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TUTORIAL PROGRAM - Curriculum [Please Print or Type] Prior training and experience requested for exemption or credit must have been obtained within ten (10) years from the date of the application. The coursework you will be identifying in the sections below shall extend over a minimum period of four (4) academic years, or eight (8) semesters, or twelve (12) quarters, or nine (9) trimesters, or thirty-six (36) months. No more than 1500 hours of clinical training and/or theoretical and didactic training is to be completed per twelve (12) month period. [Conversion of semester or quarter units into hours is as follows: 1 semester unit = 15 hours; 1 quarter unit = 10 hours.] [SECTION 1 - CLINICAL TRAINING] - Number of Hours Required is 2,250 Practice Observation Source of Instruction: Tutorial Supervisor Name of School _________________________________________ Proposed Number of Hours: _______________________ Estimated Start Date ____________End Date ________________ Request for Course Exemption / Credit: No. of Hours ___________ Date Completed (Yr./Fall;Winter;Spring;Summer) _____________________ School Name:____________________________________________________________________________________ Course Number and Name: History and Physical Examination Source of Instruction: Tutorial Supervisor Name of School _________________________________________ Proposed Number of Hours: _______________________ Estimated Start ...
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