Instructions for Lottery Application

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1 Instructions for Lottery Application Spring 2015 APPLICATION DATES: 8:00AM JANUARY 12, :00PM JANUARY 16, 2015 (for hand delivery, or postmarked by January 16, 2015 for mail delivery) Dear Applicant: Thank you for your interest in BTC's new Registered Nursing program! Please follow these instructions and use the checklist below to ensure your application packet is complete and received on time. You must submit one complete application packet. Only applicants who submit complete application packets will be entered into the lottery. Application items received separately (except official transcripts sent from other institutions) will not be accepted. Application packets received prior to January 12, 2015 or after January 16, 2015 will not be accepted. To be eligible for lottery admission to the RN program, you must first apply online to BTC and receive a BTC Student ID Number (SID) and BTC account. All correspondence will be conducted via BTC . It is your responsibility to ensure your BTC account is set up and working properly. STEP 1: APPLY TO BTC AND UPDATE YOUR CONTACT INFORMATION COMPLETED SUGGESTED ACTION DEADLINE 1/10/15 I have applied to Bellingham Technical College online and have been assigned a BTC address and Student ID Number (SID). 1/12/15 I have logged in to my BTC account and confirmed that it is set up and working properly. For directions go to: 1/12/15 I have logged in to the BTC website and confirmed that my contact information is correct. Go to and choose Student Login on the left. Then choose Student Address Update.

2 STEP 2: SUBMIT A COMPLETE APPLICATION Application Dates: 8:00am January 12, :00pm January 16, 2015 Final Application Deadline: 4:00pm Friday, January 16, 2015 (for hand delivery, or postmarked January 16, 2015 for mail delivery) Applications received prior to January 12, 2015 or after January 15, 2015 will not be accepted. You must submit one complete application packet. Only applicants with complete application packets will be entered into the lottery. Application items received separately (except official transcripts sent by other institutions) will not be accepted. COMPLETED DEADLINE ACTION 1/5/15 I have ordered official sealed transcripts from any institutions where I completed prerequisite coursework. (This is a suggested deadline to ensure that your application materials are received by the deadline.) NOTE: It is highly recommended that you submit official sealed transcripts with your application instead of having them sent by the institution directly to BTC. If you previously submitted official transcripts to BTC, you may not need to resubmit them. BTC follows a strict records retention schedule. It is your responsibility to ensure your records are currently on file. You may contact the Admissions Office to check the status of previously submitted transcripts. 1/16/15 I have completed the 7 prerequisites with a B grade (3.0) or higher and obtained official transcripts (BTC transcripts can be unofficial). Course B Grade (3.0) or higher Within last 5 years English Composition I (ENGL& 101) N/A Lifespan Psychology (PSYC& 200) N/A Intro to Statistics (MATH& 146) N/A Intro to Chemistry (CHEM& 121) N/A Human A & P 1 (BIOL& 241) Human A & P 2 (BIOL& 242) Microbiology (BIOL& 260) 1/16/15 I have obtained a print out from the WA State Department of Health website ( verifying my CNA certification and expiration date. 1/16/15 I have completed the Criminal History Background Check Notification Form (attached). 1/16/15 I completed the Registered Nursing Application Completion Form (attached) and submitted it with all of the requirements listed above to: Bellingham Technical College ATTN: Admissions 3028 Lindbergh Avenue Bellingham, WA FINAL DEADLINE: 4:00PM, FRIDAY, JANUARY 16, NO EXCEPTIONS.

