Diagnostic Medical Sonography Early Decision Application

Diagnostic Medical Sonography Early Decision Application
Program Information

Associate of Applied Science in Diagnostic Medical Sonography
Early Decision
Deadline to submit all application information: December 1

Introduction

As part of consideration for admission to the Diagnostic Medical Sonography program at BGSU Firelands, applicants must also apply and be accepted to BGSU Firelands.
Section 1: General Information
Date

MonthDayYear
Date
Name

First NameLast NameMaiden
Date of Birth

MonthDayYear
Date
BGSU ID Number
ID Number Field MUST remain hidden at all times.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
BGSU emailed preferred or other
Note: It is the applicant’s responsibility to keep the program updated on any changes to contact information.

Section 2: Academic Background
High School Status
Are you currently in high school?
Graduation Date

MonthDayYear
Date
Cumulative GPA
3.5 or higher to apply
College Coursework
Have you taken any college courses?
For each institution: College/University Name, Dates Attended (Repeat as needed)

Section 3: Prerequisite Coursework
High School Students Only

ACT Score
Accumulative ACT score
High School Coursework
For each: Course Name, High School Where Taken, Grade, Date, In Progress? (Yes/No)
Math Courses Taken in High School
List Math Courses
Science Courses Taken in High School
List Science Courses
College Credit Prerequisite College Coursework

Prerequisite College Coursework
For each: List college Course Name, college Where Taken, Grade, Date / Semester / year completed or, In Progress.
Required Courses
- GSW 1120 – Varieties of Writing
- Math 1150, 1120, 1200, or STAT 2000
- Physics 1010 and Physics 2010
- Anatomy & Physiology BIOL 3310 and BIOL 3320 or AHTH 1310
- Medical Terminology
Note: BIOL 3310 and 3320 preferred.
List Required Prerequisite Courses

Section 4: Supporting Courses (Optional Before Program Begins)
For each: Course Name, College/University Where Taken, Grade, Credit Hours, Date, In Progress? (Yes/No)
Supporting Courses
- Communications
- Psychology
- Cross-Section Anatomy
- One BGP course
List Supporting Courses

Section 5: Essay Submission
Essay Prompt

Why did you choose Sonography as a career, and how do you feel you are prepared to enter the DMS program?

Requirements
- 300 words or more
- 1–2 pages
- Typed
- Double-spaced
Essay Upload

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Section 6: References
Please give the emails of two professional references (a current employer or recent college instructor / teacher of your choice that is not related to you). Please note that by sharing their email, you are giving this person permission to complete an evaluation of you. This reference will become part of your program application and will remain confidential. Two references are required.
Email of Reference #1
example@example.com
Email of Reference #2
example@example.com

Section 7: Observation Requirement
Observation Form
Have you completed the 4–8 hour observation requirement?
Include completed observation form.

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Note: If you have not yet finished the observation requirement, please email the completed form to ___@bgsu.edu as soon as you complete it.

Section 8: Program Information Meeting
Did you attend the sonography program information meeting?

Section 9: Criminal Background Information
Have you ever been convicted of a misdemeanor or felony?
Explanation
Ohio Residency
Have you been a resident of Ohio for the past 5 years?
If no, list previous addresses from past 7 years:
Address 1
Address 2
Address 3

Section 10: Applicant Agreement
Agreement Statement

A signature authorizes BGSU Firelands to verify all provided information, conduct criminal background checks, review references, and confirm health requirements including:
- Drug screening
- Fingerprinting
- Health examination requirements
Certification

Applicant certifies:
- Information is complete and true
- No disqualifying criminal convictions
- Understands admission is not guaranteed
Signature Fields
Signature
Date

MonthDayYear
Date

Section 11: Reference Form
Applicant Information
Applicant Name

First NameLast Name
Applicant Signature
Reference Information
Reference Signature
Printed Name

First NameLast Name
How long have you known the applicant?
In what capacity?
Additional comments
Overall Recommendation
Overall Recommendation
Rating Scale (4 = Superior, 0 = Unacceptable)

Rate applicant in:
Attitude
Communication
Concern for Others
Cooperation
Judgment
Motivation
Personality
Responsibility
Reliability
Self-Confidence

Section 12: Pre-Admission Disclosure Form
Applicant acknowledges awareness of:
- Flu vaccine requirement
- Health requirements
- Background check
- Drug screening
- Tobacco policies
- Body piercing/body art restrictions
- Non-traditional clinical rotations
- Elevated grading scale
Printed Name
Applicant Printed Name

First NameLast Name

Section 13: Application Checklist
Applicant confirms:
- Accepted to BGSU Firelands
- Program application complete
- All transcripts submitted
- Observation form submitted
- Essay submitted
- Information meeting attended
- Two references submitted
Should be Empty:

Diagnostic Medical Sonography Early Decision Application

Program Information

Introduction

Section 1: General Information

Section 2: Academic Background

High School Status

College Coursework

Section 3: Prerequisite Coursework

High School Students Only

ACT Score

High School Coursework

Math Courses Taken in High School

Science Courses Taken in High School

College Credit Prerequisite College Coursework

Prerequisite College Coursework

Required Courses

Section 4: Supporting Courses (Optional Before Program Begins)

Supporting Courses

Section 5: Essay Submission

Essay Prompt

Requirements

Section 6: References

Section 7: Observation Requirement

Section 8: Program Information Meeting

Section 9: Criminal Background Information

Ohio Residency

Section 10: Applicant Agreement

Agreement Statement

Certification

Signature Fields

Section 11: Reference Form

Applicant Information

Reference Information

Overall Recommendation

Rating Scale (4 = Superior, 0 = Unacceptable)

Section 12: Pre-Admission Disclosure Form

Printed Name

Section 13: Application Checklist