Associate Degree Nursing Program Application Fall 2018

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Associate Degree Nursing Program Application Fall 2018 PLEASE PRINT CLEARLY DATE 1. Last Name First: MI Maiden Other Names: Andrew College Student ID # Email Mailing Address City State Zip Code Phones (Cell) (Home) (Work) 2. Have you ever been admitted to (yes no ) or attended a nursing program (yes no ) If yes, why did you leave? 3. Have you completed any other health care education programs? (yes no ) LPN RN EMT/Paramedic CNA Other Do you hold any professional licenses? (yes no ) If yes, please give the name of the licensed profession, license number and state(s) of licensure Have any of your professional licenses been revoked, suspended or limited in any way? (yes no ) If yes, please explain 4. Why did you choose Andrew College? 5. Why did you choose nursing? Please respond in the form of an essay (no more than 2 pages) and attach it to your application.

6. Please attach 2 letters of reference from teachers, employers, etc. who can attest to your intellectual capacity, skill level or and/or work ethic. 7. Please include unofficial transcripts of ALL previously attended colleges. Your application will not be considered until all documents have been received. Admission to the Nursing program is competitive and based on the size of the class, therefore admission is not guaranteed to all who have a completed application. Important Notice: The Nursing program requires criminal background checks and drug screens upon acceptance and throughout the nursing program as required by clinical agencies. A student, who is denied access to a clinical agency will be dismissed from the program due to the inability to complete the program requirements. Andrew College Nursing will NOT seek additional areas for clinical placement. I certify that the information I have submitted is true Signature Date Submit your completed application and additional documents to: Andrew College Nursing Program 501 College Street Cuthbert, Georgia 39840 8/3/16, 8/16/16, 9/12/16, 10//17, 01/08/18

Dear Nursing Program Applicant: ANDREW COLLEGE Associate Degree Nursing Program Thank you for your interest in the Andrew College Nursing program. We look forward to receiving all of your application materials. Please be aware that admission to the program is competitive and class size is limited. All things being equal, completed applications will be considered on the basis of the date they were received. Acceptance into the program is not guaranteed. Qualified students may apply to the program in subsequent years if they are not admitted initially. Further information about admission to the program and other general program information may be found on the web at: www.andrewcollege,edu or you may contact the Andrew College Nursing Division at 229-732-5960. Nursing Admissions Checklist: 1.Applied and accepted to Andrew College 2.Completed separate application to the Nursing program 3. Submitted essay of 2 pages or less 4. Two references submitted 5. Submitted information on all other professional licenses, if applicable. 6. Submitted unofficial transcripts of all colleges attended. The Associate Degree Program is approved by The Georgia Board of Nursing 237 Coliseum Drive Macon, GA 31217 478-207-1640 Southern Association of Colleges and Schools 1866 Southern Lane Decatur, GA 30033 Telephone: (404) 679-4500 Website: www.sacs.org 4/11/17, 01/08/18

Admission Requirements Specific to the Nursing Program Admission Requirements: 1. Completed application to the Nursing Program submitted by application deadline (TBA) including supplemental documents and unofficial transcripts. 2. Admission to Andrew College 3. Completion of all Learning Support requirements 4. Completion of A& P I within 5 yrs. of admission and a grade of "C" or higher 5. Students may repeat a general education course only one time to obtain a C or higher. 6. GPA of 2.5 or above from HS and/or on all college work 7. Completion of College Health Form including current immunizations, however, Nursing will require additional physical, immunization, and PPD forms once accepted. 8. Criminal background check * (through PreCheck once accepted) 9. Drug screen * (through PreCheck once accepted) 10. Liability Insurance (group rate through the Andrew College Nursing Program) 11. Admission preference may be given to students with the highest GPA's and those who have completed the most general education courses. 12. Applicants who have earned less than a grade of C in two or more nursing courses while enrolled in a previous nursing program are not eligible for admission to the Andrew College Nursing Program. 13. Submission of copies of all professional licenses held by the applicant 14. It is strongly recommended that all students have health insurance. You will be responsible for all health related costs that you incur whether in class or clinical. 15. Completed Basic Life Support for Healthcare Providers certification (once accepted) 16. Students must have transportation to and from assigned clinical sites and must be able to attend all clinical sites as assigned. Our clinical partners have the right to deny placement to any student. Students denied clinical placement for any reason will not be able to complete the program requirements, therefore, they will be withdrawn from the program.

Andrew College Nursing will NOT seek additional areas for clinical placement should a student be denied placement. Students with criminal findings on the background check and/or a positive drug screen who are denied clinical placement will not be able to complete the program, therefore, they will be withdrawn from the program. Clinical sites include (but not limited to): Southwest GA Regional Medical Center, Hospital Authority of Miller County, Donalsonville Hospital, Southeast AL Medical Center, Medical Center Barbour, Aspire Behavioral Health & DD Services, Dialysis Clinic Inc, Joe-Ann Burgin Nursing Home, Phoebe Putney Memorial Hospital, West Central Health District. 8/3/16, 8/16/16, 9/12/16, 1/31/17, 01/08/18