Application Guide

Transcription

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2 TABLE OF CONTENTS CENTRE FOR NURSING STUDIES... 2 ADMISSION REQUIREMENTS... 2 APPLICATION PROCESS... 5 APPLICATION DEADLINE... 6 PROGRAM COSTS STUDENT FINANCIAL ASSISTANCE... 8 COUNSELLING SERVICES... 9 COURSE DESCRIPTIONS... 9 CREDIT RECOGNITION IMMUNIZATION DOCUMENTATION Application Guide

3 CENTRE FOR NURSING STUDIES Centre for Nursing Studies The Centre for Nursing Studies (CNS) offers a continuum of educational opportunities for individuals who wish to pursue nursing careers that are challenging and relevant to the changing health care system. These opportunities include a Bachelor of Nursing (Collaborative) Program and a Practical Nursing Program. It also offers Post-Basic Specialty Programs, Professional Development Courses, Re-Entry Programs for Registered and Licensed Practical Nurses and Competency-Based Assessments for Practicing Nurses and Internationally Educated Nurses through Continuing Nursing Studies. The CNS is the lead institute for Practical Nursing Education in Newfoundland and Labrador. Approximately 70 students are admitted annually in September at the CNS site. The College of the North Atlantic offers the CNS Practical Nursing Program at various campuses throughout the province. ADMISSION REQUIREMENTS Academic Admission Requirements Applicants who have followed the High School Curriculum of Newfoundland and Labrador Applicants shall have completed Graduation Requirements for high school as set by the Department of Education and obtained an overall average of not less than 65% in 3000 level courses. OR Applicants in their final year of high school who will complete the graduation requirements for high school as set by the Department of Education and obtained an overall average of not less than 65% in 3000 level courses may be conditionally accepted prior to the writing of final exams. This conditional acceptance will be subject to verification that the applicant has obtained an overall average of not less than 65% in 3000 level courses, when final examination results are released. Applicants who have followed the High School Curriculum of other Provinces of Canada Applicants from other provinces of Canada are required to have successfully completed Grade XII in the University Preparatory Program (in the case of Quebec students, Secondary V Certificate) and obtained an overall average of not less than 65%. Application Guide

4 Applicants who have followed the College of the North Atlantic Comprehensive Arts and Science College Transition Program (CAS) Applicants who do not meet the requirements for admission under one of the two categories listed above but do hold a high school diploma may be eligible for admission under this category. Students applying under this category must successfully complete all qualification requirements for the award of the CAS certificate from the College of the North Atlantic. Applicants who have followed the Adult Basic Education Program (ABE) Applicants shall have completed the Level III Adult Basic Education Certificate (ABE) with the approved combination of thirty-six credits as set by the Department of Education. Applicants for Mature Student Status An applicant, 21 years of age or older within one month after the beginning of the Program who has not fulfilled the admission criteria outlined previously. These candidates are expected to provide an official transcript of the highest level of education completed. Note: All applicants must follow the Application Process outlined in this guide and must supply all documentation described therein. General Admission Requirements English Language Requirement Applicants must be competent in the English Language. A test of English language will be required for: applicants whose first language is not English; applicants who have completed high school in a language other than English; Applicants who do not meet the criteria above but have postsecondary courses completed in English should contact the Chair of CNS Admissions for further instruction regarding testing. The tests with the acceptable scores are: 1. IELTS (International English Language Testing System Academic version). Scores: overall score of 7.5 with scores of 7.5 speaking, 8.0 listening, 7.0 reading and 7.5 writing. Application Guide

5 2. CELBAN (Canadian English Language Benchmark Assessment for Nurses). Scores: 8 speaking, 10 listening, 8 reading and 7 writing. The official results of test score must be submitted before a decision will be made on your application. Test scores are valid for two years from the testing date. All cost associated with the English language requirements are the responsibility of the applicant. Interviews The Centre for Nursing Studies reserves the right to interview applicants in any of the admission categories. Assessments An applicant may be recommended to write The Canadian Adult Achievement Test (CAAT) or other assessment type test. Testing takes place April or May. Application Guide

