The Palm Beach State College Lake Worth book store will have a study guide in stock.
The Student Learning Center (SLC) at the Palm Beach State College Lake Worth location provides Vocational Preparatory
Instruction (VPI) for students who need additional skill to pass the NFSI test. For more information, please call 561/8683795. (Check with the testing center on a campus nearest to you for availability of the NFSI test, not all testing centers
offer the NFSI test. Testing center numbers are listed below). There is a $45.00 fee for this exam. Please pay the cashier
and report to the testing Center (with photo ID) to arrange to take the exam.
Testing Centers
Belle Glade
Boca Raton
Lake Worth
Palm Beach Gardens
(561) 993-1125
(561) 862-4324
(561) 868-3012
(561) 207-5359
Exemptions: Students with a two (2) year degree in Associate in Applied Science or higher; students who have taken
and successfully completed the Postsecondary Education Readiness Test (PERT); or students who have already met the
minimum cut scores, within the past two years, on the PERT, SAT1 or ACT-E, are exempt from the placement test.
Documentation required.
ACCEPTED STUDENTS WILL NEED A CLEAR CRIMINAL HISTORY BACKGROUND, DRUG
SCREENING AND ACCEPTABLE MEDICAL EXAM, COMPLETED AT THEIR OWN EXPENSE, PRIOR
TO STARTING THE EMT PROGRAM.
Details and deadlines regarding this procedure will be discussed at the mandatory orientation.
Page 4 of 7
EMT Application
Program Application
EMT Program
Spring 2016 (2016-2)
ApplicantPoint
PointSystem
Systemfor
for Selection
Selection
Applicant
SPRING
DEADLINE:
November21,20,
2015
FALL DEADLINE:
November
2014
After all eligibility requirements for placement into the selection pool have been satisfied, the following point system
will be utilized for selection into the program. Only one point value from each of the Educational Points Category
will be awarded. All documentation MUST be on file at the Palm Beach State College Admissions Office, Lake
Worth, BY THE DEADLINE date (November 20, 2015).
I.
IV.
U.S. VETERAN
….…………………………………………………………………. 1
The applicant must submit copy of DD214 with honorable discharge.
EDUCATIONAL POINTS (Maximum Points-6)
The applicant must have official college transcripts sent from post-secondary institutions.
College Degree earned from any accredited institution.............................................................. 6
OR
30 or more college credits ............................................................................................................ 5
OR
Up to 29 college credits ............................................................................................................... 4
OR
80% level on all areas of I/O Solutions & *PERT, ACT-E & SAT1…………………………… 3
OR
75% level on all areas of I/O Solutions..……………………………………….…………………2
*(Test scores must place the student into college level courses in all areas.)
MAXIMUM POINTS POSSIBLE .......................................................................7
Acceptance: Applicants who are selected will be notified within 10 business days after the application
deadline date. The acceptance notice will include registration information. If a student is selected and
does not enter the program, or is not selected, he/she must reapply and is not guaranteed acceptance in
any subsequent selection process.
ALL communication will be sent to your my.palmbeachstate.edu e-mail account including all acceptance
documentation.
Page 5 of 7
EMERGENCY MEDICAL
MEDICAL TECHNICIAN-BASIC
TECHNICIAN-BASIC (EMT)
(EMT) APPLICATION
APPLICATION
EMERGENCY
Spring
2016 DEADLINE:
November
20, 2015
SUMMER
DEADLINE:
April 15, 2013
Your criteria for selection can be viewed at www.palmbeachstate.edu/pantherweb under Limited Access Application Status
and ALL communication will be sent to your my.PalmBeachState.edu e-mail account including all acceptance
documentation.
Application is to be submitted to the Registration Office on or before the Deadline.
CREDIT PROGRAM CODE B217
Please Type or Print Clearly
1.
PALM BEACH STATE COLLEGE STUDENT ID ___ ___ ___ – ___ ___ – ___ ___ ___ ___
