Fillable Current NCC Students - Program Application For Transfer (Nassau Community College)

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Current NCC Students - Program Application For Transfer (Nassau Community College)

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Revised January 2018
NASSAU COMMUNITY COLLEGE
Respiratory Care Program
APPLICATION FOR ADMISSION
- For Change of Area By Students Currently or Formerly Attending NCC Only -
Students Who have Never Attended NCC Apply Through Admissions Office
NOTE: INCOMPLETE APPLICATIONS WILL BE RETURNED UNPROCESSED
Office Use:
Date Submitted:
Received: By Hand Via Mail Via Email
Remedial Status Confirmed
Yes No
Transcript(s) Submitted
Yes No
Hospital Visit Confirmed
Yes No
Video Viewing Confirmed
Yes No
Minimum Req. Met:
Yes No
Interview Scheduled for:
Application Returned/Incomplete
Name of Candidate:
Email Address:
Street Address
City:
Zip Code:
Banner #
Phone(s) - Home:
Cell:
Work:
High School Attended:
Year of HS Graduation
Current NCC Area of Concentration: Total NCC Credits to Date: Current NCC Cum:
Other College(s) Attended
Total Credits
CUM
Degrees Held
None, or list below:
None, or list below:
ADMISSION REQUIREMENTS COMPLETED: (Submit Unofficial Copies of Transcripts of ALL Coursework)
SUBJECT
REQUIREMENT
GRADE
INSTITUTION
DATE
Math
Two years of pre-college math
[May Substitute NCC MAT 109]
Biology
High School Biology or college equiva-
lent (e.g., Bio 101, or AHS 131)
Chemistry
High School Chemistry or college equiva-
lent (e.g., CHE 107)
Candidate Verifications: (Check appropriate boxes and sign to verify statements.)
Remedial Courses: None were required as a result my NCC placement exam; OR All required courses successfully completed.
“Life & Breath” Video (available online at http://www.aarc.org/careers/what-is-an-rt/life-breath-video/): Viewed
Observation Experience: Completed (Attach completed & signed documentation form available at www.ncc.edu/respiratorycare)
Candidate’s signature verifying statements:
SPECIAL NOTICE to currently enrolled Non-Degree students seeking admission to Respiratory Care:
In addition to completing the above, the following documents must be submitted to the
Office of the Registrar by the application deadline:
1. Official high school transcript (if not previously submitted to Registrar)
2. Official transcripts from ALL colleges previously attended (if not previously submitted to Registrar)
3. Students with international academic transcripts must submit a course-by-course credential evalua-
tion by WES.org or IES.AACRAO.org.
4. Official AP/IB scores or CLEP exam if you have previously taken these tests or exam.
5. Review of transfer credits form for students with college credits.
click to sign
signature
click to edit
Revised January 2018
NCC Respiratory Care Program – Application for Admission – Current NCC Change of Area Students Page 2.
Candidate Statement (Optional)
In the space below, candidates may enter a typewritten statement (maximum length, 1 page) describing why they desire to enter the
profession of respiratory care. Neither candidate statements nor letters of recommendation are required as part of the application.
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Current NCC Students - Program Application For Transfer (Nassau Community College)

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Completed 21 September 2020

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