6 APPLICATION PROCESS The number of students admitted to the Practical Nursing Program is determined annually by the provincial human resource needs for Licensed Practical Nurses (LPN s). Applications to the Program at the Centre for Nursing Studies (CNS) will be reviewed for admission when all documentation has been provided: completed and signed application form payment of $30.00 processing fee copy of official birth certificate from the Department of Vital Statistics certified copy of high school transcript from the Department of Education or equivalency certificate certified copy of Level II grades (if presently attending high school), along with Level III Term One results copy of official transcript of all post-secondary courses/programs two references personal statement a personal interview (if requested by the CNS) Once an applicant receives a letter of acceptance, the following documents will be required: certificate for CPR Health Care Provider Level (HCP) completed after January 1, 2015 and Standard First Aid completed since December 1, 2013 immunization documentation (see page 11) Criminal Record Screening Certificate/Police Records Check and Vulnerable Sector Check in satisfactory standing (local police force) (dated no earlier than July 2015) Child Protection Records check (may be required) Personal Statement Guidelines Applicant must complete a personal statement by answering the questions outlined on the Personal Statement Form. Reference Guidelines Please remove the two applicant reference forms from your application package and give to your referees. Referees should forward the references directly to the CNS on your behalf (FAX: ). Your references should be provided by individuals that you have had a professional relationship with, such as previous or current employers and/or teachers or professors. If you have been involved in a significant capacity with a volunteer organization, a formal representative from that organization may also be an appropriate reference. It is recommended that you do not obtain references from friends, co-workers, or your health care provider. Application Guide

7 Criminal Records Screening Certificate/Police Records Check In compliance with Eastern Health s Affiliation/Student Placement Agreements, prior to commencement of a placement, all students are required to obtain satisfactory certificate(s) of conduct for review and consideration. Approval of placement is contingent upon presentation of a certificate of conduct satisfactory to Eastern Health. While only original certificates of conduct issued within the last six months will be considered prior to commencement of the student s first placement, additional certificates of conduct will not be required for each placement area throughout the course of the program as long as the student remains a continuous student in the program. APPLICATION DEADLINE The deadline for the receipt of applications and all data required to complete the application is MARCH 15 th. For more information or an application, please contact the address noted below. Registrar, Non-Degree Programs Centre for Nursing Studies Office 1007, Southcott Hall 100 Forest Road St. John s, NL AlA le5 Telephone # (709) Fax # (709) dwaterman@mun.ca Application Guide

8 PROGRAM COSTS PROGRAM SERVICE COST Application Processing Fee (non-refundable) Confirmation Fee Payable on Acceptance (nonrefundable) Administration Fee (Term I) *Tuition Per Semester (Sept, Jan, May, Sept) See below for AE&S Funding and International Fees Textbooks and Lab Kits (approximate) (purchased by student at MUN Bookstore) Uniforms/lab coat (approximate) (purchased by student individually) Graduation Fee (collected at start of Semester 4) Canadian Practical Nurse Registration Examination Fee (payable to CLPNNL) The Canadian Nursing Students Association (CNSA) CNS Nursing Society Fee 5.00 The above costs are subject to change without notice. *FUNDING: Students funded by the Department of Advanced Education and Skills (AE&S) should notify the Centre for Nursing Studies Business Office at *INTERNATIONAL APPLICANTS: International fees apply. Please contact the CNS for more information. Applicants who hold a Canadian Passport or have Permanent Residency Status in Canada are not considered international applicants and therefore are not subject to international fees. Application Guide

9 STUDENT FINANCIAL ASSISTANCE Canada-Newfoundland and Labrador Student Financial Assistance The Government of Canada and the Government of Newfoundland and Labrador work together to provide student financial assistance in the form of loans and grants for eligible applicants. The Student Financial Services Division administers this program for residents of Newfoundland and Labrador. Students are encouraged to visit the Student Financial Services website at for complete details on the programs and services available including the application process. The website allows students to check on the status of their application and provides assessment information. Students can also contact Student Financial Services by: Telephone (709) (toll free) Fax (709) The Student Financial Service office is located at Coughlan College, 216 Prince Phillip Drive on the St. John s campus of Memorial University. Business hours Monday to Friday 9:00 a.m. to 4:30 p.m. Counter service 10:00 am to 4:00 pm Mailing address Student Financial Services P.O. Box 8700 St. John's, NL AlB 4J6 Include your Social Insurance Number on all correspondence and have it available when calling the Student Financial Services Division. You can apply for both provincial and federal student financial assistance Apply online, the expected processing time is 10 business days Application Guide