2.
NAME
____________________________________________________________________________________________________
Last
First
Middle
Suffix
Please list all previous names under which documents may be sent _______________________________________________________________
3. LOCAL ADDRESS _________________________________________________________________ ________________________________
CITY
NUMBER AND STREET ADDRESS
_______________________________________________________________ ____________________
COUNTY (or PROVINCE)
4. HOME TELEPHONE (
STATE
)______________________
5.
____________
ZIP CODE
WORK TELEPHONE (
)______________________
CELL TELEPHONE (
)______________________
E-MAIL ADDRESS:
________________________@my.palmbeachstate.edu
6. DATE OF BIRTH ______/____/_____
Month
Day
Year
TRANSCRIPTSOfficial transcripts must be sent directly to Palm Beach State College from issuing school/agency. All applicants, including
college transfers, must submit high school or GED transcripts directly to Palm Beach State College. College transfer students must submit official
transcripts from all colleges in which applicant has enrolled.
7. HIGH SCHOOL GRADUATE?  Yes  No
OR
GED?  Yes  No
8. COLLEGE/UNIVERSITY
List all postsecondary colleges or universities you have enrolled. Omission of any constitutes falsification of records and voids application.
NAME OF INSTITUTION
CITY/STATE
DATES
DEGREE CREDIT
Spring2016(2016-2) Application
To list more colleges/universities, attach a separate page.
9. AMERICAN HEART ASSOCIATION CPR CARD (submit copy with your application)
Please check one:
 American Heart Assoc. CPR Card “Healthcare Provider” level.
 Do not have CPR Card
Expiration Date on card _____________
You must provide a copy of your CPR card to the Admissions Office before the deadline.
10. Have you taken NFSI (National Firefighter Selection Inventory –Form 3 Test) test with a score of 75% or better?
(NFSI) scores cannot be older than 2 years by the application deadline date)
11. Have you attended the EMT Information Session?
 Yes
 No
 Yes
 No
□ Exempt
I understand that falsification or omission of any information may result in my dismissal or rejection from the College.
________________________________________________________________
___________________________________
SIGNATURE OF APPLICANT
DATE
Page 6 of 7
EMT Program
Important Student Checklist Read Carefully!
Important Student Checklist
Emergency Medical Technician Checklist
- Please Read Carefully!
To Complete Eligibility For Placement In The Selection Pool
You DO NOT have to wait until all requirements are met to submit your application, but remember that
everything MUST be complete and submitted to the Palm Beach State College Admissions office by the
deadline date.
GENERAL PALM BEACH STATE COLLEGE
CREDIT APPLICATION COMPLETED and $40 nonrefundable one-time fee ($75 for International students)
OFFICIAL HIGH SCHOOL DIPLOMA OR GED SENT
TO PALM BEACH STATE COLLEGE: official
transcripts are to be mailed from your High School to the
PBSC Admissions Office.
AGE REQUIREMENT MET: all students must be at least
18 years of age on or before the start of the program.
ATTEND A PROGRAM INFORMATION SESSION: All
students are encouraged to attend one of the following
information sessions:
 October 5, 2015 at 2:00 pm at PSD108
Or

November 4, 2015 at 6:00 pm at PSD108
AMERICAN HEART ASSOCIATION CPR
CERTIFICATION
EMT APPLICATION SUBMITTED
OFFICIAL COLLEGE TRANSCRIPTS: official
transcripts are to be mailed from ALL prior colleges to the
Palm Beach State College Admissions Office; this includes
incomplete college work due to withdrawals or dropped
courses.
I/O SOLUTIONS NFSI TEST: 75% or higher required in
all areas of test.
ATTEND A MANDATORY PROGRAM
ORIENTATION: All accepted students MUST attend one
of the following Mandatory Orientations:

December 1, 2015 at 6:00 pm at PSD108
Or

December 2, 2015 at 9:00 am at PSD108
Applicants who are selected will be notified within 10 business days after the application
deadline by email to their …..@my.palmbeachstate.edu account.
Page 7 of 7