3 Evaluation Process Within two business days after submitting your application packet, you will receive an to your BTC address with a randomly assigned Lottery ID Number (Example: B ). IMPORTANT: This number will be used to identify you in the results posted online. Between January 20, 2015 and January 26, 2015, all application packets will be evaluated and categorized as either Complete or Incomplete. By 5:00pm on Friday, January 26, 2015 evaluation results will be posted on the Registered Nursing program page at All Lottery ID Numbers will be listed and categorized as either Complete or Incomplete. Note: These are NOT the lottery results. Applicants who submitted an incomplete application will have the opportunity to appeal between January 29 February 3, 2015 by submitting an appeal form located on the web. If you submitted an Incomplete application packet, you will be notified via BTC of the incomplete items. Only applicants who submitted a complete application packet will be entered into the lottery. STEP 3: CHECK YOUR APPLICATION STATUS COMPLETED DEADLINE ACTION 1/26/15 I have checked the Registered Nursing program page at for the status of my application packet. Note: The evaluation results posted on 1/30/15 are NOT the lottery results. 1/28/15 For applicants who submitted an Incomplete application packet only: I have checked my BTC account for an explanation of incomplete items. Due to the volume of applicants, please do not call or the Admissions Office about the status of your application packet. Lottery Process BTC will use a computerized random number generator to produce the Lottery ID Numbers and lottery results. The lottery will take place on February 2, 2015 in the presence of two Admissions staff members and one BTC Administrator. Eight applicants will be drawn to fill 8 program seats. Two applicants will be drawn as alternates. Alternate candidates will only be offered a seat in the program if a lottery winner declines or forfeits his/her seat. Alternate candidates receive no priority for future program admission. Results will be posted on the Registered Nursing program page at by 5:00pm on February 2, Lottery winners and alternates will also be notified via BTC . Lottery winners and alternates must respond via BTC to accept or decline their seat by 5:00pm February 9, Winners and alternates who do not respond by the deadline will forfeit their seat in the program and must reapply for future lottery admission.

4 Lottery winners who decline their seat in the RN program may not defer to a future quarter and must reapply for future lottery admission. STEP 4: CHECK LOTTERY RESULTS COMPLETED DEADLINE ACTION 2/9/15 I have checked the Registered Nursing program page at for lottery results. 2/16/15 For Lottery winners and alternates only: I have responded to my acceptance or alternate status via BTC . Application packets will not be retained for future lottery drawings. If you are not selected for Fall 2013, you may reapply for future admission. All application packets materials (excluding official transcripts) will need to be resubmitted according to future lottery application instructions. Future RN program start dates will be posted on the RN web page. Thank you for choosing the Registered Nursing program at BTC! BTC Admissions & Advising Office DUE TO THE VOLUME OF APPLICANTS, PLEASE DO NOT CALL OR THE ADMISSIONS OFFICE ABOUT THE STATUS OF YOUR APPLICATION.

5 ASSOCIATE DEGREE NURSING ADMISSIONS INFORMATION To be eligible for program entry by lottery selection, follow the steps below: Apply online indicating Associate Degree Nursing (ADN) as your program intent at: Applicants will receive a Student Identification (SID) number and BTC student within 2-3 business days. Complete placement testing to identify the prerequisite coursework you can enroll in. Visit: for additional test information and the BTC Assessment Center drop-in test schedule. If you have completed equivalent testing or prerequisite coursework at a regionally accredited institution, you may request to have your records evaluated for test waiver. Submit official transcripts or test scores with the BTC Evaluation Request form to the Admissions & Student Resource Center. Complete the 7 prerequisites listed below with a B (3.0) grade in each course. Only the first two attempts at required coursework will be considered. If your first attempt resulted in a grade less than B and it was more than 5 years ago, you will be allowed a 2 nd retake to meet the minimum grade requirement. Students who have special circumstances that warrant an exception may submit a Request for Exception to Course Retake Policy form (available in the Admissions Office). Associate Degree Prerequisite Courses English Composition I (ENGL& 101) Lifespan Psychology (PSYC& 200) Prerequisite Entrance Requirements Reading & Sentence Skills assessment scores or AENGL 100 (formerly COM 170) General Psychology (PSYC&100) Intro to Statistics (MATH& 146) Intermediate Algebra (MATH 099) or College Level Math score Introduction to Chemistry (CHEM& 121) Intermediate Algebra (MATH 099) or Note: Not equivalent to the former WCC CHEM 121 course College Level Math score Human A & P 1 (BIOL& 241) General Biology w/lab (BIOL& 160) and CHEM& 121 Human A & P 2 (BIOL& 242) Human A & P 1 (BIOL& 241) Microbiology (BIOL& 260) General Biology w/lab (BIOL& 160) and CHEM& 121 Complete Nursing Assistant training and obtain certification. Please note: Students who previously completed certificated nursing assistant training who did not take the certification exam, must obtain certification. Certification must be completed within one year of training. Continue on back of sheet

