BISHOP STATE COMMUNITY COLLEGE BAKER-GAINES CENTRAL CAMPUS 1365 DR. MARTIN LUTHER KING JR. AVENUE MOBILE, AL (251) /

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BISHOP STATE COMMUNITY COLLEGE BAKER-GAINES CENTRAL CAMPUS 1365 DR. MARTIN LUTHER KING JR. AVENUE MOBILE, AL 36603-5362 (251) 405-4495/405-4503 Please mark 1 st and/or 2 nd choice. Mark your Practical Nursing Program 1 st and 2 nd choice ONLY if you are able to attend Fall Day ONLY day or evening program. Spring Evening ONLY Associate Degree Nursing Program LPN to RN Mobility Program NUR 200 Fall Day Summer Day ONLY Evening Spring Evening ONLY Spring Day Check here if you are a graduate of the Evening PN Program within the last two (2) years Check one: ( ) NUR 201 Summer ( ) NUR 201 Fall Check one: ( )Day ( )Evening ( )Day ( )Evening APPLICATION DEADLINES Associate Degree & Practical Nursing Programs LPN to RN Mobility Program June 1 st for FALL SEMESTER Admission October 1 st for SPRING SEMESTER Admission to NUR 200 October 1 st for SPRING SEMESTER Admission March 1 st for SUMMER TERM Admission to NUR 200/NUR 201 June 1 st for FALL SEMESTER Admission to NUR 201 Please read and respond to the following in order to facilitate completion of the Nursing Program Application. The Application to Nursing must be submitted each semester/term of requested admission. The ADN Standard Track and Practical Nursing Track are offered Fall and Spring Semester only. The LPN to RN Mobility Track offers Summer and Fall admission to NUR 201 for graduates of the ACS Practical Nursing Curriculum within the last two (2) years. Applications must be submitted by October 1 st for Spring Semester admission to NUR 200 and March 1 st for Summer Term admission to NUR 200. Graduates of the ACS Practical Nursing Curriculum must submit application to the ADN LPN to RN Career Mobility Track by March 1 st for Summer Term admission and June 1 st for Fall Semester admission. There is no admission for the ADN Standard Track or Practical Nursing Track during the Summer Term. Effective Fall Class 2011 (application deadline June 1 st ), the TEAS-V nursing entrance exam will be required for all applicants. Scores are good for three (3) years. See the College s website (www.bishop.edu) for additional information. The applicant is responsible for having all items completed and returned to the NURSING OFFICE in Suite 210, by the deadline dates to complete application process. The student must ATTACH DOCUMENTATION, where applicable. DOCUMENTATION WILL BE VERIFIED BY NURSING 210 PERSONNEL BY SIGNATURE IN OFFICE USE ONLY AREA. Revised 01/05/11 - IMT 1

Admissions Checklist 1. Apply to Bishop State Community College. 2. Request an OFFICIAL high school* (if no college work has been completed) and college transcript from ALL colleges attended, if applicable. Official transcripts should be mailed or can be brought by student in sealed envelope to: Bishop State Community College Baker-Gaines Central Campus, Suite 106 1365 Dr. Martin Luther King Jr. Avenue Mobile, AL 36603-5362 3. Allow 21 days from the time you request your transcript(s) to inquire if they have been received and evaluated. ALL official transcripts must be received in order to proceed with this process. You may visit the BSCC website to print out a copy of courses that were accepted. This step should be completed at least two (2) weeks prior to the deadline date. Internet: www.bishop.edu Log on to B.O.R.I.S. Print transcript (251) 405-4400 4. Complete the Nursing Program application. 5. Complete the ATI TEAS-V exam. Information is available at www.bishop.edu under Programs of Study Nursing. 6. Letter from all previous colleges of nursing stating you were not dismissed due to ethical, legal or moral reasons. This should be on letterhead from the director of nursing. 7. All areas on application are complete and accurate. Incomplete applications WILL NOT be considered. 8. Name on application is current legal name and matches copy of photo ID and name in BSCC s AS400. 9. Attach a picture ID (driver s license or student ID ONLY) to nursing application. Career Mobility (LPN to RN) applicants ONLY 10. Attach copy of a valid unencumbered Alabama practical nurse license. If out-of-state, you must APPLY FOR and RECEIVE an Alabama license prior to submitting your application. Must show Alabama PN license prior to submitting application. 11. For Summer 2011, the COMPASS Reading score of 76 or higher will be accepted. After Summer 2011, the ATI TEAS-V exam will be required. 2

