3201 W. 16th St. • Sedalia, MO 65301-2199	Applicant Information and Application Materials
Industrial Maintenance Professional Certificate (CMRT)	

Total Productive Maintenance 
Professional Certificate 
(Industrial Maintenance)

Applications now accepted for fall 2015 
DEADLINE for priority enrollment: 5 p.m. July 17, 2015 
-	LAST CHANCE for tuition assistance - 

Please return all application materials to:
Ginger Champion, Fielding 253A
State Fair Community College
3201 West 16th St.
Sedalia, MO 65301
Email: vchampion@sfccmo.edu
Fax: (660) 530-5827
If mailing materials, it is highly recommended to mail them one week prior to 
deadline to ensure timely arrival.

For Questions, contact Ginger Champion at (660) 596-7411
or Tammy Hamilton at (660) 596-7296

State Fair Community College does not discriminate on the basis of race, color, national origin, sex, disability, religion, sexual orientation, veteran status, or age in its programs and activities or in employment. The following persons have been designated to handle inquiries regarding the nondiscrimination policy: Director of Human Resources, Hopkins Student Services Center, (660) 596-7484, or Dean of Student and Academic Support Services, Hopkins Student Center, (660) 596-7393. The Hopkins Center is located on SFCC‘s Sedalia campus at 3201 W. 16th St. Sedalia, MO. 65301. Inquires also may be directed to the U.S Department of Education, Office of Civil Rights atOCR.KansasCity@ed.gov

Dear Applicant:
Thank you for your interest in State Fair Community College’s Professional Certificate in Total Productive Maintenance. Successful program completers may qualify to sit for the Certified Maintenance and Reliability Technician (CMRT) exam. For eligibility and other frequently asked questions about the CMRT certification, visit the Society for Maintenance & Reliability Professionals, SMRP at http://www.smrp.org/files/CMRT%20Candidate%20Guide%20for%20Certification%20%20Recertification.pdf
Participants are admitted to the college on the same basis and procedure as other students. However, admission to the college does not ensure eligibility for the MoManufacturingWINs funded tuition.
The program is part of the MoManufacturingWINs grant, which means additional eligibility requirements must be met for entrance into the grant-funded aspect of the program. To apply for the two-semester Professional Certificate in Total Productive Maintenance, each applicant must complete the following items.  Remember, there is a program limit of only 16 students, so do not delay your application. First (eligible) come, first (eligible) served!
Checklist of Required Materials begins here:
Please check off as you complete each task. For your application to be considered, each bulleted item must be completed accurately. This checklist is provided for your benefit and should not be submitted with your application packet.
Step One: Meet State Fair Community College Admission Procedures: (If you are currently attending SFCC you should have already completed the tasks listed in this section.)
•	_____Go to SFCC website at www.sfccmo.edu and click How to Apply.
o	_____New students click New Student link, complete the online admissions form and request appropriate transcripts using form located at this link.
o	_____Follow remaining steps, submit placement scores and complete the Free Application for Federal Student Aid (FAFSA) at www.fafsa.gov. SFCC’s school code for the FAFSA application is 007628. This step is strongly recommended.
Step Two: Meet State Fair Community College Industrial Maintenance Course Procedures:
•	_____Read through this entire application packet.
o	_____ Complete eligibility form located at the end of this packet and submit completed form to Ginger Champion.
Step Three: Complete MoManufacturingWINs eligibility testing:
•	As part of the Total Productive Maintenance program, the following assessments must be completed prior to enrollment: Digital Literacy and WorkKeys/NCRC+. Please contact the Testing and Career Center at (660) 530-5818 or email careerservices@sfccmo.edu to schedule an appointment. 
o	Digital Literacy assesses Basic Computer Use, World Wide Web, Windows, Using Email, and Microsoft Word www.digitalliteracyassessment.org.
o	WorkKeys/NCRC+ assesses the following areas: Applied Mathematics, Locating Information and Reading for Information. The NCRC+ ranks individuals in the following soft skills categories: Work Discipline, Teamwork, Customer Service Orientation, and Managerial Potential. Individuals scoring below a level 5 for any NCRC/WorkKeys area will be defined as “Low-Skilled” for the purposes of MoManufacturingWINs eligibility. The desired score is level 4 or above.
The first 16 students with complete applications who meet the MoManufacturingWINs eligibility requirements will be invited to join the upcoming class. Students who accept are enrolled in the classes by an advisor.
Application materials received after cutoff dates will be considered for the current semester if seats are available. If class is full, applicants will be considered for the next available class offered. After each cutoff date, all complete applications will be evaluated. All incomplete packets will be ineligible.
All students who enroll in the Industrial Maintenance courses will be required to enroll in Toolbox 2.0 as part of the MoManufacturingWINs grant. Students will be required (MANDATORY) to come to campus for an orientation/review day to complete this process and turn in necessary paperwork. Be sure to bring a photo ID to orientation.
Failure to attend orientation/review day disqualifies the applicant.
Participant Guidance:
MoManufacturingWINs is required to serve a target population which includes Trade Adjustment Assistance eligible participants, unemployed participants, underemployed participants and low skilled participants. There is flexibility to include a broad spectrum of individuals (as participants) from varied socioeconomic backgrounds for training purposes.