10 The Department of Advanced Education & Skills (AE&S) Students may be eligible for income support through the Department of Advanced Education and Skills (AE&S). Income Support telephone inquiries can be made to the following numbers depending on region: Avalon: Toll-free: Central: Toll-free: Western: Toll-free: Labrador: Toll-free: Or via to COUNSELLING SERVICES Guidance and Counselling by the faculty begins from the time the student is officially registered in the Program. Helping students achieve their goals is a major focus of faculty at the CNS. In addition to faculty, an experienced counsellor assists students with academic and personal issues. COURSE DESCRIPTIONS N101 Introduction to Nursing Concepts Course descriptions are subject to change. This course explores the nature of human needs throughout the lifespan. It introduces the student to the role of the practical nurse in promotive, preventive, curative, rehabilitative and supportive care across the health continuum. This course contains a lab component. CN101 Nursing Practice for Introduction to Nursing Concepts This practice course provides the student with opportunities to integrate knowledge and apply competencies necessary to care for clients requiring basic nursing care. N102 Anatomy and Physiology I This course is designed to provide information about the basic concepts of the structure and function of the human body. The structural levels of organization and the integumentary, musculoskeletal, nervous and endocrine systems, as well as the senses are covered in this course. Emphasis is given to the relationship between structure and function and homeostasis. Application Guide

11 N103 Therapeutic Relationships This course introduces the student to the principles of therapeutic communication. It is designed to enable the student to establish and maintain professional therapeutic relationships with individuals and groups, and introduces teaching-learning principles. This course contains a lab component which focuses on enhancing self-awareness and the application of therapeutic communication principles. N104 Medication Administration This course will provide the student with knowledge and skills to prepare and administer medications to stable clients under the supervision of a clinical instructor. Opportunities to practice supervised administration of medications will begin in semester two. This course contains a lab component. N106 Medical-Surgical Nursing Concepts This course is designed to introduce students to medical-surgical nursing concepts. Concepts related to perioperative nursing care, fluid and electrolyte balance, intravenous therapy and blood transfusions will be covered. Emphasis will also be on the care of clients experiencing acute and chronic health conditions associated with the integumentary, musculoskeletal, neurological, sensory and endocrine systems. This course contains a lab component. N201 Mental Health Nursing Concepts This course introduces the student to nursing concepts that focus on individuals, families and small groups requiring nursing interventions across the lifespan. Course content includes psychopathology, as well as exploring the meaning of mental health and illness to the individual and family. CN201 Nursing Practice for Mental Health Nursing Concepts This practice course provides the student with opportunities to integrate knowledge and apply competencies necessary to care for clients in mental health settings. N202 Anatomy and Physiology II This course is designed to provide information about the basic concepts of the structure and function of the human body. The circulatory, lymphatic, respiratory, digestive, urinary and reproductive systems are covered, as well as the processes of human development and heredity. Emphasis is given to the relationship between structure and function, and homeostasis. Application Guide

12 N204 Health Assessment This course will provide the student with the knowledge and skills required to perform health assessment for clients with predictable outcomes. Course content focuses on history taking and physical examination using a systems approach. The emphasis is on the normal; enabling the student to distinguish normal from abnormal findings. Although covering the lifespan, emphasis is placed on health assessment of the adult client. This course contains a lab component which focuses on history taking and applying the psychomotor competencies of physical assessment. N205 Gerontological Health Nursing Concepts This course will examine issues of health and wellness in the older adult. Students will explore common chronic and episodic challenges of health and healing in later life. Changing demographics and societal forces influencing health care of older persons will be analyzed and critiqued. CN205 Nursing Practice for Gerontological Health Nursing Concepts This practice course provides the student with opportunities to integrate knowledge and apply competencies necessary to care for the clients in long-term care settings. N206 Medical-Surgical Nursing Concepts This course is designed to provide further information on medical-surgical nursing concepts. Concepts related to cancer and autoimmune disorders will be covered. Emphasis will also be on the care of clients experiencing acute and chronic health conditions associated with the hematological, cardiovascular, respiratory, gastrointestinal, urinary and reproductive systems. This course contains a lab component. CN206 Nursing Practice for Medical Surgical Nursing Concepts This practice course provides the student with opportunities to integrate knowledge and apply competencies necessary to care for clients in adult medical-surgical settings. N301 Community Health Nursing Concepts This course examines the principles of primary health care, population health and the application to community health nursing. A broad range of community health issues will be discussed, with a key focus on strategies to improve the health of populations. This course will also provide the student with an opportunity to explore and identify the role of the practical nurse in promoting, restoring, protecting and supporting the health status of clients in the community setting. Application Guide

