RE Paramedic Program Fall 2010 by fnz82095

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									                  Malcolm X College
                               One of the City Colleges of Chicago

                                                                                     Malcolm X College
                                                                         EMS Program Office, Room 2617
                                                                            1900 West Van Buren Street
                                                                                  Chicago, Illinois 60612
                                                                                         (312) 850-7124


RE: Paramedic Program Fall 2010


Dear Prospective Student:


Thank you for your interest in the Malcolm X College Paramedic Program. Our Program offers the
student: The only Paramedic Program in Chicago; a program that meets and exceeds the National
DOT Standards; and a unique internship experience with the Chicago Fire Department.

Enclosed is the application packet for the Program starting Fall Semester 2010. The Program runs for
one year, beginning with the Fall 2010 semester and continuing through Summer semester 2011.
Classes meet on Mondays & Wednesdays from 9:30AM to 2:00PM and on Fridays from 9:30AM to
4:20PM. 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. The deadline for application return is no
later than Friday, April 23, 2010 at 4:00 p.m.

Please note: Biology 116 (College Level General Anatomy & Physiology equivalent or higher level
course such as BIO 226) is one of the Paramedic Program admission requirements.

Student selection will be based upon the following: meeting pre-requisites; completion of your
application packet; results of the Paramedic Program entrance exams; and, completion of the
Paramedic Program interview. Interviews will be scheduled between May 28th and
June 14th.

If you have any questions, please call the EMS office at 312-850-7124.


Sincerely,


Patrick M. Mroczek
Paramedic Program Didactic Coordinator
Malcolm X College                                                                         Rvsd.2009.pm
   MXC Paramedic Program - Application Information

Enclosed you will find the following documents:

A. Information documents – In addition to the application packet, you will find the following
   information:

  1. Malcolm X College (MXC) Paramedic Program - Program description and admission
     requirements.

  2. 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. The EMT-B
     Refresher Course will be (must choose all three): April 3, 2010 9:00AM to 5:00PM, April
     10, 2010 9:00AM to 5:00PM, and April 17, 2010 9:00AM to 5:00PM (Flyer enclosed).

  3. Timeline – Dates and deadlines for application process.

B. Application Forms – The following documents are to be completed and returned as per
   instructions.

   1. Malcolm X College “Student Information and Enrollment Card” - Complete and
      sign, even if you are currently a student a MXC (if you’ve accessed via email =
      additional document). Keep these documents and return on the test day.

   2. Paramedic Program Application form – Complete and sign. Applicant must attach
      clean copies of current: Illinois EMT-B license; CPR Healthcare Provider card (both
      sides): and an identifiable Drivers License or State I.D. An Application fee of $35.00
      must be submitted with application packet in the form of a Cashiers Check or Money
      Order made payable to the Malcolm X College Paramedic Program.

   3. Transcript Information
      • Official college and/or high school transcripts must be sent to Malcolm X College
         Office of the Registrar, unless you are currently enrolled as a MXC student.
         Provide an unofficial copy of all transcripts with the completed application packet.
      • Clean Copies of transcripts from previous college and high school must be included
         with application and received by the MXC EMS Department.

   4. NOTE: Biology Requirement – Provide transcripts indicating a passing grade of “C”
      or better in any of the following:
      • BIO 116 (Anatomy and Physiology equivalent or higher, such as BIO 226 & 227)

   5. Paramedic Entrance Exams – This handout provides you with information and dates
      available to take the Paramedic Entrance Exams. This is mandatory!
6. Verification of Field Experience – Return the form completed by your employer or
   preceptor validating field experience as an EMT. We strongly recommend 500 hours
   ambulance work experience by the start of the Program for the Fall of 2010.

7. 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.

8. Personal Statement Form – Please provide a personal statement expressing your
   reasons for making application to the program. No more than two pages please.

9. Checklist – Review the provided checklist to make sure your application is complete.
   Make certain you identify your reservation date for taking the Paramedic Entrance
   Exams (on your “Application Checklist”). Make certain you are at the Placement
   Testing Center, Room 1109, on the date and 15 minutes prior to the time you signed
   up for.



