DELGADO COMMUNITY COLLEGE – CHARITY SCHOOL OF NURSING
APPLICATION FOR READMISSION
RE-ENROLLMENT CONTI NGENT ON SPACE AVAILABLE
Readmission application deadlines for: Fall – March 1
st
Spring - September 1
st
Summer – December 1st
# 1-8 are to be completed by student:
(This form is a fillable PDF and must be typed. Upon
completion, print the form, sign and submit.)
1. Indicate program: PN RN
2. Indicate semester for readmission (Check one): Fall Spring Summer Year: ________
3. Student’s Name: ________________________________________LoLA#: _______________
4. Address: _______________________________________________________________________________
Number Street City State Zip Code
5. Primary Telephone #: ____________________________Alternate Telephone: ______________________
6. Personal E-Mail: ________________________________ DCC E-Mail: _____________________________
7. Last Semester Enrolled ___________________________ Level Re-Entering: ________________________
8. Answer the following Questions:
1. Have you applied to Delgado Community College for the semester to be re-admitted?
Yes No
2. Have you attended another school of nursing or college since leaving Charity?
Yes No
Student’s Signature: ________________________________________________ Date: _________________
Deliver in person or mail this form to: Delgado Community College or via e-mail: cdomin@dcc.edu
Charity School of Nursing
450 South Claiborne Avenue, Room 613B
New Orleans, LA 70112
For Office Use Only:
•
Does the applicant meet current admission requirements for re-entry? Yes No
•
DCC Cumulative GPA: ___________________ Academic Standing at DCC last date of attendance: ___________________
•
Is a DCC application required? Yes No Last term attended: ___________________
•
# of semesters since last attended: ______ Assigned Advisor: _____________________________
•
Level Entering: ___________ Course(s) Needed: _______________________________ Repeating First Enrollment
•
Must attend: LSBN/Health Advising Program Advising New Student Orientation Course Orientation
Comments: ______________________________________________________________________________________
Nursing Program Specialist
Date Approved Date
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