13 CN301 Nursing Practice for Community Health Nursing Concepts This practice course provides the student with opportunities to integrate knowledge and apply competencies necessary to care for clients in the community setting. The student is expected to collaborate with the clinical leader for direction in meeting the nursing practice objectives. N302 Maternal-Child Health Nursing Concepts Emphasis is on care of the childbearing woman, stages of growth and development and common childbearing and child development health problems. This course contains a lab component on newborn care. CN302A Nursing Practice for Maternal Health Nursing Concepts This practice course provides the student with opportunities to integrate knowledge and apply competencies necessary to care for the mother and newborn in obstetrical settings. CN302B Nursing Practice for Child Health Nursing Concepts This practice course provides the student with the opportunities to integrate knowledge and apply competencies necessary to care for children in pediatric hospital settings. Where possible, students will also be given opportunities to care for children in outpatient clinics and/or day care settings. N307 Professional Development This course introduces the student to the regulatory, legal and ethical dimensions of practical nurse practice. Content will focus on the implications of health care reform, the principles and processes of empowerment, change and conflict for effective participation. The course will facilitate discussion of factors that promote effective leadership and management in practical nurse practice and provide opportunity for the student to develop the necessary skills to write professional papers. CN401 Nursing Practice for Professional Development This practice course provides the student with the opportunities to integrate knowledge and apply competencies necessary to achieve clinical proficiency. CN402 Preceptorship This practice course provides the student with opportunities and settings to integrate knowledge and apply competencies necessary to facilitate transition from student to beginning practitioner. Application Guide

14 CREDIT RECOGNITION The CNS recognizes that students may enter its programs having acquired knowledge or competencies through work, experiential learning or formal education. These students may wish to seek credit recognition related to their program of study through a transfer credit process or through Prior Learning Assessment. Normally, students seeking credit recognition for the Practical Nursing Program will have acknowledged their intent upon acceptance into the program by contacting the program coordinator to initiate the process. Transfer Credit: Students entering the Practical Nursing Program who have completed nursing courses in another educational institution or program may be eligible for transfer credit for identified courses. In such cases the student identifies the CNS Practical Nursing Program course or courses for which equivalency assessment is requested and subsequently provides course outline and transcript information from the educational institution. The course and transcript information provided will be assessed by faculty against the CNS Practical Nursing Program courses to determine equivalency. If the assessment identifies course equivalency a transfer credit will be awarded thus exempting the students from the identified course. Applications for transfer credit will be considered following acceptance into the Practical Nursing Program at the CNS. The application is available from the Registrar and should be submitted, no later than one week of program commencement to: Registrar, Non-Degree Programs, CNS. Prior Learning Assessment Recognition (PLAR): Students entering the Practical Nursing Program who wish to seek prior learning assessment recognition based on work, experiential learning, and/or formal education in a related field may be eligible to challenge a course or courses in the Program. Prior learning is assessed by faculty and/or nurse experts against the learning outcomes established for the course using methods such as challenge examinations, oral interview/exam, portfolio assessment, and/or performance evaluation (e.g., lab and/or clinical). If prior learning is recognized through the assessment process, a student could be given exemption from an identified course or components of a course (e.g., lab). If an accepted applicant feels he/she may be eligible for credit for prior learning, he/she may contact the Program Coordinator to initiate the process. Application Guide

15 IMMUNIZATION DOCUMENTATION All students must have the following completed prior to registration. This mandatory screening is a requirement for completing clinical experience in the program: 1. Immunization Record (obtained from and updated by Public Health Nurse) to include documentation of having received the following immunizations: - 2 measles, mumps and rubella vaccines - Tetanus-Diptheria toxoid immune within the past 10 years Tdap (Tetanus, Diphtheria, and acellular Pertussis) One dose of Tdap vaccine is now recommended in adulthood (18 years of age and older). If you have not received a dose of pertussis-containing vaccine within the last ten years and are due for a tetanus booster, you should receive Tdap vaccine to meet this requirement. - Polio vaccine - 2 step TB skin test - Documentation of Hepatitis B vaccines (series of 3 vaccines) 2. Laboratory tests, for all students, as follows (arranged through family physician): - Varicella titre and Hepatitis B Immune Status (anti-hbs level or HBsAB value) The CNS acknowledges and respects the privacy of individuals. The personal information included on this form is collected under the authority of Sections 32 and 33 of the Access to Information and Protection of Privacy Act and will be used for processing your application, the administration of student records, and coordinating your academic program. Contact information may be shared with other agencies as it pertains solely to the administration of the program/course for which you have applied or as authorized by law. If you have any questions about the collection, use, or disclosure of information on this form, please contact Dr. Kathy Watkins, Director, Centre for Nursing Studies at Application Guide

