Transforming Lives Building Communities Degree Full-Time Nursing Application Fall 2018/ Winter 2019 Open date: Wednesday, November 1, 2017 Applicants can begin submitting program applications. Close date: Thursday, February 15, 2018 All reuired documentation listed on the application checklist must be received by the Admissions, Registration and Records office no later than 5 p.m. No postmark date allowed, no exceptions. No incomplete or late submissions will be considered. Please note: This application is for a restricted entry program, must be hand signed and submitted along with supporting documents and payment. People reuiring accommodations due to disability should contact the Disability Services Office at 503-491-6923 or dsoweb@mhcc.edu. Submit by Mail: Submit in Person: Mt. Hood Community College Admissions, Registration and Records Nursing 26000 SE Stark St Gresham, OR 97030 Student Services (room AC2253, Gresham Campus) DO NOT include this page with your application documents.
Full-Time Nursing Program Thank you for your interest in applying to Mt. Hood Community College s Full-Time Nursing program! Our program offers students award winning faculty, state-of-the-art training, cutting edge technology, and a challenging curriculum. After graduation, our graduates are expected to manage and care for groups of patients in complex nursing situations, including acute care, long term care, and in a variety of other health care settings. Please use the following information and the nursing website as a resource in answering any uestions that arise. Important Note: Some external links may be inaccessible. People reuiring accommodations due to disability should contact the Disability Services Office at 503-491-6923 or dsoweb@mhcc.edu. Helpful Hints: Go to an information session. Information sessions are a great way to learn more about the program, admissions process, meet other applicants, and ask uestions. Nursing information sessions are typically offered at the beginning of every month. Check the schedule here: mhcc.edu/nursing Read the Nursing FAQ: mhcc.edu/nursingfaq/ All communication with applicants is done via email always make sure the Admissions Evaluator has your current email address. The Admissions Evaluator will always use the email address written on the applicant s application form (even if you change it with Admissions) unless told otherwise. Make sure you add MHCC.edu to your safe senders list. If you are ready to turn in your application, but have some uestions about the process, or a piece of the application, come talk with the Nursing Admissions Evaluator during open hours: mhcc.edu/lrqa Additional Resources: Oregon Consortium for Nursing Education: ocne.org Oregon Health & Science University Nursing School Program: ohsu.edu/son Oregon State Board of Nursing: osbn.state.or.us Nursing programs in the US: allnursingschools.com National Student Nurses Association: nsna.org Oregon Center for Nursing: oregoncenterfornursing.org We Ask That You: Do not submit your application in double-sided format. Double sided applications are more time consuming and difficult to process. Follow the directions carefully and ask uestions if need be. Do not submit this page or the front cover with your application. Do not submit paperwork we do not ask for (i.e. letters of recommendation, awards, etc.). Anything that is not asked for will be shredded. Only submit a work experience form if it applies to you we don t need a blank work experience form. DO NOT include this page with your application documents. Mt. Hood Community College Rvsd 110317 Page 2 of 6
APPLICATION PACKET CHECKLIST Full-Time Nursing Program Applicant Name: Date: MHCC ID: Every item on this checklist needs to be submitted by the application deadline February 15, 2018 by 5 p.m. Only completed applications containing all the reuired documents will be considered for review. You will not be given notification if items are missing. It is the responsibility of the applicant to make sure everything was received by the deadline. Item 1. General Admission Application, Apply Online at https://my.mhcc.edu/ics/admissions. Select general studies as your major. It will change to Nursing if/when you are admitted into the program. 1. Application Checklist Page 3 2. Health Professions Division Application Page 4 3. Prereuisite Course Planning Sheet Page 5 4. (Optional) Work Experience Form (must be in a sealed envelope) and current license Page 6 5. $75 Non-Refundable Application Fee Make check payable to MHCC. Bank card/cash is only payable in person in Student Services (room AC2253). 6. Official (in a sealed envelope) College Transcript(s) From EVERY COLLEGE EVER ATTENDED (including AP/IB official transcript/scores) except MHCC transcripts. Courses may be in progress at the time of application submission but an updated transcript showing posted grades for the reuired coursework for Fall term 2017 and prior terms must be received by the application deadline. 