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PRACTICAL NURSING APPLICATION

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PRACTICAL NURSING APPLICATION
FALL 2020
1
This is a part-time practical nursing (PN) online/hybrid program and requires 21 months
(seven quarters) to complete. It is approved by the Washington State
Nursing
Commission. Edmonds Community College is accredited by the Northwest
Commission on Colleges and Universities and is authorized by the Higher Education
Coordinating Board of the State of Washington to provide this program. The PN Program
has admission requirements beyond those necessary for general admission to the college.
Please follow all directions in this application carefully in order to
gain admission to this program.
Application Information
Applicants must meet the following criteria:
Apply to Edmonds CC by visiting our website at
edcc.
edu
/admissions
or apply in
person in Lynnwood Hall, first floor before acceptance into the Nursing Program.
Understand that participation in this
program involves practice in a health care agency
and requires appropriate
medical and background clearances.* Applicants must
meet all legal
requirements and/or standards of institutions where clinical
experiences will
occur.
Complete all prerequisites and submit unofficial transcripts prior to admission.**
Have all foreign transcripts translated and evaluated by an approved agency. Contact
Enrollment Services for more information.
Satisfy the minimum grade point average of 2.75 in prerequisite courses.
The
minimum passing grade for any course is 2.0.
Take ATI TEAS (Test of Essential Academic Skills). One retest per 365
days is allowed 30 days after the initial testing date. More information:
www.edcc.edu/testing/tests/teas.html
Document six months of recent work experience in direct patient care.
Document computer proficiency.
Submit two professional recommendations related to work in patient care.
*
A national and WA state criminal background check will be required upon admission to the PN
program. Students must provide all current immunizations and TB clearance prior to the
start of the 2020 Fall Quarter. (September 14, 2020)
** A copy of official sealed transcripts must be submitted within three weeks of notification of
admission to the program or admission offer will be rescinded.
Applicants who meet the minimum criteria will be required to write an in-person essay:
Those who meet minimum criteria for TEAS scores and GPA will be notified via
E-mail by June 26.
Essay dates and times will be provided by E-mail.
Essay dates will be during the weeks of July 6 through July 17.
Applicants will be notified of final admission decisions by July 31.
Along with the application, the student must submit proof of admission into
Edmonds Community College (a copy of the automated confirmation E-mail with
SID Number will suffice).
Rev. 1/2020
Important Dates
June 19, 2020 – 5:00 pm
Final closing date to submit your completed packet
to the PN Program. All prerequisites must be
completed by this date.
June 26, 2020
Students who meet minimum TEAS and GPA criteria
will be notified of eligibility to write essay.
July 6 – 17, 2020
Proctored essay writing sessions will be scheduled
on campus.
July 31, 2020
Students will be notified of acceptance no later
than 5PM on this day. Please DO NOT call or email
to check your status prior to this date.
August 3, 2020
Financial Aid Deadline
Mail to:
PN Program Admissions
Edmonds Community College
20000 68
th
Avenue W.
Lynnwood, WA 98036-5996
-OR-
Hand deliver to:
PN Program Admissions
Print and Mail Center
Mountlake Terrace Hall 100C
Edmonds Community College
20000 68
th
Avenue W.
Lynnwood, WA 98036-5996
Print and Mail Center Hours:
7:00 am – 6:00 pm, Monday-Thursday
7:00 am – 5:00 pm, Friday
PRACTICAL NURSING APPLICATION
FALL 2020
Rev. 1/2020
2
PN Program Admission Requirements
Admission procedures/requirements may change.
Download a current application for Fall Quarter 2020.
Complete and submit application by
JUNE
19, 2020, including
:
1. Provide proof of admissions into Edmonds Community
along with the application to the PN program
2. One copy of unofficial college transcripts* verifying
completion of all prerequisite course requirements with a
minimum GPA of 2.75 or higher in these courses;
3. ATI TEAS results: total score and sub-scores
4. Verification of computer skills form
5. Two professional recommendation forms
6. Employment verification form
7. Optional: Extra consideration will be given to applicants
with a valid CNA certificate/license, MA certificate/license,
or military medical corps experience. Submit proof of
certificate, license, or military service.
8. If notified of eligibility, come to campus to write a
proctored essay
* Official sealed transcripts must be submitted within three weeks of
notification of admission to the program or admission offer will be rescinded.