16 Copyright Notice and Disclaimer The information contained in this work is the exclusive property of the Centre for Nursing Studies (CNS). This work is protected under Canadian copyright law. Except as otherwise provided for under Canadian copyright law, no part of this work may be reproduced or transmitted for any purposes, in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage or retrieval system, except as expressly permitted in writing by the CNS The CNS is the lead institute for Practical Nursing Education in Newfoundland and Labrador. The Centre for Nursing Studies reserves the right to deviate from what appears in this guide. Changes may be made in the academic program, policies, procedures, medical evaluation requirements, schedules, or costs in order to serve what the Centre for Nursing Studies considers to be in the best interests of the academic or student community or the Centre itself. The Centre for Nursing Studies thereby disclaims liability to any person who may suffer loss as a result of reliance upon information contained in this guide. Copyright 2015 Centre for Nursing Studies. All rights reserved. V:\Administration\CNS REGISTRAR\PNP\Admissions\FORMS\2015\PN Application Guide 2015 full page Nov.doc Application Guide

17 Centre for Nursing Studies Practical Nursing Program 100 Forest Road - Southcott Hall St. John s, NL AlA le5 Tel #: (709) Fax #: (709) FIRST NAME MIDDLE NAME MAIDEN NAME SURNAME Home Address: Current Address: Postal Code: Postal Code: Telephone # Cell# Telephone # Address (compulsory) Birthdate: Gender: Female Male Day / Month / Year Is English your first language: Yes No Did you complete high school in English: Yes No How many years did you study in English: Emergency Contact Person Telephone # Category that best fits your status: Currently in High School High School ABE CNA Comprehensive Arts & Science Program (CAS) Mature ACADEMIC RECORD: List academic experiences beginning with high school and including postsecondary institution. *Supporting transcripts must be provided. Institution Location Dates Attended Education Obtained WORK EXPERIENCE: List your work experiences beginning with most recent. Employer/Agency Position Held Dates Name of Supervisor

18 2 REFERENCES: Please indicate the names of two referees from whom we can expect to receive letters of reference. Forms are enclosed. (See criteria for acceptable references in application guide). Name Address Telephone Position FOR STATISTICAL PURPOSES ONLY: Are you applying to the BN (Collaborative) Nursing Program? Yes No Are you applying to the CNS PN Program offered at a College of the North Atlantic Site? Yes No If yes, specify which site: Clarenville Grand Falls-Windsor Corner Brook Other ********************************************************************************* Have you applied to the PN Program in previous years? Yes No If yes, specify site and year(s): It is the applicant s responsibility to ensure the references and all documents are supplied by the deadline application date. Incorrect and/or missing information may jeopardize your inclusion in the selection process. A decision cannot be made until your application is complete. I hereby verify that the information given on this application form is true and correct. Permission is granted to the Centre for Nursing Studies to contact previous employers and/or educational institutions to obtain personal references, to verify educational background, and/or to obtain senior high school marks, equivalency, and/or postsecondary educational transcripts. $30.00 processing fee required Date Signature of Applicant The CNS acknowledges and respects the privacy of individuals. The personal information included on this form is collected under the authority of Sections 32 and 33 of the Access to Information and Protection of Privacy Act and will be used for processing your application, the administration of student records, and coordinating your academic program. Contact information may be shared with other agencies as it pertains solely to the administration of the program/course for which you have applied or as authorized by law. If you have any questions about the collection, use, or disclosure of information on this form, please contact Dr. Kathy Watkins, Director, Centre for Nursing Studies at

19 Centre for Nursing Studies - Practical Nursing Program PERSONAL STATEMENT Please respond to the following: 1. What is your reason for choosing the Practical Nursing Program? 2. Describe how your work/volunteer/life experiences will help you succeed in this Program. 3. Describe your strengths/personal qualities that you bring to this Program? (work ethic, communication skill) 4. Please provide any additional information that you feel is relevant to your application. Date Signature V:\Administration\CNS REGISTRAR\PNP\Admissions\FORMS\2015\PN Personal Statement Form 2015.doc