1. I understand MHCC s Admissions, Registration and Records office will send all application notifications by email. It is my responsibility to set my spam filter system to accept email addresses containing @mhcc.edu even if I am currently receiving emails from MHCC. MHCC cannot be responsible for notices which are not received due to spam or junk mail handling. I will make sure to add MHCC to my safe senders list. MHCC recommends applicants to check their email on a computer and NOT on a smart phone. 2. I have read, completed, and fully understand the admission criteria as listed on the nursing website for the Nursing program at Mt. Hood Community College and OCNE. I understand that it is my responsibility to meet all program and application criteria. I verify that all statements on this application are complete and true; and I understand that falsification of any information may lead to disualification or dismissal from the program. I give my permission for release of pertinent application information to the OCNE partner schools, including Oregon Health and Science University, and the State Board of Nursing, as necessary to facilitate my program of study and to enhance the application process for future applicants. 3. I understand it is my responsibility to ensure all items are received by the application deadline and only complete applications will be evaluated for admission. Furthermore, I have read and understand the admission reuirements and procedures for applying. I understand that withholding information or giving untruthful answers to uestions on this application could be cause for non-acceptance or dismissal from the program. By signing below, I am confirming each item above is included with my application or I have confirmed they are already on file at MHCC. I understand it is my sole responsibility to submit the reuired documents, and I will not be given notice if my application is incomplete until after the deadline, at which time it will be too late to submit missing documents. Signature Date For Office Use Only: Received Date: Received By: Mt. Hood Community College Rvsd 110317 Page 3 of 6
Full-Time Nursing Program HEALTH PROFESSIONS DIVISION APPLICATION Please print and complete fully, do not leave blank. Attach extra paper if needed. Name: SSN or MHCC ID: Previous Last Name(s): Email: ALL notifications will go out via email to this address. Current Mailing Address: Street City State Zip Phone Number and Alternate Phone: ( ) ( ) Education Record: List ALL colleges EVER attended (including MHCC). Omission of any college transcript will result in non-admittance or dismissal from the program. Submit an official copy of each transcript regardless of program length, course of study, or program applicability. Failure to submit these transcripts will result in an immediate incomplete application. You do not need to submit an MHCC transcript. College Major Degree earned, if applicable: Previous Applications: List all Health Professions programs you have previously been accepted to. Program Title Year College Did you attend?* Did you finish?* *Applicants who have been previously admitted, started, but did not finish a health professions program must obtain a letter from the head of the department indicating the year(s) you attended, that you exited the program in good standing, and can speak to your ability to be successful in another health professions program. Applicants who were dismissed or withdrew from programs may not be eligible to apply. Previous/Current Licensure: Have you worked in a medical field and/or held a license? If yes, print license verification off from your state board showing details and disciplinary actions and submit with your application. State License No. License Type Expiration / Lapse Date / Revoke Date Explanation / Comments Mt. Hood Community College Rvsd 110317 Page 4 of 6
Full-Time Nursing Program PREREQUISITE COURSE PLANNING SHEET Applicant Name: Date: MHCC ID: Fill out each section accurately and in its entirety. No points will be awarded if the class is not documented or fully documented below or is listed in the wrong category. Corrections will not be made on your behalf. Submit one official (unopened) transcript from every college or university ever attended. Do not include an MHCC transcript. From these transcripts, list a minimum of 30 credit hours from the prereuisite courses listed below. The 30 credit hours must include BI231 and MTH095 (or competency through the College Placement Test (CPT) into MTH105/111) and must be completed by the application deadline date of February 15, 2018. If the math reuirement