DENMARK TECHNICAL COLLEGE
NURSING ADMISSION APPLICATION
St
udent Status
___ New: First-Time Freshmen Academic Year: _________
___ Readmit: Did not attend previous semester Date: _________
___ Transfer: From another college or university
___ Currently enrolled
P
LEASE PRINT CLEARLY (USE BLUE OR BLACK INK)
PERSONAL INFORMATION
Full Name (Last, First, Middle): ______________________________________________________________________________
Mailing Address: __________________________________________________________________________________________
City: ____________________________ County:____________________________ State: ________________ Zip: __________
Home Telephone: ( )____________________________Cell Telephone: ( )________________________
Email: ______________________________________________________________________________________
Date of Birth: _______/_______/__________ Sex: ____ Male _____ Female
*This information is voluntary and will not be used in the admission process in a discriminatory manner.
___ S. C. Resident of _____________________ ____ Vetern
County
GENERAL INFORMATION
A
re you a High School Graduate? ___Yes ___ No If yes, graduation date: _________________ (Month/Year)
I
f no, do you have a GED? ___ Yes ___ No Date you received your GED: _______________ (Month/Year)
H
ave you taken the Accuplacer Placement Test? ___ Yes ___ No If yes, please have scores sent to the Nursing Office.
H
ave you ever been convicted of a felony? ___ Yes ____ No If yes, please attach explanation.
Previous College or University Address
Graduated Date
Degree Awarded
(Please include copies of your unofficial transcripts from all previous colleges.)
Unofficial GPA: ______________ (calculated by student) Official GPA: _________ (calculated by College personnel)
Have you ever been enrolled in another nursing program? ____ Yes ____ No If yes, where? ______________________
I certify that all information provided is accurate and complete to the best of my knowledge.
A
pplicant’s Signature_________________________________________________________Date_____________________
Electronic Signature or Online Signature
The deadline for Fall 2020 admission is May 22, 2020, by 4:30 p.m.
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