MALCOLM X COLLEGE
1900 W. Van Buren St.
Chicago, IL. 60612
PARAMEDIC PROGRAM
Room 2617
312-850-7303
RE: Paramedic Program Fall 2014
Dear Prospective Student:
Thank you for your interest in the Malcolm X College Paramedic Program.
Enclosed is the application packet for the Program starting in the fall semester. The Program runs for one year,
beginning with the fall 2014 semester and continuing through summer semester 2015. Classes meet on
Mondays & Wednesdays from 9:30AM to 2:00PM and on Fridays from 9:30AM to 4:30PM. These dates and
times may be variable and do not include Clinical Rotations or Internship Assignments.
Please read the following enclosed instructions carefully. Incomplete or inaccurate applications will jeopardize
your consideration as a candidate for the program. Also take note of the admission requirements which includes
a college level Anatomy and Physiology course. This course must be successfully completed prior to program
interviews in early June.
Candidate selections are made by interview process. Interviews are granted to students who submitted a
complete application before the deadline and attain acceptable scores on the entrance exam. The interviews will
be scheduled sometime between May 28th and June 18th.
The deadline to submit the application is no later than Friday, April 25, 2014 at 4:00 p.m.
If you have any questions, please call the EMS office at 312-850-7124.
Sincerely,
Susan Santacaterina
Susan Santacaterina, RN, MHPE
Director, Paramedic Program
PARAMEDIC PROGRAM – APPLICATION DOCUMENTS
Below is a list outlining the documents enclosed in the application packet:
A. Information documents – In addition to the application packet, you will find the following
information:
1. Paramedic Program Description - Program description and admission requirements.
2. Frequently Asked Questions (FAQ) - Information regarding program application and estimated cost.
3. EMT Refresher Course –This course is OPTIONAL and is available to those students who wish to refresh skills
and knowledge prior to sitting for entrance exam.
4. Timeline – Dates and deadlines for application process.
5. Program Entrance Exam and College Placement Exams – All students are required to take EMT entrance
exams. Some students will also be required to take COMPASS placement exams in reading and/or math.
B. Application Forms – The following documents are to be completed and returned as per
instructions.
1. Paramedic Program Application form – Complete and sign. An application fee of $35.00
must be submitted with application packet in the form of a Cashier’s Check or Money Order
made payable to the Malcolm X College Paramedic Program. Applicants must attach clean
copies of the following items:
 A current Illinois EMT-B license
 CPR Healthcare Provider card (both sides)
 An identifiable Driver’s License or State I.D.
2. Transcript Information



Official college (or high school transcripts if no college background) must be sent to Malcolm X College Office
of the Registrar, unless you are currently enrolled as a MXC student.
Include an unofficial copy of all transcripts with the completed application packet that is returned to the EMS
Department.
There must be validation of successful completion (C minimum) of a college level Anatomy and Physiology
class, 4 credit hours with a lab. BIO 116, 226, 227 are acceptable. Students currently enrolled during spring
semester must provide transcript with successful completion before interview.
3. Verification of Field Experience – Return the form completed by your employer validating
work experience as an EMT.
4. Recommendation Forms (3) – Provide personal and professional recommendations from
three different sources. Spouse or family relative cannot submit these recommendations.
These forms can be mailed directly to the MXC EMS Program Office or the recommendation
can be placed in a sealed envelope with the author’s signature written across the seal, and
included with the completed application packet. It is the responsibility of the applicant to
make sure all 3 recommendations have been submitted. Fax copies are unacceptable.
5. Personal Statement Form – Provide a personal statement expressing your reasons for
making application to the program. No more than two pages, legible please.
6. Checklist – Return the provided checklist to make sure your application is complete. Make
certain you identify your requested reservation dates for taking the Paramedic Entrance
Exams. Sign where indicated on checklist.
Completed applications are to be submitted to:
Malcolm X College
EMS Program Office - Room #2617
1900 W. Van Buren Street
Chicago, IL. 60612
The deadline for return of completed application is:
Friday, April 25, 2014 at 4:00 pm.
Malcolm X College
EMS Program Office, Room 2617
1900 W. Van Buren Street
Chicago, IL. 60612
(312) 850-7124
One of the City Colleges of Chicago
Paramedic Program Application Information Form:





All applicants must fill out the Paramedic Program Application Information Form and return to EMS Program Office.
Official college transcripts are to be sent to MXC Office of the Registrar, and copies of transcripts are to be included
with the completed application packet.
Application fee of $35.00. Cashier’s checks or money order made payable to Malcolm X College Paramedic Program.
Signing this application: Certifies that the facts contained are true and complete to the best of the applicant’s
knowledge, and understand that falsified statements on this application shall be grounds for dismissal from both the
application process and/or the Paramedic Program.
ALL required documents must be submitted by the application deadline- Friday, April 25, 2014 no later than 4:00PM.
Personal Information (please print or type)
Student ID Number (if current mxc student)
Date of Application
Anticipated Start Date
Mo.
Last Name
First Name
Middle Name
Address
City
Year
Email Address
State
Zip code
County
Home Phone
Business Phone
(
(
)
)
Cell. Phone
(
)
Emergency Contact: Name, Relationship and Phone #
Birthdate
Ethnic Background
____ / ____ / ____
□
African American
□ Asian □ Caucasian □ Hispanic □ Native American □ other
Academic Background - List EMT program and all colleges or universities attended including any of the City
Colleges of Chicago.
EMT Program Attended
City
State
Dates (from/to)
Degree Earned
College/University
City
State
Dates (from/to)
Degree Earned
Health care work experience:
Employer or Dept. Volunteer
Supervisor
Address
Phone
Dates of affiliation (from / to)
Type of affiliation (paid or volunteer)
Number of hours weekly
Duties
Reason for leaving
Employer or Dept. Volunteer
Supervisor
Address
Phone
Dates of affiliation (from / to)
Type of affiliation (paid or volunteer)
Number of hours weekly
Duties
Reason for Leaving
Non-health care related work experience:
Employer
Position
Dates of Employment
Licenses / Certifications (include double-sided photocopy of each)
License/certificate
State
Expiration Date
Are you willing to submit to a: Comprehensive medical history and/or exam; Drug screening; Testing for communicable
diseases; Immunization (where necessary); Background check and have the results disclosed to the Director, MXC
Admission Review Member(s) and Clinical Site Director(s)?
 Yes  No
Have you ever been convicted of a crime?
 Yes
Signature___________________________________
Rvsd/2014 /ss
 No
Date_________________
PROGRAM ENTRANCE EXAM AND COLLEGE PLACEMENT EXAMS
A. Program Entrance Exam – EMT
All applicants are required to take an EMT entrance exam. This is a multiple question test; scores on this
exam will determine eligibility to sit for a program interview. Applicants must request a date to take this exam
by submitting your preferences on the application checklist. You will receive a confirmation by email or by
phone. Space is limited, so it is important to get the application and test date request submitted early.
Applicants must be confirmed to sit for the exam at that specific time.
Taking the Entrance Exam
1. Receive confirmation of your requested testing date from the EMS office.
2. Report to testing site (Room 1109 Testing Center or Room 2535 as described below) at least ten
minutes prior to start of the exam. Please be prompt, as no one will be allowed into the testing area
once the test begins.
You will be required to present an official, current photo ID to the testing center prior to sitting for exam. The
exam will be offered at the following dates and times:
Test Date
Monday, April 21
Tuesday, April 22
Thursday, April 24
Monday, April 28
Tuesday, April 29
Thursday, May1
Saturday, May 3*
Thursday, May 8
Test Time
9:00 am
4:30 pm
9:00am and 4:30 pm
4:30 pm
9:00am and 4:30 pm
11:00 am
9:00 am
9:00am and 4:30 pm
Location
Room 1109 (Testing Center)
Room 1109
Room 1109
Room 1109
Room 1109
Room 1109
Room 2535*
Room 1109
*There will be only one Saturday testing date offered. Space will be limited so reservations will be taken on a
first come, first serve basis. It is unlikely there will be space for candidates submitting applications on the
deadline date.
B. College Placement Exam
To enroll in the college, each applicant is required to provide evidence of college level reading. This is
accomplished by any of the following criteria:



