*This application is for NEW applicants who do NOT currently possess an RN waitlist number and who are not in our current LVN program* A completed application packet needs to be turned in to the Health Sciences Department (Room M132) no later than June 30 th, 2017 including mailed applications. Incomplete applications received after June 30 th, 2017 will not be considered. If the office is closed, you may slide your application packet under the door. INFORMATION SECTION Dear Prospective Registered Nursing Student: Thank you for your interest in our registered nursing program commencing in January. To be considered for the RN program waitlist, you must meet the following requirements by June 30 th : 1. Submit a completed RN program application (attached) to the Health Sciences office located at the Allan Hancock College, 800 South College Drive, Room M 132, Santa Maria, CA 93454. The RN program application must be received by June 30 th. 2. Be currently licensed through the Board of Vocational Nursing and Psychiatric Technicians as a California Licensed Vocational Nurse. You must turn in a current copy of your California LVN license with this application. 3. Candidates must sign up, pay for and take the merit based admissions test (dates in this packet). You must turn in your receipt with your completed packet before the test date. Please be sure that the date you sign up for and the date you turn in your completed packet are at least 24 hours in advance. 4. Academic prerequisites must be completed and grades must be posted (letter grade of C or better). Needs to be transcribed through AHC before AHC unofficial transcripts can be turned in: Biology 124 - Anatomy with lab Biology 125 - Physiology with lab Biology 128 Microbiology with lab English 101 - Freshman Composition: Exposition Math 331 Algebra 2 Psychology 101 Introduction to Psychology 5. You must be one of the following: a U.S. high school graduate or have your GED (General Educational Development) or CHSPE (California High School Proficiency Examination) or the equivalent. First time applicants will need to turn in an Official U.S. high school transcript, GED or CHSPE with this application. Copies WILL NOT be accepted. DON T WAIT. It may take a month or more for your transcript(s) to arrive. Please request that your transcripts be annotated with the last four digits of your social security number if it is not already a part of the record or write it on the envelope. 6. U.S. College/University/Military Transcripts First time applicants will need to turn in Official transcripts from all colleges/universities attended to Admissions & Records when applying for admission to the college, even if you withdrew prior to application process. Students must ALSO turn in an official transcript(s) with the completed application packet to Health Sciences. All college coursework must show completion at time of application; no in progress courses will be accepted. Failure to submit all transcripts will result in applicant disqualification. DON T WAIT. It may take several months for your transcripts to arrive. Please request that your transcripts be annotated with the last four digits of your social security number if it is not already a part of the record or write it on the envelope. 1
6. Foreign High School/College/University Transcripts If you graduated from a high school in a foreign country, check with the counseling office to see if it is considered equivalent to graduation from high school in the United States. If the high school is not equivalent, you will need to submit proof of passing the GED. Evaluation by an outside agency, at your expense, may be required if equivalency is in doubt. College/university transcripts will be accepted if evaluation reports have been certified by NACES (National Association of Credential Evaluation Services) & AICE (Association of International Credential Evaluators). Completed coursework will be considered for lower-division unit credit ONLY if the foreign institution is listed in the American Council on Education (ACE) Book. If you are submitting COLLEGE/UNIVERSITY transcripts, make sure that the evaluation is Detailed or Comprehensive and that it include the following items: Name of the Institution, dates attended, degrees earned, and graduation dates Course/Subject Level Identification (lower and upper division, etc.) Overall Grade Point Average List the semester unit value and grade equivalencies *The official transcript must be mailed to: Allan Hancock College, Attn: Transcript Evaluator, 800 S. College Drive, Santa Maria, CA 93454 You may also walk your transcripts in personally to Admissions & Records. * 7. Merit based admission criteria: All Registered Nursing applicants need to pass the merit based admission test, in addition to: complete all prerequisite courses and ADN requirements. Screening of applications will include looking at overall GPA, number of science repetitions (Anatomy, Physiology and Microbiology), and score obtained on the merit based admissions test. Any student with more than 4 attempts in any of the three science pre-requisite courses is ineligible to apply for the Allan Hancock College ADN program. *AHCRN = 1.181 (Cumulative GPA) + 0.160 (Merit Based Admission Test) 0.568 (Core Biology Repetitions)* For your convenience, the merit based admission criteria table is available on the nursing webpage (http://www.hancockcollege.edu/academic_departments/health_sciences/nursing/rn.php). Each new applicant has two attempts to successfully meet the admission criteria for the Allan Hancock College RN program. The first attempt is at the initial application. If the new applicant does not meet the criteria (cut score) on their first attempt for admission, the new applicant must meet with the Program Director (or designee) to develop an individualized remediation plan no sooner than October 1 st. The remediation plan will need to be completed prior to the following year application period. 