You must have JavaScript enabled to use this form. Required fields are marked with an asterisk '*'. As an applicant to the Physical Therapist Assistant Program at Craven Community College, I have completed the general application to Craven Community College and been accepted. * Date * Legal First Name * Middle Initial * Legal Last Name * Additional Last Names * Craven Student ID Number? * Craven Student Email Address? * Mailing Address * Address * Address 2 City/Town * State * ZIP/Postal Code * Phone Number? * Alternate Email Address Alternate Phone Number? What city are your currently living in? * What state are you currently living in? * High School Attended/GED Earned? * Year Graduated/GED Earned? * List all post-secondary institutions attended Military Service * Yes No Do you have a Bachelor Degree? * Yes No Institution? Date degree earned? Name of Degree GPA? Do you have a Master's Degree? * Yes No Institution? Date degree earned? Name of Degree GPA? Have you completed a total of 16 hours of observation (8 hours in two separate settings) and the 250-500 word reflection paper? (Both due by May 31st, see observation form for more details) * Yes No In Progress Have you completed the TEAS exam yet? * Yes No If not, what date are you schedule to take it? I understand applicants are permitted to take the TEAS no more than two times between 2/1/24 and 5/31/24 Have you completed all developmental requirements to be eligible to enroll in ENG-111? * Yes No Have you completed all developmental requirements to be eligible to enroll in MAT-110?? * Yes No Have you completed all developmental requirements to be eligible to enroll in BIO-168?? * Yes No Have you completed, with a C or above, or are you currently taking the following classes: ACA 111/115/118/122 College Success * Yes No In Progress BIO-168 (Anatomy and Physiology I) * Yes No In Progress BIO-169 (Anatomy and Physiology II) * Yes No In Progress CHM-090 or higher or High School Chemistry * Yes No In Progress COM-120 (Interpersonal Communication) * Yes No In Progress COM-231 (Public Speaking) * Yes No In Progress ENG-111 (Writing and Inquiry) * Yes No In Progress HUM-115 (Critical Thinking) * Yes No In Progress MAT-110 (Math Measurement & Literacy) or higher * Yes No In Progress PHI-240 (Introduction to Ethics) * Yes No In Progress PSY-150 (General Psychology) * Yes No In Progress Work experience as a Physical Therapy Tech, Physical Therapy Aide, Athletic Trainer, Exercise Physiologist, Massage Therapist, CNA, or Rehab Tech may qualify for bonus points. Please see admission rating sheet for more details. Do you plan to submit any work experience as part of your application? Yes No I understand that it is my responsibility to send all official transcripts to the Registrar at Craven Community so that my application can be processed. * Leave this field blank