Practical Nursing Program Requirements
Edmonds CC Prerequisite Requirements
5
ENGL&
101 English Composition l
MATH 087 Intermediate Algebra
5
BIOL& 241
Anatomy & Physiology I
5
5
BIOL& 242
PSYC& 200
Anatomy & Physiology II
Lifespan Psychology
5
All science courses must have been completed within the last
10 years (Anatomy and Physiology, Nutrition). Math& 146 is also
accepted as a prerequisite course.
Students must have a minimum cumulative GPA of 2.75 in
prerequisite courses and no less than 2.0 in any one course.
All official transcripts submitted will be evaluated for course
equivalencies.
Program General Education Requirements
NUTR& 101
CMST& 210
Human Nutrition 5
Interpersonal Comm. 5
10
62
PN courses
Core Courses
Total Program Credits
72
National & WA State Criminal Background Check*
A criminal background check is not required with your application;
however, upon admission to the PN program, a current background check
that includes a search of the National and Washington State Criminal
Database will be required through Castlebranch (information will be
provided once the applicant is admitted).
Advising
For general college advising, call 425.640.1458 or visit:
www.edcc.edu/advising
Program Information
Call the Nursing Office at 425.640.1017.
For program advising appointment E-mail:
Kyra McCoy | kyra.mccoy@edcc.edu
Equal Opportunity/Non-discrimination
Edmonds Community College assures equality of treatment in
educational and employment opportunities without regard to race,
color,
religion, national origin, sex (gender), disability, sexual
orientation, age,
citizenship status, marital status, veteran status, or genetic information.
Signature
By signing these forms, you certify that to the best of your knowledge
the statements made in this application are complete and true. Failure
to
disclose and submit official transcripts from all
schools, colleges, or
universities attended and failure to disclose and
submit complete and
accurate information may result in the
denial of admission or
subsequent dismissal from Edmonds CC. Your
application is incomplete without your signature.
Assessment/Testing: 425.640.1735 |
www.edcc.edu/testing
Advising: 425.640.1458 |
www.edcc.edu/advising
Enrollment Services: 425.640.1000 |
www.edcc.edu/es
Financial Aid: 425.640.1457 |
www.edcc.edu/finaid
Services for Students with Disabilities: 425.640.1320 |
www.edcc.edu/ssd
TEAS REQUIREMENTS:
NO Absolute Cut Scores.
Recommended total score at Proficient or above (≥ 59%)
and a Reading Sub-score ≥ 50%.
PRACTICAL NURSING APPLICATION
FALL 2020
3
ADMISSION CHECKLIST
Name
Please use this checklist to ensure that you have met all admission and prerequisite requirements for the PN program. When you have completed all
requirements
, submit everything together in a single large envelope to the address below
. Sealed letters of recommendation and employment
verification forms should be included with the application packet. It is not possible to notify applicants of missing materials.
Include this checklist in your admission packet.
1.
Apply for financial aid by August 3.
2.
College Program Requirements
Admission checklist (use as cover sheet)
Proof of admission into Edmonds Community College
Edmonds Community College Application for Admission to PN
Program
Optional: photocopy of CNA or MA certificate of completion and/or license
or documentation of military medical corps service
ATI TEAS (Test of Essential Academic Skills) results: total and sub-scores
3.
Recommendation Forms
Copy of unofficial transcripts showing completion of required
prerequisite courses
–NOTE: Official sealed transcripts
must be submitted within three weeks of
notification of
admission to the program or admission will be
rescinded.
Include translations if from a foreign institution.
Professional Recommendation Form #1
Professional Recommendation Form #2
4.
Prerequisite Course Verification/GPA
BIOL& 241 – Anatomy and Physiology I
BIOL&242 – Anatomy and Physiology I
I
Math 087 – Intermediate Algebra (or Math& 146)
PSYC& 200 – Lifespan Psychology
ENGL
& 101 – English Composition I
Courses not required for admission, but to be completed prior to the third quarter in the program:
NUTR&
101 – Human Nutrition CMST& 210 – Interpersonal Communication
5.
Employment and Computer Skills Verification
Verification of employment form(s)
Verification of computer skills form
I verify that all requirements indicated above have been completed and are included in my admission packet. I have kept a copy of
this entire admission packet for my records.
Student Signature
Date
APPLICATION MUST BE RECEIVED BY 5:00 P.M., JUNE 19, 2020Mail to:
PN Program Admissions
Edmonds Community College
20000 68th Ave W., Lynnwood WA 98036
Rev. 1/2020
Submit completed hand-carried application packets to the Print and Mail Center in Mountlake
Terrace Hall. Request a receipt.
