DEPARTMENT OF HEALTH PROFESSIONS (RN) NURSING APPLICATION PACKET FOR FALL 2017 APPLICANTS Name: Contact Number: Applying to the nursing program at Lawson State is a competitive process and is based on set criteria. Students are ranked and selected based on their academic achievements and compete against other applicants. Thus, meeting minimum qualifications does not guarantee acceptance. We wish all students success in applying for the program. Please select ONE of the following: Birmingham Campus Fall Day Note: If applying to the Birmingham Campus return your application to the Ethel Hall Health Professions Building on the Birmingham East Campus Bessemer Campus Fall Evening Note: If applying to the Bessemer Campus return your application to the A Building room 110 on the Bessemer Campus. Fall 2017 Application Deadline: June 1, 2017 (by 5:00 CST). **Faxed and/or emailed applications will NOT be accepted** It is the policy of the Alabama Community College System and Lawson State Community College, a postsecondary institution under its control, that no person shall, on the grounds of race, color, sex, religion, national origin, disability or age, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program, activity, or employment.
Today s Date: THE ALABAMA COMMUNITY COLLEGE SYSTEM Lawson State Community College NURSING PROGRAM APPLICATION APPLICATION DEADLINE FOR 2017 ADMITTANCE: June 1, 2017 by 5:00 pm (CST) I. PERSONAL DATA (PLEASE PRINT) Last Name: First: MI: Maiden: Social Security Number/ID Number: Mailing Address: City: State: Zip Code: Telephone: Cell Phone: E-mail address: II. EDUCATION High School Graduation Year: High School Name: GED (if applicable): Date completed: Are you currently taking college courses? Yes No If yes, what college List ALL colleges attended and the year (s) attended: Unofficial copies of EACH transcript, including your LSCC transcript, MUST be attached to this application regardless if official is on file with admissions. NO ACCEPTIONS. Have you ever participated in academic dishonesty (cheating) and have been disciplined for such an offense at a previous college? Yes No If yes, name the institution Have you previously been admitted to a Nursing Program? Yes No If yes, state reason for withdrawal. Do you hold a current Alabama LPN license? Yes No Have you taken the ACT or ACT Residual Test more than TWICE within a 12 month period? Yes No If yes, list all test dates:. Please note that the institution will not consider more than TWO ACT test results in one calendar year. The highest of the two will count. NOTE: ACT score must be 18 or higher. An official ACT Transcript must be submitted to the Office of Admissions and received and a copy of the report must be attached to this application. Failure to provide the Admissions Office (by this application deadline) with your official ACT transcript or not attaching your ACT scores to this application will disqualify your application.
III. IV. Attach the following to this application. Check off each block indicating that you have attached all documents. Unofficial copies of High School (only if you have no college courses completed) and College Transcripts from ALL colleges attended (including Lawson State, if applicable), must be attached for consideration (regardless if our Admissions Office has officials). Transcripts must be attached at the time of submitting application; failure to attach all transcripts will disqualify your application. Copies of ACT scores (Submit official ACT Transcripts to the Admissions Office prior to making application). Failure to contact ACT testing services and have your ACT Transcripts sent to Lawson State s Admission office by the application deadline, will disqualify your application. Official ACT Transcripts must be on file in the Admission Office and a copy of that report must be submitted with this application. Again, failure to do both will disqualify the applicant. Check the box below indicating that you have read the attached Essential Functions listing and confirm that, if accepted into the program, you can fulfill all the required Essential Functions. I have read the Essential Functions and confirm that I CAN carry out all functions as described. I have read the Essential Functions and would like to reveal that I CANNOT carry out the Essential Functions. If you CANNOT carry out the Essential Functions, please explain in detail below. If more space is needed, please type out a statement and attach it to this application. Label it: Essential Functions Admission to the nursing program is competitive, and the number of students is limited by the college. Meeting minimal requirements does not guarantee acceptance. Your signature below indicates that you have been truthful in completing this application, and it also indicates that you are fully aware that meeting minimal admission requirements does not guarantee program acceptance. Minimum admission standards include: 1. Unconditional admission to the college and current active admissions status. 2. Receipt of completed application for the nursing program by stated deadline. 3. A minimum of 18 ACT composite score, National or Residual, regardless of academic history and/or degrees. 4. A minimum of 2.5 GPA for nursing required academic core courses. 5. A minimum of 2.5 GPA cumulative high school GPA for students without prior college courses. (GED courses will be used if applicable) 6. Nursing applicants must be Eligible for English 101, Biology 201 and Math 100 or Higher. 7. Good standing with college. 8. Meeting the essential functions required for nursing. I have read the supplemental CHECK LIST provided in this packet and understand that it is my responsibility to submit required documentation with this application as well as be currently active and/or unconditional accepted through Admissions. I understand that completion of this application is a component of the student profile and does not in itself grant admission to the nursing program. I understand this application must be updated if I am not selected. I certify that the information given in this application is true and correct. I understand that providing false information may be deemed sufficient reason to dismiss the student and/or refuse admission. Applicant s Signature Date Please return to: Birmingham Day Applicants: Bessemer Evening Applicants: Lawson State Community College Lawson State Community College Bessemer Campus Attn: Department of Health Professions Attn: Department of Health Professions 3060 Wilson Road 1100 9 th Ave SW Birmingham, AL 35221 Bessemer, AL 35022 (205) 929-6329 (205) 929-3461 Note: Applications must be returned to the campus to which you are applying. *Faxed and/or emailed applications will NOT be accepted. If applying to Bessemer please return to Bessemer and if applying to Birmingham please return to Birmingham. **However, applicants to the Day program (if accepted) are not guaranteed admission to the requested campus.
