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Application for Admission Three Neshaminy Interplex Trevose, PA 19053 Phone (215) 710-3531 Fax (215) 710-3511 http://www.ariahealth.org/nursing Instructions Please read all instructions and information before completing your application. The information you provide will help us to serve you better. Submitting your application: 1. Complete and submit the application with a $60 non-refundable check or money order payable to Aria Health School of Nursing. 2. Read the enclosed information regarding entrance testing. Please send an email to EntranceExam@AriaHealth.org indicating your top 3 choices for a test date from the enclosed list. You will receive an automatic response via email with further instructions. Your test will not be scheduled until your application and application fee are received. The Admissions Office will make every effort to accommodate your first choice. 3. Type on a separate sheet of paper an essay of no less than 300 words on the following topic: What does nursing mean to you and why are you choosing it as your profession? 4. Send all official transcripts from high school, college(s), including nursing schools, directly to the Aria Health School of Nursing to the attention of the Admissions Office. 5. Forward two (2) recently dated professional or academic recommendation letter to Aria Health School of Nursing. They must be on letterhead and mailed directly to the Admissions Office from the person writing the letter. Recommendations from friends and family will not be accepted. 6. Optional interviews are available. Please contact the Admissions Office after Aria Health School of Nursing receives your transcripts, if you would like to schedule an interview. Interviews must be completed by the Paperwork Deadline. Deadline Dates: Applications are due 6 weeks before all paperwork is due. This will allow applicants and the admissions office ample time to schedule and complete all entrance testing and paperwork. Depending on the class for which student is applying, deadlines are as follows: September Admissions January Admissions Application Deadline Paperwork Deadline February 1 March 15 August 1 September 15 **It is the applicant s responsibility to have all required paperwork forwarded to Aria Health School of Nursing, as there will be no exceptions to these deadlines. DISCLAIMER: The Aria Health School of Nursing does not discriminate in its selection of students because of race, creed, color, national origin, religion, age, sex, marital status or physical handicap as required by federal law. All documents submitted become the property of Aria Health School of Nursing and cannot be returned or transferred.

Application Page 1 Biographic Information: Please print or type Birth Date: (Optional) Social Security Number: (Optional) Name: Last First Middle Home Address: Number and Street City or Town State Zip Code Home Telephone: ( ) Cell Phone: ( ) Active E-Mail Address: An Active E-mail address is required for all applications. All application updates will be provided via E-mail. U.S. Permanent Citizen: Yes No Resident: Yes No Veteran: Yes No If you are not a U.S. Citizen, please present your Green Card on your scheduled testing date. Ethnicity (Optional): Caucasian African American/Black Hispanic/Latino/Spanish Asian or Pacific Islander American Indian or Alaskan Native Other (Specify) Marital Status (Optional): Single Married Separated Divorced Would your records be listed under any name(s) other than your present last name? Yes No If Yes, please indicate the name(s): Are you: First time Freshman Seeking Readmission Transfer student Date of withdrawal: Have you previously applied to Aria Health School of Nursing or Frankford Hospital School of Nursing? No Yes Date of Application: What entry date are you applying for? (Specify Year) September: January: How did you hear about Aria Health School of Nursing? ENTRANCE TESTING: Please refer to the Instructions page of this Application.

Application Page 2 Previous Education: High School Address Date of Graduation Do you have a G.E.D? Yes No Date Received: State Awarded: All College or University Enrollment Record (including Nursing Programs) MUST be included. Please include a copy of any licensure you have acquired, ie. LPN, CNA. Employment Information: Please list all work experiences, including military service, beginning with the most recent. Please use the back of this page, if necessary, to complete your employment information. From To Title or Position Employer (Include address and phone number) Criminal Background Information: Have you been convicted* of a crime, including felonies and misdemeanors (but excluding summary offenses such as speeding tickets), which has not been annulled, expunged, or sealed by a court? Have you been convicted* of any crime associated with alcohol or drugs in any court? *Convictions include a judgment, found guilty by a judge or jury, pleaded guilty or nolo contendere, received probation without verdict, disposition in lieu of trial, or ARD. (Continued on next page)