8. Merit Based Admissions Test: All new applicants are required to take the merit based admissions test as part of the application process for the Allan Hancock College Registered Nursing Program. Students will only need to take the exam once. Students will only be allowed to retest one time (if they fail) at their own expense. The cost of the entrance exam is $50.00. A. Test Dates and Times (No other test dates will be scheduled) Dates are limited to 30 students. Tuesday, May 23, 2017; 10:00am-2:00pm Thursday, June 22, 2017; 10:00am-2:00pm B. Registration Instructions and Payment Information Complete merit based admissions form (attached) Pay at the cashier s office in Bldg. A. Must present ID and have a AHC student ID H number. Make a copy of the form and receipt and turn in with this application. C. Day of Test - The PN Predictor is 180 minutes (3 hour) test that will be held in the computer lab (M-116). You will need to bring: Valid picture ID (Driver s license, Passport, Military ID) Copy of test registration (and receipt) Scratch paper and pencil (if you desire) Paper will be turned in at the end of the test NO Calculators *Any student with more than 4 attempts in the science pre-requisite courses is unable to apply to the Allan Hancock College ADN program. 2
9. Seating Procedure and RN Priority Seating Students seated in the current LVN program at Allan Hancock College who have completed the following requirements by June 30, 2017 will be eligible for RN priority placement in the 2018 RN class: All RN pre-requisites ADN & BRN degree Requirements (speak with a counselor for specifics x3285) All Registered Nursing applicants need to meet merit based admission requirements in addition to prerequisite courses. Applicants with military education and experience related to the practice of nursing may have priority into the RN program (limited spots per year). Refer to the website for more information and requirements. Qualified new candidates completing other VN programs and qualified LVN applicants from the community will be considered for the remaining seats in the program via the waitlist. Subsequent classes will be filled as indicated above from the AHC LVN class and then from the wait list. New applicants waitlist number is assigned through a computerized random selection (lottery) process and placed at the end of the current waitlist. 10. Once accepted into the program, all students are required to have a physical (forms will be emailed in November prior to the start of the RN program), immunization records (up-to-date), current CPR certification that must be maintained by the student throughout the nursing program. Only American Heart Association Healthcare Provider or American Red Cross Professional Rescuer cards will be accepted. Documentation will be required for the following immunizations: Tuberculin skin test (expires annually on date given). Positive PPD requires a standard negative chest film with medical consultation. (expires every 2 years) Diphtheria, Pertussis, and Tetanus Toxoid (DPT) Measles, Mumps, Rubella (MMR) Hepatitis B Vaccine: Varicella (chicken pox) Flu Allan Hancock College Health Sciences office is NOT responsible for lost or misdirected applications. Please photocopy your whole packet and hand deliver or send original by certified mail via U.S. Postal Service to: Allan Hancock College ATTN: Health Sciences Office, M 132 800 South College Drive Santa Maria, CA 93454-6399 (805) 922-6966, ext. 3384 It is the responsibility of the applicant to notify Allan Hancock College Health Sciences office, in writing, of any changes in candidate status, address, or phone number. Copies of all required documents and documentation of mailing should be kept in case that proof of completion by the filing deadline is needed. Applications received in the office after June 30 th will not be considered. IMPLICATIONS FOR NURSING LICENSURE BY A STATE REGULATORY BODY Please note that fingerprinting is required for licensure as a California Registered Nurse. Persons who have been convicted of a felony are subject to close scrutiny by the Board of Registered Nursing on an individual basis. The board may refuse to issue a license even after successful completion of the NCLEX-RN if a background check reveals a significant infraction. Specific policy regarding procedures of the Board of Registered Nursing is available from that Board. Call (916) 324-2815. Should you have any questions or concerns about such policy, do not hesitate to contact the Health Sciences office at (805) 922-6966, ext. 3384. 3