NURSING PROGRAMS ESSENTIAL FUNCTIONS The Alabama Community College System endorses the Americans' with Disabilities Act. In accordance with College policy, when requested, reasonable accommodations may be provided for individuals with disabilities. Physical, cognitive, psychomotor, affective and social abilities are required in unique combinations to provide safe and effective nursing care. The applicant/student must be able to meet the essential functions with or without reasonable accommodations throughout the program of learning. Admission, progression and graduation are contingent upon one's ability to demonstrate the essential functions delineated for the nursing programs with or without reasonable accommodations. The nursing programs and/or its affiliated clinical agencies may identify additional essential functions. The nursing programs reserve the right to amend the essential functions as deemed necessary. In order to be admitted and to progress in the nursing program one must possess a functional level of ability to perform the duties required of a nurse. Admission or progression may be denied if a student is unable to demonstrate the essential functions with or without reasonable accommodations. The essential functions delineated are those deemed necessary the Alabama Community College System nursing programs. No representation regarding industrial standards is implied. Similarly, any reasonable accommodations made will be determined and applied to the respective nursing program and may vary from reasonable accommodations made by healthcare employers. The essential functions delineated below are necessary for nursing program admission, progression and graduation and for the provision of safe and effective nursing care. The essential functions include but are not limited to the ability to: 1) Sensory Perception a) Visual i) Observe and discern subtle changes in physical conditions and the environment ii) Visualize different color spectrums and color changes iii) Read fine print in varying levels of light iv) Read for prolonged periods of time v) Read cursive writing vi) Read at varying distances vii) Read data/information displayed on monitors/equipment b) Auditory i) Interpret monitoring devices ii) Distinguish muffled sounds heard through a stethoscope iii) Hear and discriminate high and low frequency sounds produced by the body and the environment iv) Effectively hear to communicate with others c) Tactile i) Discern tremors, vibrations, pulses, textures, temperature, shapes, size, location and other physical characteristics d) Olfactory i) Detect body odors and odors in the environment 2) Communication/ Interpersonal Relationships a) Verbally and in writing, engage in a two-way communication and interact effectively with others, from a variety of social, emotional, cultural and intellectual backgrounds b) Work effectively in groups c) Work effectively independently d) Discern and interpret nonverbal communication e) Express one's ideas and feelings clearly f) Communicate with others accurately in a timely manner g) Obtain communications from a computer 3) Cognitive/Critical Thinking a) Effectively read, write and comprehend the English language b) Consistently and dependably engage in the process of critical thinking in order to formulate and implement safe and ethical nursing decisions in a variety of health care settings c) Demonstrate satisfactory performance on written examinations including mathematical computations without a calculator d) Satisfactorily achieve the program objectives 4) Motor Function a) Handle small delicate equipment/objects without extraneous movement, contamination or destruction b) Move, position, turn, transfer, assist with lifting or lift and carry clients without injury to clients, self or others c) Maintain balance from any position d) Stand on both legs e) Coordinate hand/eye movements
f) Push/pull heavy objects without injury to client, self or others g) Stand, bend, walk and/or sit for 6-12 hours in a clinical setting performing physical activities requiring energy without jeopardizing the safety of the client, self or others h) Walk without a cane, walker or crutches i) Function with hands free for nursing care and transporting items j) Transport self and client without the use of electrical devices k) Flex, abduct and rotate all joints freely l) Respond rapidly to emergency situations m) Maneuver in small areas n) Perform daily care functions for the client o) Coordinate fine and gross motor hand movements to provide safe effective nursing care p) Calibrate/use equipment q) Execute movement required to provide nursing care in all health care settings r) Perform CPR and physical assessment s) Operate a computer 5) Professional Behavior a) Convey caring, respect, sensitivity, tact, compassion, empathy, tolerance and a healthy attitude toward others b) Demonstrate a mentally healthy attitude that is age appropriate in relationship to the client c) Handle multiple tasks concurrently d) Perform safe, effective nursing care for clients in a caring context e) Understand and follow the policies and procedures of the College and clinical agencies f) Understand the consequences of violating the student code of conduct g) Understand that posing a direct