Application Page 3 Have you ever withdrawn an application for a professional license, had an application for a license denied or refused, or agreed not to reapply for a license in any state, territory, possession or country? A license includes a registration or certification? Have you ever had a professional license suspended or revoked or otherwise been the subject of disciplinary action by any licensing authority in any state, territory, possession or country? If Yes, to any of the above please describe in full detail including date(s), location(s) and the nature of the offense(s): Please use the back of this page, if necessary, to complete the above description. A conviction will not automatically result in your disqualification from admission; convictions will be considered only to the extent they relate to your qualification for admission. However, failure to disclose a conviction and/or mischaracterization of a conviction automatically will result in your ineligibility for admission (even if the conviction would not have barred your admission had it been properly disclosed). Application Affidavit: To the best of my knowledge and belief, this application contains no misrepresentation or falsification and information given by me is true and complete. Any misrepresentation of falsification will be grounds to deny admission or administrative dismissal from the school. Applicant s Full Signature Date

Three Neshaminy Interplex Trevose, PA 19053 215.710-3510 WWW.ARIAHEALTH.ORG/NURSING Dear Applicant: Aria Health School of Nursing requires applicants to take an entrance examination as part of the admissions process. The results of this entrance examination will be used in conjunction with other required academic information, reference letters and essay when being considered for admission to the Aria Health School of Nursing. The test you will be taking is called The Test of Essential Academic Skills (TEAS). The TEAS is designed to predict the academic readiness of applicants prior to admission into a program of study in nursing. The four subtests are Math, Science, English, and Reading. The Admissions Committee at Aria Health School of Nursing has determined that candidates should have an Adjusted Composite Score score of 70% or higher, in order to be a viable candidate for admission. As stated above, this score is just one component in our decision making process. It is highly recommended that you read more about this test by accessing ATI s website at www.atitesting.com. You can find information about how to purchase a study guide and practice tests on this site as well. Testing dates are on the last page of the application, as well as on the Aria Health School of Nursing website: http://www.ariahealth.org/nursing. You are responsible for sending an e-mail to indicate your top THREE choices for a test date from the enclosed list. You will receive an automatic e-mail confirming receipt of your requests with further instructions. Your test will not be scheduled until your application and application fee have been received. We will make every effort to give you your first choice; however this is dependent upon the number of candidates and availability of computer space. It is your responsibility to send an email to schedule your exam. If you need to reschedule your testing date for any reason, or you miss your scheduled testing date, you must notify the school within 24 hours of your test. Failure to do so could reflect negatively on your application and may result in an incomplete application. We will NOT contact you to reschedule, it is your responsibility to contact the school to reschedule your test date. The use of calculators is forbidden. Please arrive with some sort of photo ID to verify your identity. Bring a writing utensil. (Pen or Pencil) Should you have any questions regarding this entrance examination or testing dates, you may contact us at EntranceExam@AriaHealth.org. Sincerely, The Admissions Department Accredited by: The National League for Nursing Accrediting Commission Approved by: Pennsylvania State Board of Nursing

TEAS Test Schedule ** Please be advised that the TEAS V test may only be taken twice and you MUST wait 90 days in between test dates. ** Testing Dates for January 2013 Admittance June, 2012 August, 2012 Monday 11th Monday 6th 25th 20th Tuesday 5th 27th 19th Tuesday 7th 26th 14th Wednesday 6th 21st 20th 28th Thursday 14th Wednesday 8th Friday 8th 15th 15th 29th 22nd Thursday 16th 29th 23rd July, 2012 30th Monday 2nd Friday 3rd 9th 17th 16th 24th 23rd 31st 30th Tuesday 3rd 31st Wednesday 25th Thursday 12th 19th Friday 6th 13th 20th 27th 05/08/2012