Completed applications are to be submitted to:


                          Malcolm X College
                    EMS Program Office - Room #2621
                       1900 W. Van Buren Street
                          Chicago, IL. 60612


The deadline for application paperwork return is:
    Friday, April 23, 2010 at 4:00 p.m.
       (Applications submitted after this deadline will NOT be considered.)
                             Malcolm X College
                                      One of the City Colleges of Chicago

                                                                   EMS Program Office, Room 2621
                                                                      1900 West Van Buren Street
                                                                          Chicago, Illinois 60612
                                                                                     312-850-7124

                                        THE PARAMEDIC PROGRAM

Malcolm X College (MXC) offers an educational program for licensed Emergency Medical Technicians looking to
expand their career as a Paramedic.

This program has been developed by the City of Chicago Emergency Medical Service System (Region XI),
which is a collaborative effort by Malcolm X College, Chicago Fire Department and the Chicago Resource
Hospitals: Advocate Illinois Masonic Medical Center, Northwestern Memorial Hospital, and the University of
Chicago Hospital and Clinics. The Paramedic Program is approved by the Illinois Department of Public Health,
Division of Emergency Medical Services and Highway Safety.

In addition to the Paramedic Core Curriculum, Malcolm X College is one of the few colleges in Illinois to offer an
Associate in Applied Science Degree (AAS) in this professional specialty. Successful completion of this
program’s core curriculum provides eligibility to take the licensing examination offered by the Illinois Department
of Public Health or the National Registry. Completion of the Associate in Applied Science Degree can broaden
the student’s marketability, as well as provide a strong basis for continued professional learning.

                                        ADMISSION REQUIREMENTS

The Paramedic Program courses run for three consecutive semesters. The Program begins in the Fall Semester
of each year. Register now. The informational / application packets are available: At the MXC EMS Program
Office Room 2621 or 2617; or Sent upon request – either by mail or email.

To be considered for admission the applicant must:

    •   Be a high school graduate or GED Certificate holder
    •   Be currently licensed by the State of Illinois as an EMT-B (Note – students enrolled in a current Spring
        Semester EMT class who have not completed state exam are not eligible to apply (unless you are from
        the MXC EMT spring class with acceptable course grade)
    •   Passing grade (“C” or better) in Biology 116 Anatomy & Physiology Course (or higher level such as
        Biology 226)
    •   Have a current CPR healthcare provider card
    •   Ambulance experience as an EMT-B (approximately 500 hours) by start of program is strongly
        recommended
    •   Achieve acceptable scores on admissions examinations
    •   Submit, by deadline, all application paperwork, with transcripts, to the Paramedic Program Director at
        Malcolm X College
    •   Applicant Interviews: Interviews with Chicago EMS Region XI Admissions Committee will be
        granted to those applicants who have met or exceeded the Malcolm X College Paramedic
        Program admission requirements and completed all required admission paperwork. Admission
        paperwork must be submitted no later than the posted due date.
    •   Selection factors: Selection of candidates for this program is highly competitive. Selection
        will be based on: Completion of all application paperwork; Interview results; Academic history/GPA;
        Admission testing results; EMS work experience; References; and Communication skills.
                                           Paramedic Core Curriculum

          The Paramedic Program runs three consecutive semesters starting in the fall of each year.
          Successful completion of the Paramedic Core Curriculum provides an Advanced Certificate in
          Paramedic level of training, and eligibility to take the licensing examination offered by the Illinois
          Department of Public Health or the National Registry.

          Fall Semester:

          EMT 221                   Essentials of Paramedic Medicine I                  9 Credit Hours
          EMT 222                   Paramedic Medicine Practicum I                      5 Credit Hours

          Spring Semester:

          EMT 223                   Essentials of Paramedic Medicine II                 9 Credit Hours
          EMT 224                   Paramedic Medicine Practicum II                     5 Credit Hours

          Summer Semester:

          EMT 227                Paramedic Field Internship                             6 Credit Hours
          Total Credit Hours in Major (Core):                                           34 Credit Hours


                                      Associate in Applied Science Degree

          Requirements for the Associate in Applied Science Degree – Paramedicine includes a minimum
          of 61 credit hours with at least 34 hours concentrated in the major (Core).