threat to others is unacceptable and subjects one to discipline h) Meet qualifications for licensure by examination as stipulated by the Alabama Board of Nursing i) Not to pose a threat to self or others j) Function effectively in situations of uncertainty and stress inherent in providing nursing care k) Adapt to changing environments and situations l) Remain free of chemical dependency m) Report promptly to clinicals and remain for 6-12 hours on the clinical unit n) Provide nursing care in an appropriate time frame o) Accepts responsibility, accountability, and ownership of one's actions p) Seek supervision/consultation in a timely manner q) Examine and modify one's own behavior when it interferes with nursing care or learning Upon admission, an individual who discloses a disability can request reasonable accommodations. Individuals will be asked to provide documentation of the disability in order to assist with the provision of appropriate reasonable accommodations. The respective College will provide reasonable accommodations but is not required to substantially alter the requirements or nature of the program or provide accommodations that inflict an undue burden on the respective College. In order to be admitted one must be able to perform all of the essential functions with or without reasonable accommodations. If an individual's health changes during the program of learning, so that the essential functions cannot be met with or without reasonable accommodations, the student will be withdrawn from the nursing program. The nursing faculty reserves the right at any time to require an additional medical examination at the student's expense in order to assist with the evaluation of the student's ability to perform the essential functions. The Rehabilitation Act of 1973 (Section 504) and the American with Disabilities Act of 1990 state that qualified students with disabilities who meet the essential functions and academic requirements are entitled to reasonable accommodations. It is the student s responsibility to provide appropriate disability documentation to the College. Any student who feels s/he may need an accommodation based on the impact of a disability should contact or visit one of the college's ADA counselors to coordinate reasonable accommodations, if a documented disability exist. Contact Dr. Renay Herndon in the Office for Disability Services at 205-929-3419 (on the Bessemer Campus) or Mrs. Janine McCoy Jones at 205-929-6396 (on the Birmingham campus). Or, you can visit the college's website and request a meeting online. To do so, go to www.lawsonstate.edu and click on the Student Services blue tab. Then, click on Disability Services (ADA) link and the Meet & Contact ADA Counselor link. ADA Office locations: Bessemer Campus: A-Building, 1 st floor, Student Services wing. Visit the Information Desk to see an ADA Counselor. Birmingham Campus: Leon Kennedy Building, 2 nd floor. Visit the SPACE Center to see an ADA Counselor.
LAWSON STATE COMMUNITY COLLEGE DEPARTMENT OF HEALTH PROFESSIONS NURSING PROGRAM Applicant Point System Calculation of Points for Students Meeting Minimum Admission Standards: Ranking Scores Calculated as Follows: 1. ACT or ACT Residual Test Maximum 36 Note: ACT or ACT Residual score must be at least an 18 to be considered. We will accept up to TWO ACT/ACT Residual Scores and there is no expiration on scores. ACT Residual Test MUST be taken at an Alabama Community College and the tests cannot be taken within 60 days of each other. ACT Residual scores from any institution outside of the Alabama Community College System WILL NOT BE ACCEPTED. **Be sure to check with WWW.ACT.ORG for dates, details and restrictions. 2. Selected Coursework Maximum 12 Points for grades in selected college course work are awarded as follows: A = 3 Points, B = 2 Points, C = 1 points in the following courses: Grade Points ENG 101 English Composition MTH 100 or Higher Level BIO 201 Anatomy & Physiology I BIO 202 Anatomy & Physiology II Repeated Courses (second attempt): Points for second attempt course work (repeated courses) are awarded as follows: A = 1.5 Points, B = 1 Points, C =.5 points A second attempt is determined based on whether or not the course has been repeated due to failure or withdrawal from the course. Repeating a course (within 48 months of making application) that has already been passed (with a grade of C or better) is also considered a second attempt and will be assessed accordingly. A = 1.5 Points, B = 1 Points, C =.5 points. Repeating a course after 49 months is not considered a repeat course. As a result, students will be assessed under the normal point scale: A = 3 Points, B = 2 Points, C = 1 NOTE: See Repeated Course Appeal Process information if you withdrew or failed a course due to a devastating situation/emergency that impacted your life at the time and led to the failure or withdraw. The Selection Committee does have a review process that will consider your case. If the complete appeal is approved internally, the course will count for the full points. A = 3 Points, B = 2 Points, C = 1. Keep in mind, though, that complete appeals are not guaranteed (to be approved) and are reviewed on a case-by-case basis only and judged by their legitimacy and worthiness only.