A currently enrolled student with acceptable COMPASS reading score within past year
College transcript indicating successful completion of ENG 101/102 with a grade of “C” or better
Comparable ACT scores (19 or greater) taken within 2 years
This documentation will be assessed through the copies of your transcripts which must be included in the
application.
Any applicant who has no prior college experience and does not meet the above criteria will be expected to
take the college COMPASS reading exam. These students must report to Room 1502 and complete a
Student Information and Enrollment card to get into the college system. Once you have completed the
enrollment card in Rm. 1502 you must make arrangements with the admissions department to attend
orientation and take the COMPASS placement exam.
2014/ss
CITY COLLEGES OF CHICAGO
MALCOLM X
Paramedic Program
Frequently Asked Questions:
How many candidates typically apply for the MXC program?
There are typically three applicants for each class “seat”.
I know qualified candidates need to be interviewed, who are the interviewers and how do they make selections?
The interviews are conducted by the admissions committee which is made up of representatives of: Malcolm X
College; Chicago Resource Hospitals; Chicago Fire Department; and a Field Paramedic. The committee will
ask questions of the candidate that address, and may not be limited to: Qualities such as motivation, maturity,
academic capabilities, community commitment; and provide a BLS patient scenario for the applicant to
manage. The admission committee will look at all components of the application, including academic history,
recommendations, personal statement, test scores, work history and community participation
Is there any advantage to taking the EMT class at Malcolm X College?
There is some advantage, in that students who are already enrolled at Malcolm X College have their academic
history readily available to the committee and do not need to make application to the college. Students from
MXC, only, are allowed to sit for an interview with a state license “pending” (enrolled in the current Spring EMT
class).
How much ambulance experience do I need?
The committee strongly recommends working experience as an EMT-Basic by the start of the program (fall
semester). Typically 500 hours of field experience is preferred. Documented ambulance experience is not
required at the time of interview, however given the competitive application process, field experience as an
EMT will provide an advantage for the candidate.
Are there any science prerequisites?
Yes! The applicant must have successfully completed a college level Anatomy & Physiology (A&P) course, of
4 credit hours with a lab. Courses offered at CCC which meet this requirement include BIO 116, 226 or 227. If
A&P was taken at another college it is advisable that a copy of the course description be reviewed by the
program director to assure it meets the requirement. An official transcript must be sent or handed over to the
Office of the Registrar, include a copy of the transcript with your completed application packet.
What is acceptable score on the entrance exams?
The applicant must achieve an acceptable score on the EMT entrance test (multiple choice) to be eligible for
interview. Cut-off scores are determined by Admissions committee, dependent on the candidate pool;
traditionally a score of 75% has been considered acceptable. First time applicants to the college must take
placement exams in reading and math. The EMS Department offers an EMT-B Refresher Course (not
mandatory) prior to Paramedic Program Entrance Testing.
Are there any other characteristics or qualities that can make my application more competitive?
As a community college, we look for candidates that appreciate the college mission and demonstrate service to
the community. As a health career program, we seek candidates with career goals of service as a paramedic.
When are applications available and when are they supposed to be completed?
Applications are available yearly in early February and due in late April. Specific deadlines are clearly stated in
the application packet. They can be mailed out, picked up from the EMS Office (Rm.2621), or emailed to you.
What is the cost of the program?
See reverse side.
CITY COLLEGES OF CHICAGO
MALCOLM X
Paramedic Program Cost
List Date: 1-2014
All costs are approximate and are subject to change. Refer to the current Malcolm X College “Student Schedule of Classes” for details
http://ccc.edu/departments/Pages/Tuition-and-Fees.aspx . Chicago resident cost applies.
Fall Semester (EMT 221 & EMT 222):
Tuition ($89.00 / credit hour x 14 credit hours)
Registration Fee
Other Fees – Activity Fee (Full time – 12 or more hours; includes
U-Pass. Parking, Technology and other student activities)
Lab Fee:
Clinical Fee:
Book cost (cost is approximate)
Cost of course & credentialing in: ACLS, PEPP, ITLS fee
Platinum Ed – clinical tracking system
Background check (cost is approximate)
Physical exam & blood work
Fall Semester Total Cost
1246.00
30.00
170.00
30.00
10.00
350.00
85.00 (subject to change)
80.00
50.00
130.00 (cost variable per student)
2181.00
Spring Semester (EMT 223 & EMT 224):
Tuition ($89.00 / credit hour x 14 credit hours)
Registration Fee
Other Fees – Activity Fee (Full time – 12 or more hours; includes
U-Pass. Parking, Technology and other student activities)
Lab Fee:
Clinical Fee:
Spring Semester Total Cost
1246.00
30.00
170.00
30.00
10.00
1486.00
Summer Semester (EMT 227):
Tuition ($89.00 / credit hour x 6 credit hours)
534.00
Registration Fee
30.00
Other Fees – Activity Fee (Part time – Less than 12 hours; includes
Parking, Technology and other student activities – Does not incl. U-Pass) 50.00
Lab Fee:
30.00
Internship Fee:
500.00
Summer Semester Total Cost:
1144.00
IDPH exam registration fee
40.00
***IMPORTANT: All students are required to carry their own health insurance for the entire duration of the Paramedic
Program. The above does not include student health insurance cost.***
Tuition Charge Back (Non-Chicago Residents):
Non-Chicago residents who plan to enroll in any Malcolm X College program and that program is not available at a
community college in their district should apply to their local community college board office for tuition charge back at least
thirty days prior to the first day of registration – where applicable. Prices subject to change.
Residents of Illinois living outside of Chicago per credit hour cost:
Non-residents of Illinois per credit hour cost:
2014/ss
173.56
230.35
MALCOLM X COLLEGE PARAMEDIC PROGRAM
VERIFICATION OF FIELD EXPERIENCE
This document is to verify that the following applicant:
(Applicant’s name)
has participated in direct patient care, providing BLS pre-hospital care during
the following period: (list dates of employment)
Starting date _____________________________________