6 Submit a complete application packet including the following: The Associate Degree Nursing Application Completion Form The Criminal History Background Check Notification form Official transcripts documenting prerequisite completion, including unofficial BTC transcripts A print-out from the Department of Health website verifying your Washington State CNA certification and expiration date Send program application materials & transcripts to: Bellingham Technical College, ATTN: Admissions Office, 3028 Lindbergh Avenue, Bellingham, WA Financial Aid Eligibility and Other Special Considerations For this program, financial aid is available for those who qualify. Visit the BTC Financial Aid website for additional information. Evaluation of Candidates Application packets will only be accepted during specified times. Please visit the Nursing program web page for upcoming application dates. Complete application packets will be included in a random selection lottery drawing which determines acceptance into the ADN program. Incorrect or incomplete application packets will not be considered. In order to be successful in the nursing program, students must acquire and continually demonstrate essential qualifications. Details are provided on the nursing program website. ADN students must have experience using Microsoft Word, Excel, and PowerPoint as well as and Internet skills. After Admission to the Program and Prior to Registration for Quarter 1, Students Must: Be 18 years of age Complete the following requirements: o Physical exam and specified immunizations o Criminal background check o 10-panel drug screen o Current American Heart Association Healthcare Provider CPR training o Medical insurance coverage (student insurance information is available in the Admissions Office or go to Students will be required to create an online account with Certified Background and pay a fee of $ for the background check, drug screen, and tracking of required health documents. Prior to registration for Quarter 4, second-year students must complete a second criminal background check for a $22.00 fee. Sequence & Schedule Theory classes are generally held between 8am and 5pm. Clinical times vary and may include evenings and weekends depending on the location and shift. Detailed schedules are provided on the first day of class. First Year Quarter I Credits: 15 Quarter 2 Credits: 13 Quarter 3 Credits: 13 Second Year Quarter 4 Credits: 13 Quarter 5 Credits: 13 Quarter 6 Credits: 10 Graduates of BTC s Practical Nursing program Bellingham Technical College does not discriminate against any person on the basis of race, color, national origin, disability, sex, genetic information, or age in admission, treatment, or participation in its programs, services and activities, or in employment. All Inquiries regarding compliance with access, equal opportunity and/or grievance procedures should be directed to the Associate Director of Human Resources, Bellingham Technical College, 3028 Lindbergh Avenue, Bellingham, WA 98225, or call April 2014

7 BTC Licensed Practical Nurses interested in completing the Associate Degree Nursing program should refer to the Associate Degree Nursing (LPN-ADN) Admissions Information handout. Priority Admission for Veterans, Eligible Spouses, and Trade Act Workers In October 2013, Bellingham Technical College received a grant from the Department of Labor which has allowed us to expand our Nursing program and provide additional support to nursing students. As a DOL grantee, BTC is required to provide priority to Veterans, eligible spouses of Veterans, and Trade Act-eligible workers for Nursing program admission. Students who meet the Eligibility Requirements may be eligible for priority admission. For more information, please see the Priority Admission for Veterans, Eligible Spouses, and Trade Act Workers available on the Nursing program web page or in the Admissions Office. If you have questions about the Associate Degree Nursing program, please contact Admissions & Student Resource Center at Mission Statement: Bellingham Technical College delivers superior professional technical education for today s needs and tomorrow s opportunities O:\Admissions Info\PROGRAM Handouts\PN Info 2009 Revised.doc January 15