3. Additional points Maximum 10 The points will be awarded as follows: HPS 103 Foundation Competencies for Health Science A = 7 Points B = 4 Points C = 2 Points D/F = 0 Points MTH 186 Dosage Calculations A = 3 Points B = 2 Points C = 1 Points D/F = 0 Points Grade Points HPS 103 Foundation Competencies for Health Sciences MTH 186 Dosage Calculations Total Points Awarded Earned Maximum Possible 1 ACT Score 36 Selected Course 2 12 Work 3 Additional Points 10 Total 58 NOTE: You may use this chart to help you calculate your potential points. This is for your records and does not have to be submitted with your nursing application.
Repeated Course Appeal Packet Appeals Must Be Submitted at the Time of Application Late Appeals will not be accepted Page 1 0f 2 Under what circumstances do you use this form? If you failed or withdrew from English 101, Math 100 (or higher), Biology 201, or Biology 202 due to some catastrophic event (i.e., extended hospitalization, major accident, etc ) that was beyond your control, you may consider completing this appeal process. In that way, the committee can better determine if the failure or withdrawal was due to academic reasons or other reasons beyond the student s control. Each appeal is weighed, judged and assessed and approved or disapproved on a case-by-case basis. There are no guarantees and individuals completing an appeal should not feel that by simply completing this process will guarantee approval. It does not. Every case and every circumstance is different. What happens if my appeal is approved? If your appeal is approved, the Committee will award the course you are appealing with the full credit of points (A - 3, B - 2, C - 1). If your appeal is not approved, the Committee will award your course with the standard repeat points (A 1.5, B - 1, C -.5). Will the decision be shared with me? The Selection Committee does not send that information out because the selection process is a private process. However, if you would like to find out at a later date, you can always make an appointment to meet with the Associate Dean of Nursing. During that time, full disclosure of the Committee s decision regarding your appeal will be shared with you. The Associate Dean will only discuss whether or not the appeal was granted. No discussion beyond that will be permitted. This should be a fact-finding mission on your part only. Students are only eligible for one appeal per application process. Several appeals will not be considered. PLEASE CAREFULLY REVIEW THE INSTRUCTIONS ON THE SECOND PAGE AND BE SURE TO SUBMIT A COMPLETE APPEAL WITH SUPPORTING DOCUMENTATION WITH YOUR NURSING APPLICATION. Failure to do so will void your appeal automatically. SEE NEXT PAGE
Page 2 0f 2 APPEAL PACKET (MUST BE COMPLETE AND SUBMITTED AT THE TIME OF APPLICATION) PART I: Student Information Name: What repeated course you would like to appeal: What is the name of the instructor who taught the course: Where did you take this course (institution)? PART II: Appeal Information (please attach appeal will not be considered without supporting documentation) 1. Submit a 1000-1500 word justification of the appeal. The justification must be typed, double-spaced (use Times Roman font, 12 pt. only). In your description of the situation, outline for the committee the circumstances which you believe were catastrophic enough that caused you to withdraw or fail your course. 2. Attach evidence that supports your claim. Failure to provide evidence of your claim will void your appeal automatically. Please note that evidence submitted can and will be reviewed and double-checked for authenticity. Submitting false claims to the Committee will automatically disqualify you from entering the program. 3. Attach a statement from the instructor who can vouch for your situation. Statements must be written by the instructor and signed. If the instructor is not a Lawson State instructor, the instructor must provide contact information so the Committee can reach him or her for follow-up call if they have any. If you cannot provide this statement, skip this section and submit your appeal without the support of the instructor. If you have any questions, as it relates to the appeal process, please email nursingquestions@lawsonstate.edu. NOTE: All appeals are judged based on a standard rubric of assessment.