REGISTERED NURSING PROGRAM ESTIMATED STUDENT FEES Pre-Enrollment Expenses PHYSICAL EXAM private physician IMMUNIZATIONS Hep B Series, Varicella, DPT, MMR, Flu Vaccine, TB Variable Cost Variable Cost BACKGROUND CHECK Corporate Screening $48.00 DRUG SCREENING Roblar $30.00 AHC STUDENT ID CARD WITH PICTURE $2.00 CPR CARD CPR for healthcare providers EMS 306 (½ unit) + $4 material fee + $15 textbook (AHC) $42.00 (AHC) Merit based admissions test New applicants from outside our LVN program $50.00 SKILLS KIT $85.00 (est.) IDENTIFICATION NAME PIN $6.00 UNIFORM (One Set (Patch, Pants, Shirt, Shoes) $150.00 (est.) WATCH (Not digital, must have seconds hand) $30.00 STETHOSCOPE (Prestige Medical/Littman s recommended) $30.00 ANEROID SPHYGMOMANOMETER (Prestige Medical/Littman s recommended) $30.00 COMPUTER INTERNET (Mandatory)/PRINTING SUPPLIES $150.00 (est.) Total is estimated excluding variable costs $650.00 Spring Semester TUITION (13.5 units @ $46/unit) $575.00 PARKING $20.00 HEALTH FEE, STUDENT CENTER FEES PLUS STUDENT REPRESENTATION FEE ($19+$10+$1) $30.00 REQUIRED SPRING TEXTBOOKS $500.00 (est.) MISCELLANEOUS SUPPLIES flash drive, notebooks, pens, paper, scissors, etc $200.00 Total is estimated $1325.00 Fall Semester TUITION (12.5 units @ $46/unit) $621.00 PARKING $20.00 Health Fee, Student Center fees plus student representation fee ($19+$10+$1) $30.00 REQUIRED FALL TEXTBOOKS $250.00 (est.) PRECEPTORSHIP COSTS (estimated transportation / gas costs) $200.00 MISCELLANEOUS SUPPLIES flash drive, notebooks, pens, paper, etc $100.00 Total is estimated $1225.00 State Licensure Fees APPLICATION FOR LICENSURE $300.00 FINGERPRINTING $70.00 Total is estimated $370.00 TOTAL ESTIMATED COSTS TO ACHIEVE LICENSED VOCATIONAL NURSING LICENSE $3,600.00 (excluding variable costs) Prices are subject to change 4
A completed application packet consists of: 1. Application and Confidential Applicant Survey filled out in its entirety. In order to apply to the nursing program you must have a student ID number (also known as an H#). You can get an student ID number by applying for admissions to the college online. 2. Official U.S. high school transcript or GED. 3. Official U.S./college(s)/universities transcripts - Students who have attended other accredited colleges/universities are required to submit all official transcripts to the Admissions and Records Office for an evaluation prior to applying to the Nursing program. This process can take up to 2 weeks once we receive them, please plan accordingly. This application requires a set of official transcripts, separate from the admissions and records set. All college coursework must be completed at time of application with grades posted; no in progress courses will be accepted. 4. Your unofficial AHC transcripts. This can be printed from your myhancock account, it is the my unofficial transcript link on the Student tab. You may submit your Official AHC transcript in place of the printout. You are required to turn in one or the other, but not both. 5. Copy of your current and valid California LVN license. 6. Proof of merit based admissions payment (Note: VN licensure must be current at the time of application and remain current throughout the program, no probationary licenses will be accepted.) I acknowledge and understand the following: All of my pre-requisite courses are completed or my application will be excluded. I understand notifications of status to the RN applicants will be mailed no later than July 28, 2017. Please do not call AHC for application status as information will not be released over the phone. I understand that I must meet the Merit Based Admission Criteria in order to be considered for the RN program - Screening of applications will include looking at cumulative GPA, number of science repetitions (no more than 4 attempts in science pre-requisite courses to apply for the Allan Hancock College ADN program) (Anatomy, Physiology and Microbiology), and score obtained on the merit based admissions test (PN Predictor). I have filled out the form, registered and paid for my Merit Based Admissions Test through the cashier s office in Bldg. A. I will submit a copy of the form and receipt that indicates the day that I will be testing. I understand that it is my responsibility to show up for the test on the date that I indicated. I will be required to show a valid picture ID and receipt of my registration. I also understand that my application is not complete until all requirements have been filled. I understand that I will be on a waitlist and will reapply every application period in order to keep my waitlist number until I receive notification that I will be starting the program. The Health Sciences Department is not responsible for making copies; it is my responsibility to make copies before turning in my application. I must notify the Health Sciences office immediately of any changes to my address and/or telephone number until the first day of the program start date. If my information changes after the first day of the program I will make any necessary changes during the next application period the following year. FINANCIAL AID: It is the responsibility of all applicants to check with the Financial Aid Office regarding loans, scholarships, state and federal grants. If you have not already applied DO IT NOW! Questions may be directed to the Health Sciences office by calling (805) 922-6966, ext. 3384 or from Lompoc and Santa Ynez Valley 1-866-342-5242, ext. 3384. 5