8 APPLICANT NOTIFICATION CRIMINAL HISTORY BACKGROUND CHECK For Associate Degree Nursing, Radiologic Technology, and Surgery Technology Pursuant to RCW , employees and volunteers who provide service to developmentally disabled persons, vulnerable adults, and/or children under the age of 16, must successfully pass Washington State Patrol criminal history background checks as a condition for licensing or certification. Furthermore, students enrolled in programs that require clinical training must pass a criminal history background check in order to comply with agreements between Bellingham Technical College and its clinical affiliates. Based on the program, one or more of the following checks will be conducted: Washington State Patrol Nationwide Healthcare Fraud and Abuse Scan Nationwide Database and Sex Offender Social Security Alert Residency History The information obtained through the background check will be reviewed by Admissions and, if necessary, the program Dean. Clinical eligibility decisions will be based on the list of Disqualifying Crimes for Clinical Training Eligibility (see reverse side) as well as the frequency and recent history of crimes. Please answer the questions below. Note: Failure to disclose any past or pending convictions may disqualify you from participating in clinical training. 1. Have you been convicted of any crime? Yes No If yes, fill in the blanks below. Add a page if you need more room. Felony and gross misdemeanor crimes: Degree: State: Conviction date: 2. Do you have charges (pending) against you for any crime? Yes No If yes, fill in the blanks below. Add a page if you need more room. Felony and gross misdemeanor crimes: Degree: State: 3. Have you ever received a notice from a court or state agency stating that you have sexually abused, physically abused, neglected, abandoned, or exploited a child, juvenile, or adult? Yes No 4. Has a court or state agency ever denied you a contract or license; terminated, revoked or suspended your contract or license; or have you ever given up your contract or license because a court or agency was taking action against you? Yes No 5. Has a court ever written an order of protection or a restraining order lasting more than 30 days against you for abuse, neglect, financial exploitation, domestic violence, or abandonment of a vulnerable adult, juvenile, or child? Yes No If you have any questions or concerns about your ability to pass a criminal history background check, please make arrangements for a confidential appointment with an academic advisor by calling I have been notified by Bellingham Technical College that a criminal history background check will be conducted on me. I give permission to BELLINGHAM TECHNICAL COLLEGE to release the results of my criminal history background checks to the clinical sites to which I will be assigned. Student Signature Social Security or Student ID Number Date Gender: Male Female Last (Print) First M.I. Date of Birth Past Names (Maiden) or aliases: May 2014

9 Ineligibility to participate in clinical training due to information obtained from the criminal history background check may result in a student s inability to complete the program requirements. Please note that it is possible for a student to be admitted to, and successfully complete the program and still be denied the following: Eligibility for licensure/certification upon completion of training: State authorities can usually provide guidelines only. Most applicants for licensure are evaluated on a case by case basis. In other words, students may not receive a definite yes or no concerning their criminal background issues until after they have completed training and apply for licensure or certification. Future employment opportunities: Completion of a health occupation program and licensure/certification by local agencies does not guarantee employability. Hiring facilities may still take previous background issues into consideration when choosing new employees and may conduct pre employment background checks. Disqualifying Crimes for Clinical Training Eligibility The list below is based on clinical affiliate requirements, the DSHS Secretary s List of Crimes and Negative Actions for use by ALTSA Residential Care Services for Nursing Homes, Assisted Living Facilities & Adult Family Homes, and The Washington State Nursing Commission s Decision Making Criteria for License Application, Policy A A student who has been convicted of a crime listed below will not be eligible to participate in clinical training. ANY felony conviction THREE or more misdemeanor convictions (excluding driving without a license). Results will be reviewed on a case by case basis prior to disqualification. Abandonment of a child Abandonment of a dependent person Abuse or neglect of a child Arson Assault 1, 2, 3, Assault 4 (if within the last 3 years) Assault of a child Burglary 1 Child buying or selling Child molestation Commercial Sexual Abuse of a Minor/Patronizing a juvenile prostitute Communication with a minor for immoral purposes Criminal Mistreatment Custodial assault Custodial interference Custodial sexual misconduct Dealing in depictions of minor engaged in sexual explicit conduct Driving under the influence or related conviction (if more than one conviction within the last 3 years) Endangerment with a controlled substance Extortion Incest Indecent Exposure victim under 14 Indecent exposure/public indecency Indecent liberties Kidnapping Malicious harassment Manslaughter Murder/Aggravated murder Promoting pornography Possession of drugs (controlled substances) and/or paraphernalia Possession of marijuana (if within the last 2 years) Promoting Prostitution 1 Prostitution (if within the last 3 years) Rape 1, 2, 3 Rape of child Registered sex offender Residential Burglary Robbery Selling or distributing erotic material to a minor Sending or bringing into the state depictions of a minor Sexual exploitation of minors Sexual misconduct with a minor Theft 1 Theft 2 (if within the last 5 years) Theft 3 (if within the last 3 years) Unlawful imprisonment Vehicular homicide (negligent homicide) Violation of child abuse restraining order Violation of the Imitation Controlled Substance Act Violation of the Uniform Legend Drug Act Violation of the Uniform Precursor Drug Act Violation of Uniform Controlled Substance Act Voyeurism Additional disqualifiers: o Social Security Number belongs to a deceased individual or the issue date precedes date of birth. o Registered sex offender o Sex offender match o Any misdemeanor or felony that appears on the court record that was not disclosed by the student on this form. A student who has been convicted of a crime listed below may be ineligible to participate in clinical training. Bomb threat Burglary 2 Forgery Malicious Mischief 1, 2 Possession of Stolen Property 1, 2 Residential Burglary UIBC over $250 Vehicle Theft May 2014