Target Populations
MoManufacturingWINs training programs must give priority for training to the following target population participants:

Trade Adjustment Assistance (TAA)
An individual who has lost their job, through no fault of their own (due to lack of work), as a result of foreign trade. State merit staff (DOLR & DWD) administers this program and determines individual Trade eligibility.

Unemployed
An individual who has been terminated or laid off, or has received a notice of termination or layoff; employed at a facility at which the employer has made a general announcement the facility will close within 180 days; self-employed (including employment as a farmer, a rancher, or a fisherman) but unemployed as a result of general economic conditions or natural disasters; and a displaced homemaker.

Underemployed
An individual who is working part-time but desires full time employment, or is working in employment not commensurate with the individual’s demonstrated level of educational and/or skill achievement. The local Workforce Investment Board negotiated average earnings target wage should be referenced to aid in eligibility determination.

Low-Skilled 
An individual will be required to demonstrate college readiness for placement into college level coursework, (typically coursework numbered 100 level or above) as defined in the chart below. Individuals scoring below the designated cut-off score for any area will be defined as “Low-Skilled” for the purposes of MoManufacturingWINs eligibility.

Other Grant Participant Specifications
Veterans Priority
The Jobs for Veterans Act (Pub. L. 107-288) requires priority of service to veterans and spouses of certain veterans for the receipt of employment, training, and placement services in any job training program directly funded, in whole or in part, by DOL. The regulations implementing this priority of service can be found at 20 CFR part1010. In circumstances where a grant recipient must choose between two qualified candidates for training or a service, one of whom is a veteran or eligible spouse, the Veterans Priority of Service provisions require that the grant recipient give the veteran or eligible spouse priority of service by admitting him or her into the training program or providing service. To obtain priority of service a veteran or spouse must meet the program’s eligibility requirements. Grantees must comply with DOL guidance on veterans’ priority.

The community colleges have all agreed to a set of common cut-off scores. Such cut-off scores should serve as the starting point for the definition of "Low Skilled" for credit seeking participants.  An entering student who is deficient in one or more areas will be defined as "Low Skilled".

Missouri Community College Readiness Standards

Missouri community colleges have developed a common standard for college readiness. All Missouri community college students will be required to demonstrate college readiness for placement into college level coursework (typically coursework numbered 100 level or above) as defined in the chart below using ACT scores as noted. Concordant scores in other placement tests, as indicated below, may also be used for students who do not present an ACT score.

Point considered when determining common placement scores included:
•	The adopted college readiness standard must be based on research and best practice.
•	The standard must align with other placement testing tools.
•	Consideration should be given to the approach other states took in adopting a statewide standard.

In its review of ACT based college readiness materials and publications, and in consultation with ACT staff and researchers, community colleges believe these common core standards will promote student success, provide access to college and support student learning.
These changes began in the Fall of 2011. The new testing scores are as follows:

 	ACT	COMPASS	ASSET	SAT	
Writing	18	70	41	Critical Reading 430	
Reading	18	81	41	Critical Reading 360	
Algebra	22	Algebra 66 or College Algebra 50	Intermediate Algebra 43 or College Algebra 39	  Math                  460	
Scores below these standards will result in development coursework.

