Physical Therapy Assistant Program -

Application


Albany State University – West Campus

Health Sciences Division – PTA Program

2400 Gillionville Road

Albany, GA 31707

 

 

CONTACT INFORMATION

 
 
 
 
 
 
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EDUCATIONAL BACKGROUND


*If you attended a College/University other than Albany State University, please include an unofficial transcript (for each) with this application.


 
 
 
 
 
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GRADE POINT AVERAGES (G.P.A. must be a minimum of a 2.8)

 


Use the Prerequisite G.P.A. Form to calculate your prerequisite grade point average and include the completed form with the application. Please type your prerequisite G.P.A. in the box.


 


The second G.P.A. to include on this page is your choice and may be either your overall cumulative G.P.A. or the G.P.A. for the last 40 hours of earned college credit.


Use the Cumulative G.P.A. Form to calculate the G.P.A. you choose to include and include the completed form with the application. Indicate which G.P.A. has been included by writing in the designated box for which you calculated. (i.e. either Cumulative or Last 40 hours)


 

 

OBSERVATIONAL HOURS


Must have a minimum of 40 hours.


Please summarize your observational hours as indicated below. Be sure to include the verified/signed documentation of hours with the application.

 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

REQUIRED DOCUMENTS UPLOAD



PLEASE USE THIS SECTION TO ATTACH THE FOLLOWING REQUIRED DOCUMENTS:



PLEASE NOTE: You will receive correspondence from the PTA Program Director via email by June 15, which is 2 weeks past the deadline of June 1. Please do not call to inquire about the status of an application. The PTA Program Director will not return calls or emails regarding the status of an application (with the exception being after June 15th and the applicant never received an email). Therefore, if you wish to know the application was received, please send the application as certified mail so that you receive a confirmation from the postal service that it was delivered.




REQUIRED DOCUMENTS:



Prerequisite G.P.A. Form: Must be completed even if courses are still in progress.




Cumulative G.P.A. Form (or last 40 hours of college credit earned): Must be completed.




TEAS Score Report:


The Test of Essential Academic Skills (TEAS) measures basic academic preparedness in the content area domains of reading, mathematics, science, English and language usage. To be valid for the PTA program, the TEAS may only be taken twice with a minimum of 6 weeks between the first and second attempts. The TEAS Exam must be taken in person at a testing center. A copy of your score report/s should be included with the application.


An unofficial copy of your score report/s should be included with the application.




Observational Hours Form(s):


The Observational Hours Form within this packet is not required. Any form of documented hours is acceptable as long as it is signed by a PT or PTA in the facility. All hours must be completed prior to the application deadline of June 1.




Letter of Recommendation Form:


Please include at least one completed recommendation form from a PT or PTA in a sealed & signed envelope. It is a requirement to use the PTA Program Letter of Recommendation Form. The form may be included with the application or mailed separately.


The Recommendation Form is required.


May be mailed separately from the application by the PT or PTA completing the form.




Essay:


Please include a hand written essay explaining why you have chosen PTA as a career path and why you feel you deserve a seat in the class. No specific length is required.




Copy of Unofficial Transcript(s): Required for all students, even those currently attending ASU.


 
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SIGNATURE

I hereby apply for admission to the PTA Program for Fall Semester listed below and certify this application is both correct and complete. I have read the application packet, including the essential abilities required and understand the application and selection processes. I further understand that any failure on my part to comply with these processes will result in the cancellation of my application. I am aware of the competitive nature of the application process for the PTA program and understand that meeting all minimum requirements does not guarantee admission into the program.

 
 
 

Please type in your First and Last Name.

 
 
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Personal Identifiable Information (PII) Notice:


All personal data and special categories of sensitive personal data collected or processed by Albany State University (ASU) must comply with the ASU Cybersecurity Program Plan, as authorized by the Board of Regents Policy Manual Section 10.4 Cybersecurity:


https://www.usg.edu/policies


Anyone suspecting his or her sensitive personal data has been exposed to unauthorized access, report your suspicion to:


LegalAffairs@asurams.edu


Otherwise, questions concerning GDPR can be forwarded to LegalAffairs@asurams.edu. Typing your name in the box below and submission of this application provides consent to and acknowledgment of the ASU Data Security and Privacy Policy.

 

Please check the box below to indicate that you have read and understood the PII policy above.

 

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