Print and Mail Center Hours: 7:00 am – 6:00 pm Mon – Thurs | 7:00 am – 5:00 pm Friday
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PRACTICAL NURSING APPLICATION
Rev. 1/2020
4
FALL 2020
APPLICATION
INSTRUCTIONS: PLEASE DOWNLOAD APPLICATION, OPEN AND FILL OUT, PRINT AND SIGN, SUBMIT COMPLETED APPLICATION WITH REQUIRED
DOCUMENTS.
EDMONDS CC STUDENT ID NUMBER:
DEMOGRAPHICS
Birth date
:
Month Day
Year
Email Address:
Last Name First Name Middle Initial
Previous Last Name(s)
Address Number and Street Apt. No.
City State
ZIP Code
Day Telephone No.
Evening Telephone No.
ACADEMIC HISTORY (if additional room is needed, attach another page)
Educational Institutions
Location
Years Attended
Graduated?
Name of last high school attended
City and State
From
To
Yes
No
Name of last college attended
City and State
Degree
Other college, university, vocational/technical school
attended:
City and State
Degree
Certifications/Licenses held
State Issued/ Expiration Date
License #
HEALTH CARE EMPLOYMENT (if additional room is needed, attach another page)
Name of previous employer
Position/Title
From
To
Phone #
Name of previous employer
Position/Title
From
To
Phone #
PREREQUISITES (please submit unofficial transcripts with application)
Common Course Number/Title
Where Completed
Term/Year
Grade
Did you repeat
the course?
BIOL& 241
Anatomy & Physiology I
BIOL& 242
Anatomy & Physiology II
ENGL& 101
English Composition I
MATH 087 or higher
Intermediate Algebra
PSYC& 200
Lifespan Psychology
Certification – Please read the following statements and sign in the space provided:
1.
I have reviewed the information on this form and I agree that it is complete and correct as stated.
2.
I am aware of the admission requirements and am aware that the admissions committee will review my file based on these requirements.
Student Signature
Date:
PRACTICAL NURSING APPLICATION
Rev. 1/2020
5
FALL 2020
PROFESSIONAL RECOMMENDATION FORM
(Page 1)
Applicant,
please make duplicate copies of this form to distribute to your references.
Do not submit separate letters of recommendation
(this
form is required)
. Complete Section A and then give this form to the person writing your recommendation along with an envelope addressed to
you.
Submit two sealed letters of recommendation with your application packet.
Recommender, document must be returned to the student by June 12, 2020.
A.
APPLICATION INFORMATION
(This section is to be completed by the applicant. Please print.)
Last Name
First Name
Middle Initial
Today’s Date
Previous Last Name(s)
Birth Date(Month/Day/Year)
Name of Recommender
Recommender’s Telephone Number
Address of Recommender
(City) (State and ZIP Code)
In what capacity have you
known the recommender?
Instructor Employer Supervisor
Other (please Specify)
According to the Family and Educational Rights and Privacy Act of 1974, as amended, students are guaranteed access to educational records concerning them, unless that
right is waived. Your signature below is optional; however, you (applicant) should check with the Recommender to ensure willingness to submit this form without the
guarantee of confidentiality.
I hereby waive any and all rights to inspect and review this recommendation, and I give my permission for this reference to remain confidential
between Edmonds Community College and the Recommender.
Signature of Applicant
Date
Recommender
, the applicant is seeking admission to the Practical Nursing program at Edmonds Community College. To help us assess the applicant’s
ability to successfully complete this program, we would appreciate your candid opinion regarding the qualities listed on this form. While we know it is
tempting to mark people with all superior ratings, it is rare that any individual is truly superior in every category. Please give us your honest
observations as we rely on these recommendations as a true assessment of the applicant's abilities.
Please return this form to the applicant signed
and sealed in the envelope provided to you by June 12, 2020.
Thank you,
PN Program Admissions Committee
B.
ACADEMIC HISTORY
(The following sections are to be completed by the Recommender.)
Recommender: Please respond to this academic section only if you have knowledge of the applicant’s academic history.
(circle one) Yes No N/A Please explain below: (feel free to include additional pages as necessary)
Does the applicant’s academic history indicate probable success in the Edmonds Community College Practical Nursing Program?
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PRACTICAL NURSING APPLICATION
FALL 2020
Rev. 1/2020
6
PROFESSIONAL RECOMMENDATION FORM
(Page 2)
C.
INFORMATION ABOUT APPLICANT
(Type X where it is applicable)
Check the appropriate rating based on your
evaluation of the applicant.