is met by CPT into MTH105 or higher, students must select from any other prereuisite courses to obtain the minimum 30 credits reuired to apply. MTH098 does not meet the math reuirement. For point assessment, only courses completed by the end of Fall term 2017 with a letter grade of C or better will be used. If selected into the program, ALL courses below must be completed by the end of Summer term 2018. List the courses as they appear on your transcript. For courses not taken at MHCC, do not use the MHCC euivalency, convert to uarter credits, or include +/- on your grades (i.e. B- = B). If the class is in progress for Fall term, put IP in the term/year box. Submit updated transcripts by the application deadline documenting your grade once the class is completed. Do not list courses you are planning to take Winter or Spring term. Pass or Satisfactory grade(s) will be counted as a C grade. PREREQUISITE COURSES COURSE TERMYEAR GRADE CREDITS INSTITUTION EXAMPLE BI231 FA14 A (4.0) 4 MHCC ANATOMY AND PHYSIOLOGY I, II, III - cannot be completed prior to Winter 2011 BI231 Anatomy & Physiology I BI232 Anatomy & Physiology II BI233 Anatomy & Physiology III MATHEMATICS: 0 5 credits test scores cannot be older than 02/15/2013; coursework cannot be completed prior to Winter 2011 MTH095 Intermediate Algebra or higher OR CPT into MTH105/111 ENGLISH COMPOSITION - 8 credits 1 WR121 English Composition I WR122 English Composition II OR WR123 English Composition: Research OR WR227 Technical Report Writing NUTRITION - cannot be completed prior to Winter term 2011 FN225 BIOLOGY WITH GENETICS BI102 OR BI112 OR BI212 MICROBIOLOGY - cannot be completed prior to Winter term 2011 BI234 HUMAN DEVELOPMENT PSY237 OR PSY235 and 236 GENERAL EDUCATION- cannot be skill based Humanities Elective 2 (3+ credits) 1 Applicants will need to have 8 credits of writing (which must include WR121) by the end of summer 2018 to start the program. A bachelor s degree completed by the application deadline will satisfy WR122 or WR123/227 (not WR 121). Enter BA/BS if you do not have a course to write in for the WR122 or WR123/227 box. Students must still fulfill other prereuisite courses on this list to attain the minimum 30 credit hours reuired to apply. 2 See catalog under the AAOT degree for a list of non-skilled based Humanities courses accepted. REMINDER Applicants MUST have at least a 3.0 GPA in their prereuisite courses to apply! Mt. Hood Community College Rvsd 110317 Page 5 of 6
WORK EXPERIENCE FORM Full-Time Nursing Program Student s Name: Date: / / MHCC Student ID: Dear Human Resources Associate: The above individual is planning to apply to the MHCC Nursing program and can earn points in the selection process with proof of work experience in the healthcare field. In order to receive those points, each applicant must provide official documentation that is sealed in an envelope directly from the Human Resources Associate filling out this form. We are asking you to assist this applicant with the process. Please do the following: Fill out the appropriate information below as it pertains to the employee. Date stamp this form with office name/credentials and attach to it a signed business card (or a signed letterhead in lieu of a business card). Seal it in an office envelope and sign across the seal. The sealed envelope must be received no later than February 15, 2018 by 5 p.m. to earn points, no exceptions. Applicants may submit the paperwork with their application materials, or it can be mailed directly to us at: Mt. Hood Community College Admissions, Registration and Records Full-Time Nursing Program Application 26000 SE Stark St. Gresham, OR 97030 The applicant held the following position: EMT (Emergency Medical Technician) CST (Certified Surgical Technician) Licensed or Certified Medical Social Worker or Drug and Alcohol Counselor CRT (Certified Respiratory Therapist) LPN (License Practical Nurse) CNA (Certified Nursing Assistant) CMA (Certified Medical Assistant) The employee has worked a total of hours (minimum of 401 hours) Employment begin date: / / Employment end date: / / Please note: Applicants that were/are employed as an LPN or CNA must have been performing authorized duties as defined by the OSBN and must have received ongoing or regular supervision by a licensed nurse, and must have been in a position that reuired a CNA certification or LPN license. Signature of Human Resources Associate/Title Printed Name of Human Resources Associate Human Resources phone number Facility APPLICANTS If you have ualified 401 work hours or more, you must submit BOTH this work experience form and your current, state-issued credentials (can be from outside the state of Oregon). Submitting just this form will result in zero points. Mt. Hood Community College Rvsd 110317 Page 6 of 6