The following are the courses required to complete Industrial Maintenance Professional Certificate in Total Productive Maintenance. All students enrolled in this program are expected to complete the required courses in two semesters. You may choose to enroll in one or more of the following program courses based on your needs. Students who have successfully completed the prior lower numbered course will be allowed to enroll in the next sequential course in order to continue within the program. For example those students who have successfully completed IEM 102 will be allowed to enroll in IEM 104 before new applicants are allowed to enroll in IEM 104.

Fall 2015 Morning: 8 – 10:50a T, R	Spring 2016 Morning: 8 – 10:50a T, R	
1st 8 weeks: IEM 102	2nd 8 weeks: IEM 104	1st 8 weeks: IEM 112	2nd 8 weeks: IEM 114	
Fall Afternoon: 12:30 – 3:20p T, R	Spring Afternoon: 12:30 – 3:20p T, R	
1st 8 weeks: IEM 106	2nd 8 weeks: IEM 108	1st 8 weeks: IEM 122	2nd 8 weeks: IEM 124	
Full 16 weeks: IEM 126	Full 16 weeks: IEM 128	
Participates will complete 30 credit hours in 32 weeks.
For program acceptance you will be required to complete:
1.	MoManufacturingWINs eligibility form (last 2 pages of this application packet).
2.	The physical requirements of this occupation typically include lifting up to 45 pounds, pushing, pulling, reaching, walking, standing, crawling, kneeling, ascending and descending ladders, manual dexterity, and working in cramped positions for sustained periods of time.
For specific Essentials Qualifications, please visit our web page at http://www.sfccmo.edu/essentialqualifications, and then the Industrial Technology link.
If you have questions, please feel free to contact us.
Tammy Hamilton
Instructor, Industrial Maintenance
Phone: (660) 596-7296
Email: thamilton@sfccmo.edu 	Ginger Champion
Admissions and Advisement Coordinator
Phone: (660) 596-7411
Email: vchampion@sfccmo.edu 	

Special Services Accommodations:
Students with disabilities who require special accommodations should contact the SFCC Access Office, located in Student Services, Hopkins Building, 660-530-5832, at the beginning of the semester. If you have emergency medical information to share, or need special arrangements in case the building must be evacuated, please see instructor privately after class or make an appointment to meet with them.
Please know that reasons for all disability services are confidential and will never be discussed with any instructor, student, or staff, without your written consent.

Non-Discrimination/Accommodation Notice:
State Fair Community College does not discriminate on the basis of race, color, national origin, sex, disability, religion, sexual orientation, veteran status, or age in its programs and activities or in employment. The following persons have been designated to handle inquiries regarding the nondiscrimination policy: Director of Human Resources, Hopkins Student Services Center, (660) 596-7484, or Dean of Student and Academic Support Services, Hopkins Student Center, (660) 596-7393. The Hopkins Center is located on SFCC‘s Sedalia campus at 3201 W. 16th St. Sedalia, MO. 65301. Inquires also may be directed to the U.S Department of Education, Office of Civil Rights at OCR.KansasCity@ed.gov.

Accommodation Notice:
Interested persons may obtain information as to the existence and location of services, activities and facilities at State Fair Community College that are accessible to and usable by persons with disabilities by contacting the Access office, Student Services Office, Hopkins Student Services Center, Room 751, SFCC, 3201 W. 16th Street, Sedalia, Mo 65301, (660) 530-5832.

Student Success Center:
The mission of the Student Success Center is to work with you to help you define, clarify and achieve your academic, personal and professional goals. The Student Success Center connects students who are having difficulty in their courses with the support they may need to succeed. If you have questions or concerns about your ability to succeed during the semester, please do not hesitate to contact the center at success@sfccmo.edu or (660) 596-7253 or stop by Hopkins Student Services Center, Room 754.

Industrial Maintenance Professional Certificate in Total Productive Maintenance Fee Schedule 2015
The Industrial Maintenance courses are offered through the MoManufacturingWINs Grant, so all eligible participants will receive tuition for free until October 1, 2015. This does not include fees or additional expenses needed to complete the class.

