Fillable Petition for Entry Form Spring 2021 Semester ADN (Waukesha County Technical College)

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Petition for Entry Form Spring 2021 Semester ADN (Waukesha County Technical College)

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Petition for Entry Form
Spring 2021 Semester
ADN Core/Clinical Nursing Courses
Note: Only students who have applied to and have been officially admitted to WCTC’s Nursing
Program are eligible to petition. Please do not submit a petition if you have not been admitted.
WCTC Advising
800 Main Street; room C-021
Pewaukee, WI 53072
262.691.5400
Name: ID: Date:
Phone #: WCTC Student Email:
General Education Requirements
Grades of C or better indicate X if completed or IP if in progress:
Written Comm/English Comp I Microbiology
General Anatomy & Physiology Introduction to Psychology
Oral/Interpersonal Communication Introduction to Sociology
Advanced Anatomy & Physiology
Developmental Psychology
If marked“IP”, please indicate where you are taking the course.
If you are transferring in credits from another college, make sure the credits have been transferred by emailing transfercredit@wctc.edu.
Only WCTC transcripts are accepted for the petition process.
Written Documentation (submit ONLY requested documentation as indicated below). All items must be
completed to be considered for a seat. You may scan or submit a picture of these documents. Pictures must
be clearly visible.

Attach copy of your WCTC unofficial college transcript with required courses highlighted in marker
(Log onto MyWCTC Account, select link for “myWCTCaccount” > “Student Records” > “Unofficial Transcripts”)

Attach documentation of a completed Nursing Assistant Class.

Attach copy of NLN-PAX test results: MINIMUM score of 100 composite and 50 verbal, 2 attempt limit.
(Log onto MyWCTC Account, select link for “MyWCTCaccount” > “Student Records” > “View Test Scores”)
Petition Packet submission procedure:
The above documentation must be emailed to nursingpetitionsubmissions@wctc.edu between November 1- 14, 2020. This email
is for petition submissions only. No one will respond to messages sent to this email address.
Include your full name and ID in the subject line of the email.
No submissions will be accepted after November 14, 2020.
For office use only:
C or IP App. Date Accept Date
Priority admission will be given to current WCTC students who have completed all of the following
requirements by the end of fall 2020 term 1 and who have previously petitioned in the May 2020 petition
period. Students who are complete and are a direct transfer, will be placed on a waitlist. Candidates
who are in process with the following requirements are not guaranteed a seat. Selection will be made
based upon Admission date and seat availability. Those who are in progress with requirements will be
placed on a waitlist and notified of their status only if a seat becomes available.
Petition for Entry Form
Spring 2021 Semester
ADN Core/Clinical Nursing Courses
Please read and initial the following statements:
WCTC Advising
800 Main Street; room C-021
Pewaukee, WI 53072
262.691.5400
I understand that early, late or incomplete packets will not be considered.
If I am selected and choose not to begin taking the core/clinical nursing courses, my petition packet will be voided and I
MUST submit a new packet for future semesters.
I will be notified via WCTC Official Email on or before November 25, 2020 of my petition status. I understand that if I
am in progress with courses or a direct transfer student, I will be placed on a waitlist. I will be notified via WCTC official
email if a seat becomes available. I WILL NOT CALL OR EMAIL to inquire about my selection status prior to this date.
I must complete a Mandatory online orientation. Orientation will include information on using Viewpoint Screening to
upload Health and Safety Requirements for the program. This information will be found in my acceptance letter.
I understand that if for any reason I do not complete the mandatory Nursing Orientation as stated above or
adhere to deadlines in the acceptance letter, I will not be able to begin nursing core classes. I will need to
resubmit a new petition for a subsequent semester.
I will need to have an acceptable Criminal Background Check before starting core/clinical nursing courses. This will
be completed through Viewpoint Screening.
___ I will upload documentation of Student Health and Safety Requirements to Viewpoint Screening by January 15, 2021.
Please refer to the Nursing Petition FAQ on the nursing program webpage for a list of these requirements.
______ I will upload documentation of an up to date American Heart Association BLS CPR Certification to Viewpoint Screening
by January 15, 2021. No other CPR or outdated certifications will be accepted for this requirement.
I will need to fill out a form verifying that I can perform the technical standards required of a nurse. This will be completed
through Viewpoint Screening.
If I am accepted into core/clinical nursing courses and agree to enroll, a permit will be placed on my account so that I
may register on December 4, 2020. I must register for the indicated core nursing courses no later than December
22, 2020. If I choose not to enroll, after I have accepted the placement, I am required to notify the WCTC Nursing
Department, 262.691.5579, at least one week prior to the start of classes. If I fail to notify the WCTC Nursing
Department or drop the first week of courses I will be ineligible to petition for the following semester. I will be
eligible to petition for future semesters.
Student signature: Date:
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Petition for Entry Form Spring 2021 Semester ADN (Waukesha County Technical College)

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Completed 10 October 2020

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