Paramedic Application

Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
BTECH Student ID
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name

First NameLast Name
Emergency Contact Email
example@example.com
Emergency Contact Phone Number
Please enter a valid phone number.
UPLOAD ACADEMIC ASSESSMENT
Submit your Assessment & Learning Center score sheet, which was provided to you upon completing your Academic Assessment. If you have already taken the Academic Assessment and need a copy of your score sheet, please email testing@btech.edu to request a copy and upload it to this application BEFORE the deadline. (If you need to take the Academic Assessment, you can email or go to btech.edu/assessment to schedule it.)
Upload Assessment & Learning Center score sheet

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The "Submit" button, located on the last page of this application (checklist page), will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

Paramedic Application
Upload EMS certification cards received through the National Registry

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Paramedic Application

Courses from other institutions may meet BTECH course competencies. Official transcripts and course descriptions will need to be provided and will be considered on a case-by-case basis.
Upload EMS certification cards received through the National Registry
Complete Emergency Medical Technician program or Advanced Emergency Medical Technician program(verified with a copy if EMS certification through National Registry). You must have a current certification to be awarded points. Please upload your upload Utah Bureau of EMS License.
Upload Utah Bureau of EMS License

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Upload Current AHA BLS CPR Card

Hold a current AHA BLS CPR certification card
Upload AHA BLS CPR verification (Front and Back)

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Immunization Verification

Some clinical locations require students to adhere to federally recommended standard precautions to protect themselves and to prevent the spread of disease in clinical areas. To view Immunization requirements please visit https://btech.edu/wp-content/uploads/Paramedic-IMMUNIZATIONS-for-Web-Page-1-1.pdf
Upload Immunization Verification

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Tuberculosis Test (TB Test)

The TB test is performed by your Doctor or local Health Department. It is a two-phase injection to evaluate exposure to Tuberculosis. It must be current within 12 months.
Upload Tuberculosis Test

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The "Submit" button, located on the last page of this application (checklist page), will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

Prerequisite Course Uploads

All pre-requite courses must be completed with a C or higher grade. Courses from other institutions may meet BTECH course competencies. Official transcripts and course descriptions will need to be provided and will be considered on a case-by-case basis. BTECH will not accept high school transcripts for college credit. If you take your prerequisite courses at BTECH, you may request a BTECH transcript. If you attended an out of state school, please do the following: find the schools accreditation status on its website and print. Go to the accrediting body's website and print out the page that says the school is regionally accredited. Provide a course description for each course so it can be determined if transfer credit can be given. Include these documents in your upload.

Unofficial Grade Worksheet: Please be aware that all grades will be verified using official transcripts. Collegiate-level course work taken at other colleges will be considered competency on a case-by-case basis. You will be notified if the course you took at another college does not meet our prerequisite competencies. BTECH will not accept high school transcripts for college credit.

	School	Year	Semester	Grade
Medical Terminology
Drugs Dosages and Calculations or Math
Anatomy and Physiology (A & P)
Or
Anatomy
Physiology

Upload official Medical Terminology Transcript OR other approved documents

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Official Transcript for Drug Dosages and Calculations, Math for PS, OR other Approved Documents

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Upload official Transcript for Anatomy and Physiology

*A combined A&P course is all that is required as a prerequisite. However, stand-alone Anatomy and Physiology courses could also demonstrate competency.
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The "Submit" button, located on the last page of this application (checklist page), will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

Emergency Medical Services Work or Volunteer Experience

List most recent work or volunteer experience first. If none, indicate by N/A.
Agency 1
Phone
Position
Supervisor Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment or Volunteer (From)

MonthDayYear
Date
Dates of Employment or Volunteer (To)

MonthDayYear
Date
Hours

Full-Time (32+ hrs/wk)Part-time (2-31 hrs/wk)
Agency 2
Phone
Position
Supervisor
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment or Volunteer (From)

MonthDayYear
Date
Dates of Employment or Volunteer (To)

