Fillable Nursing Application (Clovis Community College)

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Nursing Application (Clovis Community College)

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Spring 2016 Nursing Program Application Process
(Deadline – October 1, 2015)
We recommend that you meet with an Academic Advisor first to file a Nursing Program Degree plan. It is required
that you review the Clovis Community College’s (CCC) Catalog for the Programs of Study on pages 46-49 and the
Nursing Program Course Descriptions on page 103-105. This will give you more information on the Nursing Program
Application process and inform you of what the requirements are.
To get to the Nursing Program qualifications and the Program requirements, follow the steps
below:
Go to www.clovis.edu → Go to the Programs/Majors tab→Click on the Nursing Program. You
will then find the following topics:
•! Associate of Applied Science Degree Plan: At the right side of the page, you will find the
Associate of Applied Science Degree Plan.
•! Course Catalog: At the bottom of the page, Click on the 2015-2017 PDF
Catalog→Click on “Programs of Study” → Scroll down and click on Nursing or go to page 46.
Note: The policies and regulations contained in this catalog apply to all applicants, including those who have filed
and are following degree plan requirements of an earlier catalog. If you have any questions regarding the degree plan
or don’t live in the Clovis vicinity to visit us, contact the Academic Advising, located in the Dr. H. A. Miller Student
Services Center or call (575) 769-4020.
All applicants must complete a CCC Nursing Program Application and the Admission Application. The forms should
be completed, with care, as this application represents you to the Nursing Program Selection Committee.
Prior applications will not be included in your current file.
•! To get to the Nursing Application, follow the steps below:
Go to www.clovis.edu → Go to the Programs/Majors tab → Click on the Nursing Program
Application on the right panel.
•! To get to the CCC Admission Application, follow the steps below:
•! To download an application, go to:
www.clovis.edu → Go to the Student tab→General Application Paper
•! To complete an application online, go to:
www.clovis.edu → Go to the Student tab → General Application Online
In order for your Nursing Program Application to be considered, you must have the Nursing Program Application
completed in its entirety turned in to the Office of Admissions and Records by October 1, 2015 to be considered
for admission to the Nursing Program for Spring 2016.
If you would like to apply to enter into the program as a Semester 3 (RN…) and are not currently enrolled in the
program, you must submit a photocopy of your current LPN/LVN license. You must also have had successfully
completed General Education and Related Requirements to be considered for admission to Semester 3 classes.
For the Nursing Program Application to be considered as complete, you must have the following:
1.! Admission Application – If not currently enrolled, complete an Application for Admission to the Office
Admissions and Records.
2.! Nursing Program Application – Complete ALL sections of the Nursing Program Application,
including the transcript information. Incomplete applications will not be accepted by the office of
admissions and records. Note: If you change your address or telephone number after your
application has been submitted, you must also notify the Nursing Office at (575)769-4976. The
office hours are from 7:30am to 4:00pm.
3.! Transcripts – You must provide the Office of Admissions and Records a sealed copy of your transcript
by one of the following ways:
1.! Have your school/college to forward your Official Transcript to:
Clovis Community College
c/o Office of Admissions & Records
417 Schepps Boulevard
Clovis, New Mexico 88101
2.! You may also “hand deliver” a sealed original copy to the Office of Admissions and Records.
4.! Grade Point Average – You must meet the minimum cumulative grade point average of (GPA) of 2.5.
5.! Prerequisites – You must have successfully completed all General Education and Related Requirements
as listed on the Nursing Degree Plan prior to admission to the Nursing Program. Applicants who are
enrolled in the last of these requirements at the time of their application may be considered. All science
course requirements must have been completed no later than Fall 2010.
6.! Placement Testing – All Applicants must complete the Kaplan Admission Examination, prior to
acceptance. Once the Nursing Department has received your application for the nursing program, you
will be notified via email (CCC email) of your test date and time. If you have not received a test date by
December 7, 2015, please contact the Nursing Department.
7.! Nursing Program Application files, which do not contain all of the requirements listed above by the
October 1, 2015 deadline, are considered as “incomplete”. The incomplete applications will not be
reviewed for acceptance by the Nursing Program Director until all missing and updated information has
been received within the above mentioned deadline date. Once the Nursing Program Application is
completed with all requirements met, it will then be forwarded to the Nursing Program Director if it’s
within the semester the application was submitted.
Note: Please visit the Nursing program webpage to view immunization requirements.
Applicant
Information
Nursing Program Application
Spring 2016
Note: If you change your address or telephone number, you must notify the Nursing
Department in addition to the Admissions and Records Department.
Is this your rst application to the program: Yes_____ No_____
If no, list the year of previous application: ____________________
Have you attended another college since your last application: Yes____ No____
Where did you attend_______________________________________________________
________________________________________________________________________
If yes, you must request an ofcial copy of your transcript(s) to be mailed to the Ofce
of Admissions and Records, or you may walk in an ofcial, sealed copy.
First Middle Last (Maiden)
Date of Birth Social Security #
Address
City/State/Zip
For important application and transcript deadline information, please refer to the
Nursing Program insert.
Please print legibly
Home
Cell
Work
CCC Email (required)
Name
Phone
Name
Phone
Contact Information Emergency Contacts
LEVEL I (LPN)
LEVEL II (RN/ADN)
Signature
Applicant's Signature Date
Revised September 2015
C0 00
Male Female
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signature
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Name
SS#
Student ID #
Provisional
Agreement
I understand that my application to the Nursing Program at Clovis Community College is
on a PROVISIONAL BASIS pending receipt of transcripts from the following school(s)/
college(s)
1.
2.
3.
4.
5.
6.
I agree to complete my nursing application le no later than the published deadline for the
semester in which I am applying. (Deadlines are published on the insert contained in this
packet.)
Applicant’s Signature: Date:
C000
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Completed 24 July 2020

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