Practical Nursing Certificate Application "*" indicates required fields Name* First Last Preferred name Email* Enter Email Confirm Email Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code GCC Student ID #* Check all that apply I am a US military veteran I am currently enrolled at GCC I was previously enrolled in the GCC Practical Nursing Program Requirement #1 • College Application*Program application and transcripts (if applicable) will not be reviewed until you have submitted a GCC application. If you are already enrolled at GCC, it is highly recommended to choose Pre-Nursing/PN Intent for your major to ensure proper advising as you work on your requirements. To change your major, complete and submit a Change of Major Form in MyGCC (select "Submit a Form" in the left menu). I have completed a GCC Application for Admission Requirement #2 • High School Transcript*Submit official high school transcript or GED/HiSet transcript with graduation date (required) to the Office of Admission. All students must submit regardless of college experience. Official high school transcripts must come directly to GCC from the high school. I have submitted or requested that my official transcripts be sent to the Office of Admission Requirement #3 • Transfer Credit Evaluation*Submit official transcripts of all previous colleges attended to the Office of Admission. After your transcripts have been reviewed, transfer credit will appear in your MyGCC record and email will be sent to your GCC student email address regarding placement testing requirements. It is your responsibility to check to ensure that all transfer credit has been applied. I have submitted or requested that my official transcripts be sent to the Office of Admission I have not attended another college besides GCC I have never attended college Requirement #3a • Transfer Credit Evaluation Email* I have received my transfer credit evaluation email Requirement #4 • Math*Check only one. I have ... Completed Math 095 or HUD 138 or higher level math course at GCC with a grade of C+ or better within seven (7) years prior to entering the PNC Program Received placement assessment scores placing out of MAT 095 within seven (7) years prior to entering the PNC program Completed equivalent math course(s) at a previously attended college within seven (7) years Requirement #5 • English*Important information about the English requirement: Eligibility to take English Composition I is determined by taking placement assessments and receiving scores that place you into ENG 101. If your scores are below those noted, you must complete developmental level English (ENG 090 and/or ENG 094) before you can take English Comp I.Check only one. I have ... Completed English Composition I (ENG 101, 103, or 105) at GCC with a C or better Completed an equivalent English course at a previously attended college Requirement #6 • Science*Indicate one GCC course from the list below that you have completed within seven (7) years prior to entering the PNC Program with a grade of C or better, or the equivalent course at a previously attended college. Comprehensive Anatomy and Physiology (BIO 194) Human Anatomy and Physiology I (BIO 215) Human Anatomy and Physiology II (BIO 216) Final acceptance and enrollment in the program is conditional upon the following additional requirements that must be submitted after you receive an acceptance letter to the program. The deadlines posted in your acceptance letter are strictly enforced. Students who do not have these items completed by the posted dates WILL BE REPLACED by students on the waiting list! Criminal Offender Record Information (CORI) Acknowledgement Form National Background Check CPR Certification - American Heart Association (BLS) Verification of Health Insurance Health Requirements (see Deadline Sheet for due dates) Cumulative GPA at GCC of 2.0 Mandatory attendance at summer orientation specific to ADN/PN students Successful completion of this program requires proficiency in the performance of a variety of skills. Technical standards, meant to clarify minimal standards for essential affective and psychomotor functions, require students to Be ambulatory Be able to lift a minimum of 50 lbs Possess fine motor coordination required to perform such technical skills as preparation and administration of medications Have visual acuity to perform technical skills such as physical assessment, preparation of proper dosage of medications Have auditory perception allowing effective use of stethoscope and communication Have emotional stability required to exercise sound judgment and intervention activities Have emotional maturity to develop appropriate therapeutic relationships Agree to Terms of Acceptance & Enrollment* I understand that by submitting this application, I indicate that I have read and understand the acceptance and enrollment requirements