Dates: From _________________ to __________________
During this period, this individual worked an average of _________ hours per
week.
____________________________________________
Name
____________________________________________
Signature
____________________________________________
Title
____________________________________________
Company
____________________________________________
Phone
Note - this form must be completed and returned with other application materials
Rvsd/2014ss
MALCOLM X COLLEGE
PARAMEDIC PROGRAM
RECOMMENDATION FORM
THREE NEEDED
To the Applicant:
Type or print your name in the space provided and give this form to the individual submitting a recommendation
on your behalf. These individuals must have known you for at least 6 months. If possible, utilize your work
supervisor, co-worker and/or EMT Instructor/EMS Coordinator. Three (3) recommendation forms are required.
The completed forms are to be submitted with application packet in a sealed envelope with signature of the
author written across seal. Mail or hand-deliver packets to:
MALCOLM X COLLEGE
EMS PROGRAM OFFICE - PARAMEDIC PROGRAM
1900 WEST VAN BUREN STREET, ROOM 2621
CHICAGO, ILLINOIS 60612
Applicant
Name: _____________________________________________________________________
(First)
(Middle)
(Last)
Address: __________________________________________________________________
(Street Address)
(City/State)
(Zip)
Telephone Number: ____________________
(Daytime)
____________________________
(Evening)
TO THE RECOMMENDER: The above individual has applied to the Malcolm X College
Paramedic Program. In order to give the Admissions Committee a complete profile of the
applicant, please answer the following questions. If you have additional information,
attach a separate page. Completed recommendations are to be returned to applicant in a
sealed envelope with your signature written across the seal.
Recommender Information:
Name ____________________________________________________________________________
(First)
(Middle)
(Last)
Address _________________________________________________________________________
(Street Address)
(City/State)
(Zip)
Telephone: (Home) ______________ (Work) ______________(Pager) __________(Fax) _______
Institution _____________________________________________ Title _____________________
May we contact you if there are any further questions? Yes _____ No _______
1.
How long have you known the applicant and in what capacity?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________
2.
Please rate the applicant in the following areas using the grading scale below:
5. Excellent
4. Good
3. Fair
2. Poor
1. Unknown
____ A.
Academic potential _________________________________________________________
____ B.
Capacity for logical thinking __________________________________________________
____ C.
Ability to work with others____________________________________________________
____ D.
Ability to express ideas verbally _______________________________________________
____ E.
Ability to express ideas in writing ______________________________________________
____ F.
Motivation __________________________________________________________________
____ G.
Judgment _________________________________________________________________
____ H.
Maturity ___________________________________________________________________
3.
What have you observed to be the applicant’s strengths:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
______________________________
____________
4.
In what way would he/she be an asset to the EMS community:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
__________________________________________
Recommender’s Signature _________________________________________________________________
2014/ss
Malcolm X College – Paramedic Program
Personal Statement
NAME____________________________________________________
DATE________________________
Applicants must submit a statement describing your motivation and goals in pursuing a career as a paramedic. The
statement should be no longer the one page typed.
EMT REFRESHER TRAINING
This 24 hour EMT Refresher Training session is designed to ensure individual competency for the practicing
EMT. This course will also give the EMT the opportunity to sharpen their knowledge, skills and review the
major concepts and interventions as outlined in the NEW, United States, Department of Transportation,
Emergency Medical Technician curriculum.
It is strongly suggested that students review their current EMT textbook prior to class. A minimum grade
of 70% on the EMT posttest and full attendance will ensure the full 24 hour Continuing Medical Education
(CME) credits. The course is approved by the Illinois Department of Public Health and hour for hour CME
will be awarded.
Class Logistics
Dates:
Saturday, April 5, 2014
Saturday, April 12, 2014
Saturday, April 26, 2014
Time:
9:00 a.m. to 5:00 p.m.
Students will be given breaks. Lunch is on your own.
Location:
Malcolm X College
1900 West Van Buren
Chicago, Illinois 60612
Room: 2619
Fee:
$135.00
Note:
Bring your EMT textbook to class
Registration:
To register for the EMT Refresher Training course, report to the Continuing Education Office in room 2217,
Monday thru Thursday 9am to 5:00pm and Friday 9:00am to 4:30pm. Bring a State ID or Illinois Driver’s
License as proof of residence. After completing the registration form you will be enrolled in the class at
which time you will report to the Business Office to pay your $135.00 fee. Registrations will be taken up to
and including Friday, April 4, 2014.
If there are any questions or concerns, feel free to contact the EMS Program Office at 312 850 7410.
Paramedic Application Timeline – 2014
February 4th – April 25th
Monday, April 21 –
Thursday, May 8
Friday, April 25, 2014
Open Application - Applications are
available in the EMS office or online.
Applications can be submitted during this
time frame.
Application packets available from MXC
EMS Department. They can be mailed out
or emailed available upon request. Hard
copies are also available on-line.
Dates for entrance exam are provided in
application packet. Space is limited,
Reserve testing date with submitted
application. The earlier the application is
submitted, the more likely you will be
confirmed for your requested test date.
Deadline for completed applications to be
submitted
No later than 4:00PM
etters go
May
out5thtothrough
applicants with
th
May 16
Letters sent out with results of entrance
exams and interview dates.
May 27th through
June 19th
Interviews with Admissions Committee
Week of June 23rd
Acceptance letters sent out
Week of July 7th
Student confirmations/responses due
Week of August 20th
One-day orientation
Monday, August 25th
First Day of Class
Application Checklist – DEADLINE FOR SUBMISSION IS APRIL 25, 2014 by 4:00 pm
Make sure you have included all of the following, and include this checklist in the submitted
application:

Paramedic Program Application – Completed and signed

Application fee of $35.00 in the form of cashier’s check or money order made payable to:
Malcolm X College Paramedic Program

Official transcripts from previous college sent directly to Malcolm X College, Office of the
Registrar.

COPIES of all transcripts (unofficial) must be included in application packet and submitted to
the EMS office. Transcripts must include successful completion of 4-credit hour Anatomy and
Physiology course with a lab or documentation of currently enrolled in an approved course.

Verification of field experience – completed and signed

Recommendation Forms (3) – completed and signed. Applicant can submit recommendation
forms with packet, if document is in a sealed envelope with signature of author written across
seal. Student is responsible to verify receipt of those recommendations mailed in.

Personal Statement Form

Program Entrance Exam:
I would like to request the following testing dates for the Paramedic Entrance Exam:
1st choice ________________________
2nd choice ________________________
email address / phone # to send testing date confirmation ________________________________________________________________

College Placement Testing:
I do not need to take COMPASS exams because I have submitted transcripts with ENG
101/102, ACT composite score of 19 or greater (within 2 years), or acceptable COMPASS
scores within 1 year. sign____________________________
-ORI will take COMPASS on (date) ______________ sign ____________________________________

Enclosed a current clean copy of your: IDPH EMT-B License; CPR Healthcare Provider Card;
and Driver’s License or State ID

Application checklist – completed and signed with requests for testing dates
Please return all completed application paperwork to:
Malcolm X College
EMS Program Office – Paramedic Program
Room 2621
1900 W. Van Buren Street
Chicago, IL 60612