Deadline for this application is JUNE 30, 2017. Applications are reviewed after application period. Status notification will be mailed no later than July 31, 2017. Please type or print clearly. We will not accept illegible applications. This application may only be used for the 2017 Registered Nursing Application (First time applicants) APPLICATION NEW APPLICANT Military education and experience related to the practice of nursing? (Please refer to the website for requirements) YES Personal Information FULL NAME: Last First Middle Other names that appear on transcripts: (use commas to separate, if providing more than one) MAILING ADDRESS: Street City State Zip PRIMARY PHONE#: SECONDARY PHONE #: SOCIAL SECURITY #: DATE OF BIRTH: AHC STUDENT ID: H EMAIL ADDRESS (Required) Admission Information High School Attended: Date of Graduation or Date of GED LVN School Attended: Year Completed: Date of Graduation License Number 6
Applying for the: Associate Degree of Nursing Program 30 Unit Option (you must meet with the Director of the Nursing Program prior to the end of the application period to determine eligibility.) Completion of Nursing Prerequisite Courses Indicate courses completed (if C grade or better): Semester/Year Prerequisites Completed BIOLOGY 124 (Human Anatomy) BIOLOGY 125 (Human Physiology) BIOLOGY 128 (Microbiology) ENGLISH 101 (Freshman Comp. Exposition) Math 331 (Algebra 2) [or higher] PSYCHOLOGY 101 (General Psychology) Vocational Nursing Program Course Name/ Number Name of College Units/Grade THE ALLAN HANCOCK COLLEGE TRANSCRIBER WILL DETERMINE EQUIVALENCY OF ALL List ALL Colleges/Universities Attended after High School College/University City & State Dates Attended Degree Earned? Current Enrollment: College/University Course # of Units Grade I affirm, under penalty of dismissal, that all information supplied on this application is complete and accurate. SIGNATURE: DATE: You may hand deliver your packet to the Health Sciences office (M132) on the Main Campus or mail to: Attn: Health Sciences Department, 800 S. College Drive, Santa Maria, CA 93454. Please slide under the door if the door is closed. 7
Confidential Applicant Survey Federal and state mandates require that we compile summary data on the gender and ethnicity of applicants. To assist us in complying with this requirement we are requesting that you complete and return this form. It should be emphasized that it is the policy of Allan Hancock Joint Community College District that no person shall be discriminated against on the basis of race, color, ancestry, religion, gender, national origin, age, physical/mental disability, medical condition, marital status, or sexual orientation, information regarding the gender and ethnicity as applicants is not supplied to any other agency and is kept in a confidential file. Supplying the following information is optional and will not affect the status of your application. Name: Date: Program Applying For: Class of Ethnic Background and Gender (please check only one): African American Asian Pacific Islander (Filipino) American Indian Caucasian Asian Pacific Islander (non- Filipino) Filipino Hispanic Female Other Male I prefer not to provide this information You may hand deliver your packet to the Health Sciences office (M132) on the Main Campus or mail to: Attn: Health Sciences Department, 800 S. College Drive, Santa Maria, CA 93454. Please slide under the door if the door is closed. 8
AHC Registered Nurse Program Merit Based Admissions Exams Payment Form April 1, 2017 June 30, 2017 Merit Based Admissions Test: All new applicants are required to take the admission exam as part of the application procedure for the Allan Hancock College Registered Nursing Program. Students will only need to take the exam once. Students will only be allowed to retest one time. The cost of the entrance exam is $50.00. Test Dates and Times (No other test dates will be scheduled) Tuesday, May 23, 2017; 10:00am-2:00pm Thursday, June 22, 2017; 10:00am-2:00pm Registration Instructions and Payment Information 1. Select a date from above. 2. Fill out form below. 3. Make a copy of the form. 4. Pay at the cashier s office in Bldg. A. You must present ID and have an AHC student ID: H number. 5. Turn in copy of the form and receipt to the Health Sciences office at least 24 hours prior to the test date. H AHC Student ID Number Name Phone Signature Date Day of Test - The PN Predictor is a 180 minutes (3 hour) test that will be held in the computer lab (M-116). You will need to bring: a. Valid picture ID (Driver s license, Passport, Military ID) c. Scratch paper and pencil (if you desire) Paper will be turned in at the end of the test d. NO Calculators You must have an account with ATI in order to take this test. If you already have an account with ATI, you will not need to create a new account but it would be best to update the information. https://www.atitesting.com/home.aspx Cashier s Instructions: 1. Student will need to be able to provide a copy of the form and receipt to the Health Sciences office. 2. Budget account code related to this sheet is 12301000-4311 9
For Office Use Only Name LAST FIRST AHC Student # H Application and Prerequisites Completed: Completed Program Application Confidential Applicant Survey Official High School Transcript or GED certificate Official College Transcripts from all other colleges Copy of current LVN License Exp Date: AHC Unofficial Transcripts Biology 124 (Anatomy w/lab) Biology 125 (Physiology w/lab) Biology 128 (Microbiology w/lab) English 101 (Freshman Comp) Math 331 (Algebra II) Psychology 101 (Intro to Psychology) Merit Based Admission form and receipt (Test date): Staff verification date and initials: Notes 10