MonthDayYear
Date
Hours

Full-Time (32+ hrs/wk)Part-time (2-31 hrs/wk)
Agency 3
Phone
Position
Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dates of Employment or Volunteer (From)

MonthDayYear
Date
Dates of Employment or Volunteer (To)

MonthDayYear
Date
Hours

Full-Time (32+ hrs/wk)Part-time (2-31 hrs/wk)
The "Submit" button, located on the last page of this application (checklist page), will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

References

List the names of the three professional people who will be completing your reference evaluation forms. If employed with an agency, two forms must be completed by a paramedic or your direct supervisor. Other potential references include people who are now or who have been your employer, supervisor, former instructor, or community leader. They must have known you for at least six months and cannot be related to you. You must have three reference forms returned in order to potentially receive the maximum three points. Two reference forms are required for application consideration but will not qualify for all three points. Please make sure to inform references that they will be contacted by a representative at Bridgerland Technical College via email or text. Reference evaluations must be submitted no later than SEVEN DAYS after cohort application deadline.
Reference 1

First NameLast Name
Company/Institution
Position
Phone Number
Please enter a valid phone number.
Email
example@example.com
Reference 2

First NameLast Name
Company/Institution
Position
Phone Number
Please enter a valid phone number.
Email
example@example.com
Reference 3

First NameLast Name
Company/Institution
Position
Phone Number
Please enter a valid phone number.
Email
example@example.com
The "Submit" button, located on the last page of this application (checklist page), will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

Professional Goal Statement

Please address your career goals, why becoming a paramedic is important to you, your beliefs that will contribute to the profession, and any other pertinent information. Scoring is based on the following criteria: The statement will be graded on spelling, punctuation, grammar, and sentence structure.
The statement must be a minimum of 150 words and a maximum of 200 words.

0/200
The "Submit" button, located on the last page of this application (checklist page), will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU

Checklist

Complete the following checklist below before submitting your application. It is your responsibility to ensure that all items are completed. Please note that any missing information will render your file incomplete, and you will not be considered a possible candidate for this program.
Complete the checklist

I have completed the Bridgerland Technical College Certificate Seeking application. If not, follow the link here.I have completed the Assessment and have uploaded a copy of the Assessment and Learning Center score sheetI have completed the competitive application for Paramedic, the Reference Evaluation form, and the Professional Goal StatementI have included a copy of my current EMT certification that is valid through the entirety of the Paramedic program.I have submitted an official transcript for all pre-req coures with a grade of C or higher. BTECH will not accept high school transcripts for college credit. Pre-requisite transcripts must be from college/university where I originally completed the course. (Request an official Bridgerland transcript by visiting our website here.)I understand that providing false or misinformation regarding the grades I received in any of the prerequisite courses may render my application incomplete.I understand that after acceptance into the program, I will be required to submit to a national criminal background check, drug screen, and sex offender check.I have all my immunizations current and up to date according to CDC guidelines.I understand that applications are due July 1st.
If you have questions concerning the application process, please contact a Student Success Advisor at 435-753-6780 or email advising@btech.edu.

After the application deadline has passed, an independent scoring committee will score applications using an objective rubric. All applicants will be notified about possible acceptance into the program.

If you have questions about whether your transcripts will transfer, please contact Jaime Tanner, Administrative Assistant for Public Services, at jtanner@btech.edu
To complete the signing process, please type your full name in the signature box and click 'submit'.
The "Submit" button will save your application and send you a link allowing you to edit and update your application until all parts of the application are complete.

IF YOU DO NOT GET A LINK TO EDIT YOUR APPLICATION, EMAIL ADVISING@BTECH.EDU
Should be Empty:

UPLOAD ACADEMIC ASSESSMENT

Paramedic Application

Paramedic Application

Upload EMS certification cards received through the National Registry

Upload Current AHA BLS CPR Card

Immunization Verification

Tuberculosis Test (TB Test)

Prerequisite Course Uploads

Emergency Medical Services Work or Volunteer Experience

References

Professional Goal Statement

Checklist