There will be expenses incurred in addition to class tuition and fees. While we have tried to be as thorough as possible, expenses may vary from the estimates listed.

Student expenses not covered by grant		Student savings covered by grant		
IEM 102 book (1st 8 weeks)	$152.50 		IEM 102	 	 	
   Safety Glasses	$5.00					
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
        Total for IEM 102	$208.50		    Out of state	$200 p/credit hour – 3 credit hours 	 $600	
IEM 104 book (2nd 8 weeks)	$0 		IEM 104	 	 	
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
        Total for IEM 104	$51		    Out of state	$200 p/credit hour – 3 credit hours	 $600	
IEM 106 book (1st 8 weeks)	$169.50 		IEM 106	 	 	
   Online fee $45/credit hour	$0 		    In district	$100 p/credit hour - 3 credit hours	$300	
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
        Total for IEM 106	$220.50		    Out of state	$200 p/credit hour – 3 credit hours	 $600	
IEM 108 book (2nd 8 weeks)	$117.00		IEM 108	 	 	
   Online fee $45/credit hour	$0		    In district	$100 p/credit hour - 3 credit hours	$300	
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
       Total for IEM 108	$168		    Out of state	$200 p/credit hour – 3 credit hours	$600	
IEM 128 book (16 weeks)	$71.50 		IEM 128	 	 $300	
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
        Total for IEM 128	$122.50		    Out of state	$200 p/credit hour – 3 credit hours	 $600	
IEM 112 book (1st 8 weeks)	$0		IEM 112	 	 	
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
       Total for IEM 112	$51		    Out of state	$200 p/credit hour – 3 credit hours	$600	
IEM 114 book (2nd 8 weeks)	$0		IEM 114			
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
       Total for IEM 114	$51		    Out of state	$200 p/credit hour – 3 credit hours	$600	
IEM 122 book (1st 8 weeks)	$162.50		IEM 122			
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
       Total for IEM 122	$213.50		    Out of state	$200 p/credit hour – 3 credit hours	$600	
IEM 124 book (2nd 8 weeks)	$0		IEM 124			
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
       Total for IEM 124	$51		    Out of state	$200 p/credit hour – 3 credit hours	$600	
IEM 126 (16 weeks)	$0 		IEM 126	 	 	
   Industrial Fee $15/course	$15.00		    In district	$100 p/credit hour – 3 credit	$300	
   Industrial Fee $12/credit hour	$36.00		    Missouri resident	$140 p/credit hour - 3 credit hours	$420	
        Total for IEM 126	$51		    Out of state	$200 p/credit hour – 3 credit hours	 $600	
Technology fee (per cr. hr)	$30.00					
Grand Total	$1,488.00					
The same books are used for the following four classes: IEM 102, 104, 112, & 114.
The same books are used for the following two classes: IEM 122 & 124.

Gainful Employment Disclosure
For more information about our graduation rates and the median debt of students who completed this program and other important information, please visit www.sfccmo.edu/industrialtechnology.  

Available Financial Aid
Most of the estimated additional expenses above can be covered through any additional financial aid you receive through SFCC. Examples would be a Pell Grant, scholarships, loans, etc. Once your funding is depleted, all expenses left will be the responsibility of the student.

IMPORTANT FINANCIAL AID INFORMATION FOR STUDENTS WITH AN ASSOCIATE OR HIGHER DEGREE

Already having a degree impacts your eligibility for federal and state financial aid programs.  This is especially true if you are planning on taking prerequisite courses prior to being accepted into the program.  If this is the case for you, please contact the Financial Aid Services Office. They will be more than happy to review your situation and discuss your options.

**Please complete the following page and email, mail, or hand deliver to Ginger Champion 
or Tammy Hamilton

This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. 

This workforce product was funded by a grant awarded by the U.S. Department of Labor’s Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership.  

