DPT ATLANTA Supplemental Application

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DPT ATLANTA Supplemental Application

South College - Atlanta Campus
School of Physical Therapy
ATTN: DPT ADMISSIONS
2600 Century Pkwy NE
Atlanta, GA 30345

DEMOGRAPHIC INFORMATION

Name:

Title:

First:

Last:

Middle:

Under what other name(s) might documents be received?

Telephone number at which you can be reached between 8:00am and 6:00pm ET:

What City and State do you currently live in?

State:

Date of Birth:*

Do you consider yourself to be of Hispanic/Latino origin?*

Yes

Please select the racial and/or ethnic category with which you most closely identify.

American Indian or Alaska Native

Asian

Black or African-American

Native Hawaiian or Other Pacific Islander

White or Caucasian

Self Describe (Please use box below)

From among the following, please select the type of geographical area where you were raised:

Urban (>1,000,000 population)

Large city (100,000 to 1,000,000 population)

Mid-size city (50,000 to 99,999 population)

Large town (10,000 to 49,999 population)

Small town (2,500 to 9,999 population)

Isolated rural (<2,500 population)

From among the following statements, please select all that apply to you.

I graduated from a high school from which a low percentage of seniors receive a high school diploma.

I participated in an academic enrichment program funded in whole or in part by the Health Careers Opportunity Program, TRiO, or Upward Bound.

I am the first generation in my family to attend college (neither my mother nor my father attended college).

I applied or plan to apply for the PTCAS application fee waiver or assistance program.

I am fluent in 2 or more languages.

English is not my primary language.

I am/will be a graduate of a minority-serving institution or HBCU.

None of these apply

PROGRAM APPLICATION

How did you first learn about the South College DPT Program? Select one*

PTCAS

APTA Website

South College Website

Internet Search

South College DPT Alumni (Please use text box to add name and/or give us more detail)

Current South College DPT Student (Please use text box to add name and/or give us more detail)

Physical Therapist in your Community (Please use text box to add name and/or give us more detail)

Social Media

Other (Please use box below)

Did you review South College DPT social media accounts (Instagram, Facebook, LinkedIn) to gain more information on our program before applying?*

Yes, I have followed one or more of these accounts.

Yes, but only minimally

I did not access these accounts

At South College, we make every effort to meet students where they are and help them reach their goals. The following is a list of ways we intend to support student success.

Please let us know which of these you value the most through a rank order (1 being the most important and 9 being the least important). Please type the number associated with the importance level in the box beside each item on the list.*

Allow students to live in any geographical location via a hybrid model of education

Accelerate the time to degree (2 years to complete vs 2.5 or 3)

Foster student collaboration and team building while minimizing competition

Build a sense of community and connection between faculty and students

Provide acknowledgement and understanding of major life events

Encourage health and wellness

Promote equity, justice, and a sense of belonging

Celebrate the diversity of our program and the future patients we will serve

Communicate clearly and set clear expectations

Have you previously applied for admission to the South College DPT program?*

Yes

Which South College campus have you applied, to or intend to apply to, for admission to the DPT program? (Select all that apply)*

Atlanta

Knoxville

Nashville

Why did you choose the campus(es) from above?

If the campus of choice has reached capacity, are you open to attending a different South College DPT program location?*

The South College School of Physical Therapy has three locations with varying cohort start dates.

Atlanta (June)
Knoxville (June and January)
Nashville (September)

Yes

Maybe

Are you currently employed by Confluent Health?*

Yes

Unsure

HYBRID ACCELERATED MODEL OF EDUCATION

The South College DPT program was the first DPT Program in the nation to offer a hybrid accelerated education model. Our program was delivering hybrid education well before the Covid-19 pandemic. We were designed to be a hybrid program and we have done hybrid education very well since 2015.

What has been your experience with hybrid education?

I have not taken any online/virtual courses

I have only taken online/virtual courses during the COVID shut down

I have taken 1-2 online/virtual courses that were designed to be delivered online

I have taken 3 or more online/virtual courses that were designed to be delivered online

My entire undergraduate experience was made up of online/virtual courses

If so, how do you rate the quality of your experience with online/virtual course design?*

Excellent

Good

Neutral

APPLICANT SELF-ASSESSMENT OF READINESS FOR BLENDED LEARNING

The curriculum of the South College Doctor of Physical Therapy Program uses a blended learning model with delivery of the curriculum through a combination of online, onsite, and clinical learning environments. A number of personal qualities and life factors have been recognized as being relevant to the success of students participating in our accelerated DPT program. Please order each of the following attributes or skills in order of highest personal strength to relatively lowest personal strength. You will place a # between 1 and 8 to order with 1 being your strongest characteristic.

**NOTE: We recognize you may be strong in all of these attributes but we want you to place in order with strongest as #1. Please answer these questions honestly and only use each number once. Self-reflection is a critical behavior in clinical practice.

Time Management

Financial Resources

Self-Starter (motivated)

Creativity

Communication

Reading Comprehension

Writing Abilities

Determination

If accepted to this DPT program, realistically, how many hours per week do you have available to study?

1-10 hours

11-15 hours

16-20 hours

21-25 hours

26-30 hours

>30 hours

Please share any additional information about yourself or your journey that you would like us to know about you. This could be anything
that might help us support you throughout the program.

DISCLOSURE AND RELEASE STATEMENTS

CAPTE Accreditation Status Disclosure:

Effective April 25, 2023, South College Atlanta has been granted Candidate for Accreditation by the Comission on Accreditation in Physical Therapy Education (CAPTE), 3030 Potomac Ave., Suite 100, Alexandria, Virginia 22305-3085; phone 703-706-3245; email: accreditation@apta.org. If needing to contact the program/institution directly, please call 470-322-2807 or email codeh@south.edu. Candidate for Accreditation is an accreditation status of affiliation with the Commission on Accreditation in Physical Therapy Education that indicates the program may matriculate students in technial/professional courses. Achievement of Candidate for Accreditation status does not assure the program will be granted Initial Accreditation.

I acknowledge that I have read and understand this statement regarding the program's Accreditation status.

Yes

Please contact Lauren Johnson-Williams at lwilliams6@south.edu if you have questions or concerns regarding program accreditation status.

Blended Learning Acknowledgement:

The South College DPT Program is a blended learning program. As such, the DPT Curriculum is delivered using a combination of online distanced-based, on-site lab intensive, and clinical education course components.

This means that applicants should be technically proficient in basic internet use, have access to reliable internet, as well as able to travel to the on-site lab intensive sessions and clinical education experiences.

By checking the box below, I acknoledge that I have read this statement, understand its implications, and agree to the aforementioned conditions.

Yes

FERPA Release

South College provides for the confidentiality of student records in accordance with the Family Educational Rights and Privacy Act (FERPA), as amended. I understand that in order to consider my application to any other campus DPT program, the Office of Admissions will release my student records as necessary to members of the DPT Admissions Committee, employees of South College and others who have a need to access my student records in order to process my application for admission.

Yes

Clothing Size

Please let us know your size for ordering t-shirts should you be offered a seat and pay your seat deposit. Letting us know will ensure quicker delivery.

T shirt Size:

As acceptance of this registration, please type your full name below.

By entering your name, the last four digits of your social security number, and submitting the document, you electronically agree and confirm your understanding of the items, as outlined, in the above document as well as authorize the payment of the Supplemental Application fee to South College.

Supplemental Payment ($60.00):

Full Name:

Last four of social:

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