20 NAME OF APPLICANT: Centre for Nursing Studies - Practical Nursing Program 100 Forest Road - Southcott Hall St. John s, NL AlA le5 Telephone #: (709) Fax #: (709) APPLICANT REFERENCE FORM [Professional Referee Only] ADDRESS OF APPLICANT: NAME OF PERSON PROVIDING REFERENCE: ADDRESS OF REFEREE: IN WHAT CONTEXT DO YOU KNOW THIS APPLICANT? EMPLOYER ; MANAGER/SUPERVISOR ; TEACHER ; OTHER (SPECIFY) HOW LONG HAVE YOU KNOWN THE APPLICANT IN THIS CONTEXT? DO YOU FEEL THAT YOU KNOW THE APPLICANT WELL ENOUGH TO BE COMFORTABLE IN SUPPLYING THIS REFERENCE? PLEASE PROVIDE WRITTEN INFORMATION THAT WOULD BE HELPFUL IN THE ASSESSMENT OF THIS INDIVIDUAL'S APPLICATION, CONSIDERING THE FOLLOWING: QUALITY OF WORK, DEPENDABILITY, COMMUNICATIONS AND MATURITY. PLEASE FEEL FREE TO PROVIDE ADDITIONAL INFORMATION BEYOND THE AREAS LISTED. Please See Page 2 Other Side.

21 PLEASE RANK THE FOLLOWING CHARACTERISTICS OF THE APPLICANT: Initiative/ Quality of Work Ability to Handle Stress Sense of Responsibility/ Dependability Leadership Qualities Interpersonal Communication Workplace/School Maturity Attendance Workplace or School Strong Good Satisfactory Needs Improvement Unable to Assess Please sign and date this form and forward directly to The Centre for Nursing Studies postmarked on or before March 15 th. Thank you for your time and cooperation. DATE SIGNATURE ORGANIZATION TELEPHONE NUMBER References can also be faxed directly to the Practical Nursing Program Registrar at V:\Administration\CNS REGISTRAR\PNP\Admissions\FORMS\2013\PN Reference Form 2013.doc

22 NAME OF APPLICANT: Centre for Nursing Studies - Practical Nursing Program 100 Forest Road - Southcott Hall St. John s, NL AlA le5 Telephone #: (709) Fax #: (709) APPLICANT REFERENCE FORM [Professional Referee Only] ADDRESS OF APPLICANT: NAME OF PERSON PROVIDING REFERENCE: ADDRESS OF REFEREE: IN WHAT CONTEXT DO YOU KNOW THIS APPLICANT? EMPLOYER ; MANAGER/SUPERVISOR ; TEACHER ; OTHER (SPECIFY) HOW LONG HAVE YOU KNOWN THE APPLICANT IN THIS CONTEXT? DO YOU FEEL THAT YOU KNOW THE APPLICANT WELL ENOUGH TO BE COMFORTABLE IN SUPPLYING THIS REFERENCE? PLEASE PROVIDE WRITTEN INFORMATION THAT WOULD BE HELPFUL IN THE ASSESSMENT OF THIS INDIVIDUAL'S APPLICATION, CONSIDERING THE FOLLOWING: QUALITY OF WORK, DEPENDABILITY, COMMUNICATIONS AND MATURITY. PLEASE FEEL FREE TO PROVIDE ADDITIONAL INFORMATION BEYOND THE AREAS LISTED. Please See Page 2 Other Side.

23 PLEASE RANK THE FOLLOWING CHARACTERISTICS OF THE APPLICANT: Initiative/ Quality of Work Ability to Handle Stress Sense of Responsibility/ Dependability Leadership Qualities Interpersonal Communication Workplace/School Maturity Attendance Workplace or School Strong Good Satisfactory Needs Improvement Unable to Assess Please sign and date this form and forward directly to The Centre for Nursing Studies postmarked on or before March 15 th. Thank you for your time and cooperation. DATE SIGNATURE ORGANIZATION TELEPHONE NUMBER References can also be faxed directly to the Practical Nursing Program Registrar at V:\Administration\CNS REGISTRAR\PNP\Admissions\FORMS\2013\PN Reference Form 2013.doc