PTA Program Form

  • I. Personal Information

  • II. Education

  • List All Colleges Attended:
  • III. Volunteer Experience

  • IV. References - Instructor, PT or PTA, and Employer

  • V. Employer - List all employment for the last three years.

  • VI. Essay: Please submit an essay of 500 words using one of the following questions:

    1. Some students have a background, identify interest, or talent that is so meaningful that they believe their application would be incomplete without sharing it. If this sounds like you, please share your story.
    2. Describe a time when you were confronted with obstacles, challenges or a setback. How did it affect you, and what did you learn from the experience?
    3. Describe an experience in your life that involved problem solving with a group or an individual whose culture or background was different from your own. How did this affect you and what did you learn from the experience? What was the outcome?
    If your application is incomplete and/or if false information is provided, your application will NOT be considered.

    I understand that I am responsible for ensuring that all application material is accurate and received by the deadline. Completion and submission of this application is a component of the student profile, and does not in itself grant admission to the PTA Program. I also understand that providing false information may be deemed sufficient reason to dismiss the student and/or refuse admission.

    It is the official policy of Bishop State Community College that no person shall, on the basis of race, color, disability, sex, religion, creed, national origin, or age, be excluded from participation, be denied the benefits of, or be subjected to discrimination under any program, activity, or employment.