Date: THE ALABAMA COLLEGE SYSTEM NURSING PROGRAM APPLICATION A Photo Must Be Attached to Application Copy of Current Driver s License, Student ID required. No personal photos will be accepted. Program Applying For: Registered Nursing Program Practical Nursing Program Career Mobility Program I. PERSONAL DATA Last Name: First: MI: Maiden: Student Number: Permanent Address: City: State: Zip Code: Home Phone: Cell Phone: E-mail address: Work Phone: 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 courses currently enrolled in:(list additional courses on a separate sheet of paper if necessary.) List all colleges attended and the year(s) attended: College Years Attended Degree Seeking/Completed Have you previously been admitted to a Nursing Program? Yes No If yes, state reason for leaving or withdrawal. (Include Bishop State Community College Nursing Program) Which college s nursing program When Do you hold a current Alabama LPN license? Yes No If yes, are you applying for the Career Mobility Track? Yes No Have you taken the Reading portion of the COMPASS Exam (Career Mobility only) or TEAS-V Exam? Yes No If yes, date tested Your name, as listed when tested. 3

III. Complete this section only if you are applying for the Career Mobility Track (LPN TO RN) Are You Currently Employed? Yes No Place of Employment: Employer s Address: City: State: Zip Code: Employer s Phone Number: Name of Supervisor: Are You Employed Full-Time Part-Time Initial Date of Employment: I understand that completion and submission of this application is a component of the student profile and does not in itself grant admission to the nursing program. I understand an application must be resubmitted 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. Minimum admission standards include: 1. Unconditional admission to the college. 2. Receipt of completed application for the nursing program(s). 3. For students with previous college: minimum of 2.5 GPA on last 24 credit hours. 4. Without prior college work (GED acceptable): minimum of 2.5 GPA on last 24 hours. 5. Eligibility for ENG 101 and MTH 100. Effective Fall 2010, MTH 116 for PN applicants and MTH 100(with MTH 098 and lab MTH 080) as a prerequisite for ADN applicants. MTH 100 and BIO 201 are required prerequisites for the Career Mobility Program. Completion of BIO 103 with a C or better or waiver. 6. Eligibility for BIO 201 during the first term of associate degree nursing and practical nursing. 7. Good standing with college. 8. Meeting the essential functions or technical standards required for nursing. Admission to the Nursing Program is competitive, and the number of students is limited by the number of faculty and clinical facilities available. Meeting minimal requirements does not guarantee acceptance. *If any false information is provided, your application will NOT be considered. Applicant s Signature Date Date received: Initials: NOTE: COLLEGE APPLICATION, COLLEGE AND/OR HIGH SCHOOL TRANSCRIPTS MUST BE ON FILE IN ADMISSIONS ROOM 106 NO LATER THAN 21 DAYS BEFORE THE APPLICATION DEADLINE. IT IS RECOMMENDED THAT YOU CHECK WITH ADMISSIONS TO SEE IF YOUR FILE IS COMPLETE PRIOR TO THE DEADLINE. Please bring or mail to: Department of Nursing Suite 210 NO faxed copies accepted! Baker-Gaines Central Campus Bishop State Community College 1365 Dr. Martin Luther King, Jr. Avenue Mobile, AL 36603-5362 4

BISHOP STATE COMMUNITY COLLEGE NURSING PROGRAM EVIDENCE of COMPUTER SKILLS This is to verify that I have basic computer skills as evidenced by the following: Satisfactory completion of computer course or Job-related experience and training: (Please describe in detail) I understand that computer literacy is required to obtain the Certificate or Associate in Applied Science degree in Nursing and that nursing courses will have computer-assisted instruction, computer-based examinations or involve types of skills such as word processing and Internet access/searching. It is my responsibility to have the necessary skills. Nursing Faculty Approval Date Student s Signature Date Student s Name Printed Student Number 5