Today’s date:                                                                                                                            Student ID #:	
STUDENT INFORMATION	
Last name:	First:	Middle:	Birth date:	Age:	Gender:	
				       /          /		 M	 F	
Street address:	City:	State, ZIP Code:	
			
Contact phone # : (          )	Social Security#:
	Email address:	
Ethnicity:
 Black or African American  American Indian or Alaskan Native  Asian  Hispanic/Latino  White  Native Hawaiian or Other Pacific Islander  More than one race  Not specified 
	Are you of Hispanic/Latino origin? 

 Yes        No	Are you a U.S. Citizen?  Yes        No

 No, but work authorized	
Where did you first learn about the MoManufacturingWINs grant:    SFCC    Career Center/WIB    UAW    Other	
MILITARY/DISABILITY/EMPLOYMENT/SCHOOL INFORMATION	
DISABILITY INFORMATION	TAA/TRA INFORMATION	
Are you disabled?	 Yes

 No	If yes, what percent?	Are you eligible for TAA/TRA benefits?	 Yes       No		
EMPLOYMENT INFORMATION	
Are you currently employed?	 Yes              No	If yes, who is your employer?	
If no, do you receive Unemployment Benefits?	 Yes              No	What is your occupation?	
	What is your current monthly gross earnings? $	
 MILITARY INFORMATION	

Have you completed your Selective Service Registration?    Yes        No         Not Applicable	

Are you a U.S. Military Veteran?	
Branch of Military Service	
From (dates)	
To (dates)	
Are you a spouse to a veteran?	

 Yes        No	
	
       /         /	
       /      /         	
 Yes        No	

 SCHOOL INFORMATION	
Are you currently attending State Fair Community College?	 Yes              No	Highest Educational Level Completed:	
Semester:

 FALL
 SPRING
 SUMMER

Year:	Are you full-time or part-time?

 Full-time (12 or more credit hours for fall/spring; 6 or more credit hours for summer)

 Part-time (less than 12 for fall/spring; less than 6 for summer)	 Less than HS Diploma/ no GED
 HS Diploma/GED
 Some College, no degree	
		 Completed AA/AAS degree
 Bachelor’s Degree
 Graduate Study above Bachelor’s 	
What is your major?	
If UNDECIDED, what majors are you considering?	
What is your educational goal?	 Non-credit certificate completions                Credit 1 year certificate 
 Credit less than 1 year certificate                 Credit Associate Degree	

OFFICE USE ONLY	
Acceptance Date to MMW Program: 	Student ID:	Declared Major: 	
Financial Aid Status:	Pell Grant eligible?	 Yes        No
		
Verify Status                 Full Time        Part Time
                                   Non Credit Student	Credit accepted for prior learning	 Yes        No
Credits:_______		
Assessment Scores                         Date Taken	Source:  Accuplacer   ACT   WorkKeys/NCRC   Other      	
	Reading Score		Level:  College Level 
           One Level Below
           Two Levels Below
           Three Levels Below	•	Refer to ACCUPLACER Placement Guide for Levels	
	English Score		Level:  College Level 
           One Level Below
           Two Levels Below
           Three Levels Below		
	Math Score		Level:  College Level 
           One Level Below
           Two Levels Below
           Three Levels Below		
	Campus Code		Program Code		Term Code		Semester Start Date		
	Credit/Non Credit Code		Entering Student Status	  New, first-time any college
  Previously attended any college 
  Returning student from current college
	Term Credit Hours Attempted: 		
					Term GPA:		
					Term Credit Hours Completed:		
Pre WorkKeys Assessment                 Date Taken: 	MHW Completed	
Applied Math 	Score:  
 3         6
 4         7
 5
	Transitions Course  
AAS Health Information Management
Certificate 
CMT program 		
Reading for Information	Score:  
 3         6
 4         7
 5
	TALENT		
Locating Information 	Score:  
 3         6
 4        
 5			
EXIT USE	
Exit Date from Program: 	
Post WorkKeys Assessment                 Date Taken: 	MHW Completed	
	Applied Math 	Score:  
 3         6
 4         7
 5
	Transitions Course  
AAS Health Information Management
 Certificate 
CMT program 		
	Reading for Information	Score:  
 3         6
 4         7
 5
			
	Locating Information 	Score:  
 3         6
 4        
 5			

This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.