Physical Therapist Assistant Program Application

Admission to the program is competitive; application to the program does not constitute admission

Personal Information

County of Residence

*Program contact is made through email. Please ensure you accept emails from and that you check your emails regularly.

List all colleges and universities attended, including KCKCC, beginning with most recent. Please request each college forward two (2) official transcripts, one to the college registrar and one to the PTA program. Your application is not complete until transcripts are received. Transcripts from KCKCC will be requested by the PTA Program Coordinator.

Colleges Attended

Degrees Earned:
Check all that Apply

Course Requirements

**These courses must be completed prior to admission into the PTA program

HUDV 100/01 Strategies/Orientation**

*waived for those with > 30hr transferring in to KCKCC.

BIOL 0143 - Anatomy and Physiology**

PSYC 0101 - Introduction to Psychology**

MATH 0104 - Intermediate Algebra**

ENGL 0101 - Composition 1**

ENGL 0102 - Composition 2

SPCH 0151/53 - Public Speaking / Interpersonal Communications

PSYC 0101/03 - Child or Human Development

Humanities Elective

Please complete the following information about the for hours observation you completed. Additionally, please submit a reflection paper outlining how your observation experience confirmed your desire to enter the field of physical therapy and what skills you possess that would be of benefit to a physical therapy department.

If you have a documented disability that requires accommodations for the interview assessment, you must contact the Academic Resource Center at 913-288-7670. It is recommended that this process be started 6 weeks prior to the application deadline.

Have you received the PTA Program Information brochure?

Please notify the Program Coordinator of any change of address, phone, or email.

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7250 State Avenue | Kansas City, KS 66112 | 913-334-1100
An Equal Opportunity Educational Institution
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