Two-year Associate Degree Nursing (ADN) Program RN Applicant Checklist

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Two-year Associate Degree Nursing (ADN) Program RN Applicant Checklist Application Deadline: March 1, 2018 to be considered for the two-year ADN program in Fall 2018. All admission requirements must be completed on or before March 1, 2018. The TEAS must be completed on or before February 17, 2018. If not admitted to the nursing program in Fall 2018 and you want to apply in the future, you must complete a new application packet. Application materials are not kept from one academic year to the next. Admission Requirement Checklist University of Pikeville Application for Admission (online). Complete a UPIKE application only if you are not a current UPIKE student. Submit an online application at: http://www.upike.edu/admissions/apply-to-upike. University of Pikeville Nursing Program Application Complete an application each admission year. Test of Essential Academic Skills (TEAS) with paid $55 fee (Refer to TEAS registration dates and fee.) Minimum TEAS score of 55 percent required. One retake allowed for those with less than 55 percent. Official transcripts of GED, high school, college/university and LPN coursework submitted to the University of Pikeville Office of Admissions. Composite score of 19 or higher on ACT or its equivalent. The highest subscores on the three most recent qualifying ACTs (i.e., 19+) are used for ranking. Those with current LPN license, a bachelor s degree or 10 or more years post-high school graduation may petition for ACT composite of 18. University/college GPA of 2.0 or higher. For high school seniors: Your high school transcript will be evaluated on GPA, rank, grades in science and math courses and attendance. No ranking points are awarded for high school courses. A minimum ACT composite of 18 will be considered only for: (a) LPNs with a current license; (b) those with a bachelor s degree; or (c) those that are 10 or more years post high school graduation and have at least 24 credit hours of college coursework with a cumulative GPA of 3.0. NOTES: 1. The only prerequisite courses for admission to the nursing program are completion of preparatory Math and English courses, if required by ACT or equivalent scores. 2. Courses in the major must be at least a C grade and only repeated one time. The grade on the second attempt, including W grades, may stand as the final grade. Transfer credit is subject to approval of the Registrar s Office. 3. Required science courses must be within the last 10 years. Otherwise, the science course must be repeated. 4. Any exception will be determined on an individual basis.

ADMISSION RANKING CRITERIA NOTE: DO NOT SUBMIT THIS FORM WITH YOUR APPLICATION. KEEP IT FOR YOUR REFERENCE. Applicants are ranked on a point system based on the following criteria. All applicants not selected in the first round may be placed on an alternate list. The alternate is notified as positions become available prior to the start of semester classes. Applicant s Name Date of Nursing Program Application Points for Ranking 1. ACT composite (most recent qualifying score); Date Tested The highest subscores on the three most recent qualifying ACTs are used for ranking. Those with current LPN license, a bachelor degree or 10+ years post-h.s. graduation may petition for ACT composite of 18. ENG 1 27+ =5 pts. 1 25-26=4 pts. 1 23-24=3 pts. 1 21-22=2 pts. 1 19-20=1 pt. 1 < 19= 0 pts. MTH 1 26+ =5 pts. 1 25=4 pts. 1 23-24=3 pts. 1 21-22=2 pts. 1 19-20=1 pt. 1 < 19= 0 pts. SCI 1 25+ =1 pt. 1 24 = ½ pt. 2. Grades in science courses (must be within the last 10 years) Grade on second attempt stands, including any grade with a W. One-half point is deducted if science course was, or needs to be, repeated. BIO 171 1 A=3 pts. 1 B=2 pts. 1 C=1 pt. 1 Repeat (- ½ pt.) Date Completed: BIO 172 1 A=3 pts. 1 B=2 pts. 1 C=1 pt. 1 Repeat (- ½ pt.) Date Completed: BIO 273 1 A=3 pts. 1 B=2 pts. 1 C=1 pt. 1 Repeat (- ½ pt.) Date Completed: 3. TEAS composite percentage Date Test #1 Date Test #2, if needed Minimum TEAS of 55 percent required. One retake allowed for those with less than 55 percent. 1 80+ =3 pts. 1 70-79=2 pts. 1 67-69=1.5 pt. 1 60-66=1 pt. 1 55-59=0.5 pt. 1 Repeat 4. Prior healthcare experience (Must submit proof of current certification or licensure) Licensed Practical Nurse (LPN) Certified, licensed, or registered in healthcare field (other than LPN) 1 2 pts. 1 1 pt. Title 5. 6. Bachelor s degree in any discipline with a cumulative GPA of 2.5 or higher 1 1 pt. BIO or CHEM courses with a B grade or higher may receive < 2 points on individual basis, only if there are no BIO 171, BIO 172 or BIO 273 course grades and no repeated or D courses. List course and grade here: TOTAL POINTS* *The nursing admissions committee reserves the right to further evaluate an applicant based on a review of all ACT and TEAS subscores, academic history, and professional behaviors. Reviewer Comments:

NURSING PROGRAM APPLICATION Completion of this nursing program application is one of the admission criteria to the Elliott School of Nursing s associate degree in nursing program. Please refer to RN applicant checklist and nursing brochure for a complete list of admission criteria to submit by the application deadline. All admission requirements must be completed on or before March 1, 2018. The TEAS must be completed on or before February 17, 2018. If not admitted to the nursing program in Fall 2018 and you want to apply in the future, you must complete a new application packet. Application materials are not kept from one academic year to the next. APPLICATION DEADLINE (readmission only) Nov. 1, 2017 for readmission to 2 nd or 4 th semester of the nursing program March 1, 2018 for admission consideration to Fall Semester 2018 Social Security Number: - - Date of Birth / / Name Last First MI/Maiden Address Number & Street/Route # or P.O. Box # City State Zip How can we contact you? Complete all that apply. Home phone number: ( ) - Mobile phone number: ( ) - Text: ( ) - E-mail: Person to be notified in case of emergency: Name Relationship Preferred phone number for emergency contact: In order of attendance, list the dates of high school (or GED diploma), vocational or LPN school, colleges and universities. If additional space is needed, please use reverse side. Official transcripts must be submitted from each institution attended. NAME OF INSTITUTION DATES ATTENDED DEGREE or MAJOR Are you currently enrolled at the University of Pikeville? o No oyes Have you taken the TEAS on one of the UPIKE scheduled test dates? No; not yet registered; No, but registered for (date): ; Yes, date taken: TEAS score of 55 percent is required. One retake allowed for those with less than 55 percent. Are you certified, licensed or registered in a healthcare field? o No o Yes If so, what is your title? Submit a copy of your certification and its expiration date with this application

You must complete the remaining essay and signature line. Type no more than a one-page essay which clearly states your reply to the two questions below (about two paragraphs single-spaced). Staple your essay to this application and submit by the deadline. Answer the questions below by stating the main reason why you want to become a nurse and an honest appraisal of why you should be admitted to the nursing program. This essay is read by a member of the nursing admissions committee. Its quality can have an influence on your final ranking points. 1. Why do you want to become a registered nurse? What meaning would it have for you to be a registered nurse? 2. Why should the NUR Admissions Committee admit you to the UPIKE nursing program? What strengths will you bring? Use examples if appropriate. The A.D.N. program has approval status from the Kentucky Board of Nursing (KBN). The KBN may delay or deny anyone who has been convicted of a felony or a misdemeanor from taking the nursing licensure examination. The university and affiliating agencies may require a criminal background check and drug screen. These agencies have the right to deny a student s clinical placement based upon findings of the criminal background check or drug screen. Should this situation occur, the school of nursing does not guarantee the student s placement in the nursing program or at an alternate site and the student may need to withdraw from the program. Progression in the nursing program is dependent on completion of required activities by deadline dates, adherence to nursing program policies, minimum standardized testing scores, completion of required remediation, C or higher grade in pre-/corequisite and nursing courses, and final Satisfactory rating in the clinical portion of nursing courses. It is the policy of the university that no student shall be excluded from participating in, be denied the benefits of, or be subjected to discrimination in any program sponsored by the university because of gender, race, religion, sexual orientation, age, handicap or national origin. Students with disabilities requiring accommodations should contact the Disabilities Resources Office located in the Student Services Counselor s Office. Accommodations are made on an individual basis according to documented need. I affirm that all information supplied in the application is complete and accurate. I understand that withholding or giving false information will result in my being ineligible for admission to the nursing program. My signature indicates my understanding of the statements on this application. Applicant s Signature Date The hardcopy of this Nursing Program Application is to be sent to: Elliott School of Nursing 147 Sycamore Street University of Pikeville Pikeville, KY 41501 Contact the Elliott School of Nursing at 606-218-5750 if additional information is needed.

TEST OF ESSENTIAL ACADEMIC SKILLS (TEAS) Registration Form Completion of this TEAS registration form with $55 non-refundable fee is one of the admission criteria to the Elliott School of Nursing s associate degree nursing program. The TEAS will only be administered on the dates listed below. The last regularly scheduled TEAS is Feb. 17, 2018. Seating is limited. Name: Last First MI/Maiden Address: Number & Street/Route # or P.O. Box # City State ZIP Contact (There must be a valid number to confirm, remind, or notify you of TEAS dates or changes): Primary Phone: ( ) - Alternate Phone: ( ) - Text: ( ) - To register for TEAS (Prepayment and Pre-Registration Required). NO CREDIT CARDS! Place a check mark next to the desired TEAS date. The TEAS fee is $55 (non-refundable). Make your check payable to the University of Pikeville. Mail or hand-carry this TEAS registration form and $55 payment prior to the registration deadline to: TEST DATE Elliott School of Nursing University of Pikeville 147 Sycamore St. Pikeville, KY 41501-1194 TEAS MUST be taken on one of the dates listed below. REGISTRATION DEADLINE AND $55 PAYMENT q Saturday, December 16, 2017 (9 a.m. 12:30 p.m.) December 13, 2017 q Saturday, January 6, 2018 (9 a.m. 12:30 p.m.) January 3, 2018 q Saturday, January 20, 2018 (9 a.m. 12:30 p.m.) January 17, 2018 q Saturday, February 3, 2018 (9 a.m. 12:30 p.m.) January 31, 2018 q Saturday, February 17, 2018 (9 a.m. 12:30 p.m.) February 14, 2018 *Feb 17 is the LAST scheduled TEAS. Please plan accordingly. If retesting needed, an alternate date will be scheduled. IMPORTANT INFORMATION ON TEAS EXAM The TEAS is taken once per admission year if you receive the cutoff score of at least 55 percent. With score less than 55 percent, one retake is allowed. You may repeat the TEAS on any date listed. You will be notified of your registration status when your registration form is received. The $55 fee is non-refundable. Walk-ons are not permitted. Valid picture identification is required. An information session on nursing program requirements, a review of the application process, and a question and answer period will take place on each TEAS date promptly at 9 a.m.