Registration Form Human Anatomy Challenge Exam Master of Occupational Therapy Program Department of Occupational Science & Occupational Therapy University of British Columbia The Human Anatomy Challenge Exam has been established for applicants of the MOT program who wish to demonstrate the skill set and knowledge base in gross human anatomy required by all applicants prior to entry. This exam is best suited for applicants who have a strong understanding of gross human anatomy, and who have: Completed a course that has been reviewed but is not accepted to fulfill the Human Anatomy requirement due to lack of required content. Completed a course that covers the required content but was offered through an institution that is not recognized. This exam is only recommended for applicants who have a strong understanding of gross human anatomy. Applicants will successfully challenge the Human Anatomy requirement if a grade of 76% or higher is received on this exam. Applicants can only sit the Human Anatomy Challenge Exam once per application year. The exam is multiple-choice, and applicants will be given 1.5 hours to complete the exam under the supervision of an invigilator. Notes or study materials of any kind are not allowed in the examination room. Applicants will be tested on the content required of an accepted Human Anatomy course, which includes: Bones, joints, muscles, nerves, and blood vessels in the upper limbs of the human body Bones, joints, muscles, nerves, and blood vessels in the lower limbs of the human body Bones, joints, muscles, nerves, and blood vessels in the back and thorax of the human body All sittings of the Human Anatomy Challenge Exam will take place in the Department of Occupational Science at Occupational Therapy, which is located in the UBC Hospital in Vancouver. The examination room will accommodate a maximum of 5 applicants per sitting. A fee of $250 is required to sit the Human Anatomy Challenge Exam. The fee can only be paid by cash or cheque (payable to the University of British Columbia) and mailed or dropped off to: Department of Occupational Science & Occupational Therapy Attention: MOT Admissions T325-2211 Wesbrook Mall Vancouver, BC V6T 2B5 Your seat in the exam is not confirmed until payment has been received. The deadline to submit the registration form and fee is at least 14 business days before the date selected for the exam. Page | 1 Registration Form Human Anatomy Challenge Exam Master of Occupational Therapy Program Department of Occupational Science & Occupational Therapy University of British Columbia STUDENT INFORMATION Full Name: Mailing Address: City: Province: Phone Number: Postal Code: Email Address: EXAMINATION INFORMATION Choose only ONE date and time option for writing the Human Anatomy Challenge Exam. All sittings of exam will take place in the Department of Occupational Science at Occupational Therapy, which is located in the UBC Hospital in Vancouver. Date Time Date Time November 6, 2014 10:00 AM November 20, 2014 10:00 AM December 4, 2014 10:00 AM December 18, 2014 10:00 AM January 8, 2015 10:00 AM January 22, 2015 10:00 AM PAYMENT SUBMISSION A fee of $250 is required to sit the Human Anatomy Challenge Exam. The fee can only be paid by cash or cheque (payable to the University of British Columbia) and mailed or dropped off to: Department of Occupational Science & Occupational Therapy Attention: MOT Admissions T325-2211 Wesbrook Mall Vancouver, BC V6T 2B5 REGISTRATION FORM SUBMISSION Your completed registration form can be emailed to mot.admissions@ubc.ca or faxed to the attention of MOT Admissions at 604-822-7624. Page | 2