10 ASSOCIATE DEGREE NURSING PROGRAM APPLICATION COMPLETION FORM Once you have completed all prerequisite courses and final grades have been posted, submit this document and all forms listed below. Application packets are only accepted during posted application dates (see the Nursing program web page for upcoming dates). Incomplete packets will not be accepted. Name (Last, First, MI): SID or SSN: Former Name: Phone No: Date: Current Address: STREET CITY STATE ZIP Please complete all of the items below and attach required documents. 1. Apply online and indicate Associate Degree Nursing as your program (Go to 2. Check one: I am already on the PN wait list and am applying for lottery selection for the next cohort. I understand that I will be removed from the wait list and no longer eligible for grandfathering. I am not on the PN wait list and am applying for lottery admission. 3. Check one (If applicable): I am requesting priority admission because I am a Veteran, Eligible Spouse of a Veteran, or Trade Act Eligible Worker (see Nursing web page for details). 4. I have read the lottery instructions and understand the application requirements and lottery process. Date Signature Please attach the following items: Criminal History Background Check Notification form Print out from the Department of Health website ( verifying your WA state CNA certification and expiration date. Official transcripts showing evidence of completion of all 7 prerequisite courses with a B (3.0) grade or higher (BTC transcripts can be unofficial). Evidence of Completion of RN Prerequisites (check all that apply) Associate Degree Nursing Prerequisite Courses Office Use Only I have attached unofficial BTC transcripts (required for all English Composition (ENGL& 101) coursework taken at BTC) Introduction to Statistics (MATH& 146) I have attached sealed, official transcripts from another Lifespan Psychology (PSYC& 200) institution Human A&P 1 (BIOL& 241) My records are already on file or have been ordered from: Human A&P 2 (BIOL& 242) Intro to Chemistry (CHEM& 121) Microbiology (BIOL& 260) Submit complete application packet to: Bellingham Technical College, ATTN: Admissions, 3028 Lindbergh Ave, Bellingham, WA Bellingham Technical College does not discriminate against any person on the basis of race, color, national origin, disability, sex, genetic information, or age in admission, treatment, or participation in its programs, services and activities, or in employment. All Inquiries regarding compliance with access, equal opportunity and/or grievance procedures should be directed to the Associate Director of Human Resources, Bellingham Technical College, 3028 Lindbergh Avenue, Bellingham, WA 98225, or call April 2014

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