School of Nursing

First Name *

Last Name *

Address *

City *

State *

Zipcode *

Daytime Phone *

Evening Phone *

Email Address *

Estimated Start Date

Have you taken the SAT? *

If so, what are your scores?

Have you completed a college-level introductory biology course with a lab, taken within the past 5 years, with a grade of C or better? *

Have you completed a college-level introductory chemistry course with a lab, taken within the past 5 years, with a grade of C or better? *

Highest Level of Education *

H.S. or GED Graduation Date *

Have you taken the ACT? *

If so, what are your scores?

Was your overall ACT score of 21 or higher? 20 in reading and 20 in mathematics. Or a SAT score of 1500 in reading and 1410 in mathematics *

How did you hear about the program? *