PTHA 1409 Intro to PT-Petition Form Summer 2015
Read the following carefully:

PTHA 1409 Introduction to Physical Therapy is a prerequisite course for admission into the PTA Program. Due to a limited number of seats, a petition is required to register for this course.

Final rankings occur the week prior to registration. Students granted a seat in the course will receive an email from the administrative assistant for the PTA Program with instructions for registering. Please be aware that seats are not guaranteed if you receive a petition. You must register AND pay (or set up payment) by the deadline dates provided in the email. Failure to do either will forfeit your seat and the next person will be offered the petition.
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What is your first name? *
What is your last name? *
What is your ACC student ID number? *
Include the letter with the number. Ex: j0123456
What is your ACC email address? *
An ACC email is preferred, but a personal account is acceptable if you do not have an ACC email. Please check this account regularly.
What phone number can we use to contact you? *
Please include the area code and use this format: 512-555-5555. This would only be used to contact you with time sensitive matters such as an unexpected opening, last minute drop, etc. Please double-check to make sure the phone number is correct.
Prerequisite Information
Read the following carefully:

Selection for PTHA 1409 is based on two factors: 1) students who have completed more prerequisites for the PTA program will have higher priority for a seat in PTHA 1409, and 2) after students have been ranked according to prerequisite completion status, any ties will be resolved based on the time and date the petition was received. If you completed prerequisites outside of ACC, you must provide ACC the transcripts for verification.

In the following section, please provide the prerequisite(s) completed, the grade in the course, the semester/year, and the school in which it was taken. The Health Sciences office will have to verify all your information, so please be honest and accurate. If you have not sent in your transcripts to ACC, make sure the PTA Program administrative assistant receives a copy of your transcripts. We cannot verify grades without transcripts. (Grades are for verification only. Your grade does not count against you for petitioning to get into PTHA 1409 Intro to PT.)
Prerequisite 1: English Comp 1
Use the following key: 0= not taken, 1=F, 2=D, 3=C, 4=B, 5=A, 6=CLEP/Credit, 7=In progress
Clear selection
Prerequisite 1: English Comp 1
In what semester, year, and school was it completed? Ex: Fall 2010 Univ of Texas at Austin or n/a
Prerequisite 2: College Level Math
Use the following key: 0= not taken, 1=F, 2=D, 3=C, 4=B, 5=A, 6=CLEP/Credit, 7=In progress
Clear selection
Prerequisite 2: College Level Math
In what semester, year, and school was it completed? Ex: Fall 2010 Univ of Texas at Austin or n/a
Prerequisite 3: Intro to Psychology
Use the following key: 0= not taken, 1=F, 2=D, 3=C, 4=B, 5=A, 6=CLEP/Credit, 7=In progress
Clear selection
Prerequisite 3: Intro to Psychology
In what semester, year, and school was it completed? Ex: Fall 2010 Univ of Texas at Austin or n/a
Prerequisite 4: Medical Terminology
Use the following key: 0= not taken, 1=F, 2=D, 3=C, 4=B, 5=A, 6=CLEP/Credit, 7=In progress
Clear selection
Prerequisite 4: Medical Terminology
In what semester, year, and school was it completed? Ex: Fall 2010 Univ of Texas at Austin or n/a
Anatomy and Physiology Prerequisite Requirement
There are various ways to complete this prerequisite. Please note that for any class to transfer for this requirement, it must be a course taken through a Biology Department (no Kinesiology or Exercise Science courses are eligible for transfer). Please look at each option to determine how or if you have fulfilled this requirement.
Prerequisite 5 (option 1): BIOL 2404 Intro to Anatomy and Physiology
Use the following key: 0= not taken, 1=F, 2=D, 3=C, 4=B, 5=A, 6=CLEP/Credit, 7=In progress
Clear selection
Prerequisite 5 (option 1): BIOL 2404 Intro to Anatomy and Physiology
In what semester, year, and school was it completed? Ex: Fall 2010 Univ of Texas at Austin or n/a
Prerequisite 5 (option 2): BIOL 2304 Human Anatomy (with associated lab)
Use the following key: 0= not taken, 1=F, 2=D, 3=C, 4=B, 5=A, 6=CLEP/Credit, 7=In progress
Clear selection
Prerequisite 5 (option 2): BIOL 2304 Human Anatomy (with associated lab)
In what semester, year, and school was it completed? Ex: Fall 2010 Univ of Texas at Austin or n/a
Prerequisite 5 (option 3): A&P 1 AND A&P 2 from another school or Human Anatomy from another school are acceptable
Use the following key: 0= not taken, 1=F, 2=D, 3=C, 4=B, 5=A, 6=CLEP/Credit, 7=In progress (for A&P1 and 2, just provide the grade for one of the courses)
Clear selection
Prerequisite 5 (option 3): A&P 1 AND A&P 2 from another school or Human Anatomy from another school are acceptable
In what semester, year, and school was it completed? Ex: Fall 2010 Univ of Texas at Austin or n/a
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