          General Education Courses:

          Course                                                                        Credit Hours
          English                       101                                             3 Credit Hours
          Biology                       120                                             3 Credit Hours
          Sociology                     201                                             3 Credit Hours
          Psychology                    201                                             3 Credit Hours
          Communications                Elective                                        3 Credit Hours
          Social Science                Electives                                       5 Credit Hours
          Humanities/Fine Arts          Elective                                        3 Credit Hours
          Physical/Life Sciences        Elective                                        4 Credit Hours___
          Total Credit Hours in General Education:                                      27 Credit Hours

          Total Credit Hours Required for AAS:                                          61 Credit Hours

                                    For more information call or write:
                                           Malcolm X College
                                           EMS Program Office, Room 2621
                                           1900 W. Van Buren Street, Chicago, IL. 60612
                                           EMS Office: 312-850-7124

                                    Paramedic Program Director
                                    Email: mxc-ems@ccc.edu                              312- 850-7303
                                    EMT-B Program Director, Tony Scipione:              312- 850-7410
                                    Email: tscipione@ccc.edu

JW.2009
        Malcolm X College - Paramedic Program

                             Frequently Asked Questions:

How many candidates typically apply for the MXC program?
We usually have at least two applicants for each class “seat”.

I know qualified candidates need to be interviewed, who are the interviewers and how to 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; 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 and work history.

Is there any advantage to taking the EMT class at Malcolm X College?
Yes. 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.”

How much ambulance ride time do I need?
The committee strongly recommends 500 hours of ambulance experience as an
EMT-Basic by the start of the program (fall semester). 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 a passing grade of “C” or higher in BIO 116, Anatomy & Physiology
(A&P), or a higher level A&P course, such as Biology 226, will be acceptable. If Biology A&P was
taken at another college (passing grade of “C” or better), you will need to request official transcripts 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 typically must achieve a score of 75% on the EMT entrance test (multiple choice) to be
eligible for interview. The applicant also must demonstrate reading and math skills at the college level.
We are offering an EMT-B Refresher Course (not mandatory) prior to Paramedic Program Entrance
Testing.

When are applications available and when are they supposed to be completed?
Applications are available upon request. They can be mailed out, picked up from the EMS Office
(Rm.2621), or emailed to you. The deadline for submitting completed applications is clearly identified
within the application packet. Completed applications are due in the EMS Office April 23, 2010.

                                                                                                    JW.2009
                            Malcolm X College
                                    One of the City Colleges of Chicago


              EMT-B REFRESHER TRAINING
This 24-hour EMT-B Refresher Class is designed to ensure individual competency for the
practicing EMT. This course will also give the EMT-B, who intends to apply to the Malcolm X
College Paramedic Program, the opportunity to sharpen their knowledge, skills and review the
major concepts and interventions as outlined in the DOT Emergency Medical Technician
Basic Curriculum.
This class is also open to the EMT-B who wishes to take the class to enrich their knowledge,
skills and receive C.M.E.
It is strongly suggested that students review their current EMT-B textbook prior to the class.
A minimum grade of 70% on the EMT-B Post Test and full attendance will ensure the
full 24 C.M.E. Hours approved by the IDPH. Hour for hour C.M.E. will be awarded for time
attended. This EMT-B Refresher Course is intended for the licensed EMT-B only.


EMT-B Refresher Class Logistics:
Dates:        Saturday, Apri 3, 2010
              Saturday, April 10, 2010 and
              Saturday, April 17, 2010
Time:         9:00 AM to 5:00PM (All three days) - You will be given breaks during class.
              Lunch is at your own expense.
Location:     Malcolm X College
              1900 West Van Buren Street
              Chicago, Illinois 60612
              Room # 2619
Tuition:      $90.00
Note:         Bring your EMT-B Textbook to class


Registration:
To register for the class, report to Malcolm X College, Room 1600 Prior to February 26,
2010. Bring a state ID Card or Illinois Driver License or Birth Certificate and proof of your
current address.
Complete the Continuing Education Registration Form given to you from Student Services
(Room 1600). Inform Student Services that you wish to register for the EMT-B Refresher
Training Class. Take your Registration Card and Tuition Fee then report to the Business
Office, Room 1440. Your Registration Card and Tuition Fee will be collected at this time.
        Paramedic Application Timeline – 2010


Open House Dates:        The Paramedic Program will host an Open
                         House for prospective students to pick up
February 18, 2010        an application (or requested/received
                         sooner), meet with instructors and answer
1:00pm – 5:00pm          any questions regarding the program.
Room 2616

Available Upon Request   Application packets available from MXC
                         EMS Department. Also, available upon
                         request.
Friday, April 23, 2010   Deadline for completed applications to be
No later than 4:00PM     submitted

Monday, April 19th to    Entrance exams administered through
Saturday, May 8th        testing center (dates available for testing
                         listed on information sheet)

May 7th through          Letters sent out with results of entrance
May 21st                 exams and interview dates.