Superior
Above
Average
Average
Below
Average
Poor
Unable to
Evaluate
Integrity/Honesty/Judgement
Reliability
Clinical Competence
English Communication Skills: Written
English Communication Skills: Oral
Ability to Analyze Problems/Make Decisions
Ability to Follow Directions
Ability to Handle Stress/Conflict
Attitude/Behavior
Caring/Compassion
Cooperation/Teamwork
Initiative/Self Direction
Commitment to Ethnic and Cultural Diversity
D.
PLEASE GIVE EXAMPLES THAT ILLUSTRATE THE ABOVE CRITERIA
(use additional pages as necessary)
E. RECOMMENDATION FOR ADMISSION
I strongly recommend the applicant without reservation
I recommend the applicant
I do not recommend the applicant
F.
SIGNATURE
Signature of Recommender
Today’s Date
Printed Name of Recommender
Recommender’s Telephone Number
Title
Name of Organization
Address (Street)
(City)
(State and ZIP Code)
PRACTICAL NURSING APPLICATION
FALL 2020
7
EMPLOYMENT VERIFICATION FORM
Applicant,
please make duplicate copies of this form to distribute to your employer(s).
Do not submit separate letters from employers (this
form is required)
. Complete Section A, and then give this form to the person verifying your employment along with an envelope addressed to
you.
Submit sealed employment verification forms with your application packet.
Employer, document must be returned to the student by June 12, 2020.
A.
APPLICATION INFORMATION
(This section to be completed by the applicant. Please print.)
Last Name
First Name
Middle Initial
Today’s Date
Previous Last Name(s)
Birth Date (Month/Day/Year)
Name of Person Verifying Employment
Position
Facility/Employer(Street)
(City)
(State and ZIP Code)
In what capacity have you known the person verifying employment?
Supervisor Employer Human Resources Department Other (specify)
According to the Family and Educational Rights and Privacy Act of 1974, as amended, students are guaranteed access to educati onal records concerning
them, unless that right is waived. Your signature below is optional; however, you (applicant) should check with the Recommender to ensure willingness to
submit this form without the guarantee of confidentiality.
I hereby authorize my supervisor, employer, or the Human Resources department to release the information indicated below. Add itionally, I
release the issuing agency from all liability whatsoever for issuing the requested information.
Signature of Applicant
Date
To the supervisor, employer, or Human Resources Department:
The applicant is seeking admission to the Edmonds Community College Practical Nursing program. To help us assess the applicant’s ability to
successfully complete this program, we would appreciate your certification of employment.
Please return this form to the applicant signed and
sealed in the envelope provided to you by June 12, 2020.
Thank you,
PN Program Evaluation Committee
B.
EMPLOYMENT VERIFICATION
(This section is to be completed by the employer. Please print.)
Name of facility
Please list the following information regarding the employee indicated above:
Applicant’s Position
Dates of applicant’s employment/current status
Signature of Employer
Employer Printed Name and Position
Phone Number and/or Email where employer can be reached
Rev. 1/2020
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8
PRACTICAL NURSING APPLICATION
FALL 2020
COMPUTER SKILLS VERIFICATIONFORM
Name: Student ID Number:
We are looking for an HONEST ASSESSMENT of your computer skills. Please check boxes of skills ONLY in which you are PROFICIENT
KEYBOARDING EXPERIENCE
Successful completion of computer skills course
Proficiency with typing/keyboarding
WORD PROCESSING
Document Format
Name/open/save and close files
Copy, move, and delete files
Fundamentals of File Management
Set margins
Select fonts
Use bold and underlining
Use paragraph settings
Change line spacing
Create tables
Check spelling/grammar
Move/copy text
Create headers and footers
Create, save, and convert document in .pdf
format
SPREADSHEETS
Distinguish between cells, rows, and columns
Sort data, columns
Print spreadsheets
Create headers and footers
INTERNET USAGE
Use search engines
Downloading
Bookmarks
Research
Awareness of security/privacy issues
E-MAIL
Sending/receiving attachments
Use of appropriate language, grammar, etiquette
PRESENTATION SOFTWARE
Microsoft Power Point or equivalent
GOOGLE DOCS
Creating documents
Collaboration and sharing documents
ONLINE COURSE EXPERIENCE
Successful completion of online course
Experience with: (circle all that apply)
Blackboard, Angel, Moodle, Canvas
Please list any courses or online courses you have taken below:
Successful completion of computer skills course(s):
(Course Name and Number) (Qtr/Yr Taken)
(School)
(Credits/Grade)
Successful completion of online course(s):
(Course Name and Number) (Qtr/Yr Taken)
(School)
(Credits/Grade)
Student Signature
Date
This form must be submitted with the student’s application materials.
Rev. 1/2020
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Completed 4 February 2021

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