LAWSON STATE COMMUNITY COLLEGE DEPARTMENT OF HEALTH PROFESSIONS STANDARD ASSOCIATE DEGREE NURSE CURRICULUM 2017-2018 First Term Course Theory Lab Clinical Credit Contact MTH 100 or higher 3 - - 3 3 BIO 201 Human Anatomy and Physiology I 3 1-4 5 NUR 102 Fundamentals of Nursing 3 2 1 6 12 NUR 103 Health Assessment - 1-1 3 NUR 104Introduction to Pharmacology - 1-1 3 Term Total 9 5 1 15 26 Second Term Course Theory Lab Clinical Credit Contact English ENG 101 3 - - 3 3 BIO 202 Human Anatomy and Physiology II 3 1-4 5 NUR 105 Adult Nursing 5 1 2 8 14 NUR 106 Maternal and Child Nursing 4-1 5 7 Term Total 15 2 3 20 29 Third Term Course Theory Lab Clinical Credit Contact PSY 200 Psychology 3 - - 3 3 BIO 220 Microbiology 2 2-4 6 NUR 201 Nursing Through the Lifespan I 3-2 5 9 Term Total 8 2 2 12 18 Fourth Term Course Theory Lab Clinical Credit Contact Speech SPH 106 or SPH 107 or SPH 116 3 - - 3 3 PSY 210 Human Growth and Dev 3 - - 3 3 NUR 202 Nursing Through the Lifespan II 3-3 6 12 Term Total 9-3 12 18 Fifth Term Course Theory Lab Clinical Credit Contact Humanities Elective 3 - - 3 3 NUR 203 Nursing Through the Lifespan III 4-2 6 10 NUR 204 Role Transition for the Registered Nurse (Preceptor 3:1) 2-2 4 8 Term Totals 9-4 13 21 Note: Please be advised that Financial Aid will not cover (pay) the tuition of courses that students have already taken and have passed. Therefore, if students wish to retake a course that they received an "A", "B", "C" or "D" in, they can do so, but they will have to pay for the course themselves. Note: The federal government views a grade of "D" as passing, but not Lawson State. Students who receive a "D" in classes are required to retake the course as part of their degree requirements. However, Financial Aid will not be applied. Program Totals: Total Credit Hours: 72 Hours Total Contact Hours: 1680 General Education: 30 Hours Nursing Hours: 42 Hours
LAWSON STATE COMMUNITY COLLEGE Department of Health Professions Associate Degree Nursing Estimated Cost Term I: Term II: Term III: Term IV Term V Level I Tuition (15x$120) 1,800.00 Facility Renewal Fee (15x$9) 135.00 Technology Fee (15x$9) 135.00 Special Bldg Fee (15x$10) 150.00 Student Insurance 10.00 Liability Insurance 16.00 Testing Fee 160.00 Background and Drug Screening Fee 110.00 Books and Instructional Packets 700.00 Blood Pressure Cuff/Stethoscope, Pen Light, Scissors, & Thermometer 60.00 *Uniforms 70.00 Lab Coat 36.00 Name Pin 6.00 (Depending on uniform cost) $ 3,388.00 Tuition (20X$120) 2,400.00 Facility Renewal Fee (20X$9) 180.00 Technology Fee (20X$9) 180.00 Special Bldg Fee (20x$10) 200.00 Student Insurance 10.00 Testing Fee 315.00 Books & Instructional Packets 400.00 $ 3,685.00 Level II Tuition (12X$120) 1,440.00 Facility Renewal Fee (12X$9) 108.00 Technology Fee (12X$9) 108.00 Special Bldg Fee (12x$10) 120.00 Student Insurance 10.00 Liability Insurance 16.00 Testing Fee 315.00 Background and Drug Screening Fee 80.00 Books & Instructional Packets 200.00 $ 2,397.00 Tuition (12X$120) 1,440.00 Facility Renewal Fee (12X$9) 108.00 Technology Fee (12X$9) 108.00 Special Bldg Fee (12X$10) 120.00 Student Insurance 10.00 Testing Fee 150.00 Books & Instructional Packets 300.00 $ 2,236.00 Tuition (13X$120) 1,560.00 Facility Renewal Fee (13X$9) 117.00 Technology Fee (13X$9) 117.00 Special Bldg Fee (13x$10) 130.00 Student Insurance 10.00 Testing Fee 315.00 Books & Instructional Packets 300.00 Graduation Fee 75.00 $2,624.00 Total for 5 Semesters $14,330.00 Additional costs associated with State Licensure **State Board Application Fee 85.00 **NCLEX RN Test Fee 200.00 Temporary Permit Fee (If desired) 50.00 Total $ 335.00 *The cost of the uniform will depend on your preference for a pant suit or dress. There is an additional charge for extra large and extra tall uniforms **These expenses are those that are necessary to write the State Board exam and become licensed in the state of Alabama. Note: These costs do not include the cost of CPR course, medical exam and immunizations, watch, stockings/hose, or nursing shoes. Costs are based on prices in affect as of 08/01/2017, and may change without notice. Prices do not include sales tax, when applicable. Prices are subject to change without prior notice.