May 28th through         Interviews
June 14th

Monday, June 21st        Acceptance letters sent out


Friday, July 16th        Student confirmations/responses due


Friday, August 20th      Paramedic Program Orientation
Monday, August 23rd      First Day of Class
                                    Malcolm X College
                                        EMS Program Office, Room 2621
                                          1900 W. Van Buren Street
                                             Chicago, IL. 60612
                                               (312) 850-7124

Paramedic Program Application:
•      All applicants must fill out both the Paramedic Program Application as well as the Malcolm X College
       Application form.
•      The applicant must arrange to have all Official Transcripts sent to MXC Office of the Registrar, and copies of
       transcripts, turned in as part of the completed application packet, to the EMS Program Office.
•      Application fee of $35.00. Cashiers 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-April 23, 2010 no later than 4:00PM.

Please Print or Type
Social Security Number                                Date of Application            Anticipated Start Date
                                                                                     Mo.            Year
Last Name                                              First Name                    Middle Name

Address                                                                               Email Address


City                        State                      Zip code                  County


Home Phone                                             Business Phone                       Cell. Phone
(       )                                              (      )                             (   )
Emergency Contact: Name, Relationship and Phone #




List high school and all colleges or universities attended including any of the City Colleges of
Chicago. If never attended any other college, write “none”.
    High School                        City                State   Dates (from/to)     Degree Earned



EMT Program Attended                   City                State   Dates (from/to)     Degree Earned



College/University                     City                State   Dates (from/to)     Degree Earned
Health Care Work Experience:
List all health care work experiences, both paid and volunteer, beginning with your present
position (You may use a continuation sheet if you need additional space).
Employer or Dept. Volunteer                                                   Supervisor

Address                                                                       Phone

From                        To                     Volunteer                 Paid

Duties




Reason for leaving




Employer or Dept. Volunteer                                                   Supervisor

Address                                                                       Phone

From                        To                     Volunteer                 Paid

Duties




Reason for Leaving




Work Experience (Non-health care related):
           Employer                           Position                   Dates of Employment




Licenses / Certifications – Include photocopy of each. Use continuation sheet if necessary:
                     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     No



Signature___________________________________                                Date_________________
                                      Malcolm X College
                                One of the City Colleges of Chicago

               REQUEST FOR COLLEGE/UNIVERSITY TRANSCRIPT

INSTRUCTION TO APPLICANT:
Please mail your REQUEST FOR TRANSCRIPT OF RECORDS form to your College/University.

RECORDS OFFICE                                              Date of Request:


                                             Name of School


                                                Address


City                                            State                             Zip

       ( )     Fall/Year               ( )    Spring/Year          ( )     Summer/Year

I have applied for admission to Malcolm X College and request that you send an official copy of
my academic records to:
                                       MALCOLM X COLLEGE
                                  Office of the Registrar, Room 1325
                                     1900 West Van Buren Street
                                        Chicago, Illinois 60623

If there is a transcript fee, please contact me and not Malcolm X College. The following information is
provided to assist you in identifying my record. My name and other name(s) used when I attended
your institution:


Last                          First                 M              Other Name(s) Used

Birthdate:                             Social Security Number:

Student ID or PeopleSoft Number (If applicable):

Dates of Attendance:                                        to
                                       Month/Year                          Month/Year
Signature:

Address:


City                                             State                           Zip

(Area Code) Telephone Number                                (E-Mail Address)
      Malcolm X College – Paramedic Program
                                   Paramedic Entrance Exams
  Each applicant is required to take the following admission exams:

  • Paramedic Entrance Exam (required by all applicants)

  • COMPASS Reading Exam (with acceptable score within past year) -or- Official college transcript
     indicating successful completion of ENG 101 with a grade of “C” or better

  • COMPASS Mathematics Exam (with acceptable score within past year) -or- Official college
     transcript indicating successful completion of Math 118 (General Education Mathematics) with a
    grade of “C” or better

  Each applicant is required to provide evidence of academic proficiency at EMT–B, English and Math
  levels. All applicants are required to take the EMT-B entrance exam. Applicants who have
  successfully completed ENG 101 and/or Math 118 are required to submit your official college
  transcript as evidence of proficiency (must be sealed and sent to the Office of the Registrar – Copy of
  transcripts must be included in the application packet). The Paramedic Entrance Examinations will be
  offered at the MXC Placement Testing Center Room 1109 on the following dates and times:

TEST DATE                  TEST TIME       TEST DATE                    TEST TIME
Monday through Wednesday,                  Monday through Wednesday,
                          10:00 AM                                   10:00 AM
April 19, 20, and 21                       April 26, 27, and 28
Thursday, April 22        5:00 PM          Thursday, April 29        5:00 PM
Saturday, April 24          9:30 AM        Saturday, May 1               9:30 AM
                                            Saturday, May 8              9:30 AM

     Identify the date and time of your exam reservation on the application checklist.
  _______________________________________________________
  Taking the Entrance Exam:

      •   Report to Room 1502 with completed green Student Information and Enrollment cards:
          30 minutes prior to taking the exam(s) in order to apply; when completed, then go to
          Room 1109 the Placement Testing Center. Please be prompt. No one will be allowed
          into the testing area once the test begins.
      •   You must present an official photo ID to the testing center prior to taking the exam.
      •   Testing is completed on individual computer terminals.
      •   Test results will be sent out by the EMS Department. Do not request test results from the
          Placement Testing Center.

  Note: Students who have taken the COMPASS exams during the past year must request a copy of the
  results from Placement Testing Center.
  Revsd/2009.pm
 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.2009.jw
             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 _________________________________________________________________
                                                                                              2009.jw
               Malcolm X College - Paramedic Program
                                  Personal Statement
Name:                                                                Date:

   Candidates must submit a statement no greater than two single side pages in length,
   describing your career goals and objectives of pursuing paramedicine as your career.




Rvsd.2008.jw                                          Use the back of this page for additional documentation.
                    Malcolm X College - Paramedic Program
                             Application Checklist
   Make sure you have included all of the following, and include this checklist:

Malcolm X College “Student Information and Enrollment Card” - Completed and signed. Do NOT return
these. You will need these completed forms to apply in the New Student Center on the day of
your test!

Paramedic Program Application – Completed and signed

Application fee of $35.00 in the form of cashiers check or money order made payable to:
Malcolm X College Paramedic Program

Official transcripts from previous college or high school sent directly to Malcolm X College, Office of the
Registrar.

Copies of all transcripts must be included in application packet and submitted to our EMS office.
Transcripts must include successful completion of BIO 116 Anatomy and Physiology, or higher
level such as BIO 226.

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

This completed Paramedic Program Application Checklist

Testing Requirements – I will be taking the entrance exams on - identify the exams you will be taking by
placing a check next to the exam. Any/all exams you will be taking will be taken on the same date/time.:

Paramedic Entrance Exam        X    COMPASS Reading                 COMPASS Mathematics

Sign: ______________________Print Name:                               Test Date Chosen:


Enclose a current clean copy of your: IDPH EMT-B License; CPR Healthcare Provider
Card; and Drivers License or State ID –

                 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
         Deadline for all application paperwork submission:
    Friday, April 23, 2010. No later than 4:00p.m. No exceptions.
                                                       Application packet.2009.jw



                                       Malcolm X College
                                      Paramedic Program Cost
                                                            List Date: 4-2009

  All costs are approximate and are subject to change. Refer to the current Malcolm X College “Student Schedule of Classes” for details.
                                                     Chicago resident cost applies.


Fall Semester (EMT 221 & EMT 222):
Tuition ($79.00 / credit hour x 14 credit hours)                       1106.00
Registration Fee                                                          25.00
Other Fees – Activity Fee (Full time – 12 or more hours; includes
U-Pass. Parking, Technology and other student activities)                150.00
Lab Fee:                                                                  30.00
Clinical Fee:                                                             10.00
Book cost (cost is approximate)                                          200.00
Cost of course & credentialing in: ACLS, PEPP, ITLS & State Exam Fee 117.00
Background check (cost is approximate)                                    50.00
Physical exam & blood work                                      Cost variable per student
Fall Semester Total Cost                                                 1688.00

Spring Semester (EMT 223 & EMT 224):
Tuition ($79.00 / credit hour x 14 credit hours)                                        1106.00
Registration Fee                                                                          25.00
Other Fees – Activity Fee (Full time – 12 or more hours; includes
U-Pass. Parking, Technology and other student activities)                                150.00
Lab Fee:                                                                                  30.00
Clinical Fee:                                                                             10.00
Spring Semester Total Cost                                                              1321.00

Summer Semester (EMT 227):
Tuition ($79.00 / credit hour x 6 credit hours)                          474.00
Registration Fee                                                          25.00
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:                                             1079.00

Graduation Application Fee                                                                 20.00
***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:                        180.15
Non-residents of Illinois per credit hour cost:                                              301.55
                                                                                                      JW.4-2009

								
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