Nursing Admissions Information Associate in Applied Science

Transcription

1 Associate in Applied Science Nursing Admission Information

2 General Information The Redlands Community College (RCC) Department of Nursing offers traditional and advanced placement pathways to the Associate in Applied Science in Nursing at Redlands Community College in El Reno, Oklahoma. The pathway requires 38 credit hours of science and support courses and 32 credit hours of nursing coursework. A graduate of this program is eligible to write the National Council Licensure Examination (NCLEX) for licensure as a Registered Nurse. Any student may declare a nursing major while enrolled in general education or support courses. These students are not admitted to the nursing program. A separate application and admissions process is required for admittance to the degree-granting program. Students are admitted to the nursing program based on a points system. Selection points are determined using the applicant s pre-admission examination scores, retention grade point average (GPA), and grades earned for coursework required for degree completion. Accreditation The program is approved by the Oklahoma Board of Nursing and accredited by the National League for Nursing Accrediting Commission. Information can be obtained from the respective agencies: Oklahoma Board of Nursing 2915 North Classen Boulevard Suite 524 Oklahoma City, Oklahoma voice / fax National League for Nursing Accreditation Commission 3343 Peachtree Road NE, Suite 500 Atlanta, GA, fax Admission requirements Acceptance into the Nursing Program Applicants must: 1. Successfully complete the pre-admission exam (TEAS V) in the last 12 months with a score of 65%. 2. Apply for admission to the college if the student has not attended RCC in the last two years. The online application can be found at the RCC website ( 3. Complete a nursing school application (included with this handbook). Must include a copy of TEAS exam results and two official copies of high school and college transcripts.(one transcript for Redlands Community College and one transcript for Redlands Community College Nursing Program) 4. Complete CHEM 1215 or 1315 (Chemistry I with Lab) or a 4 hour chemistry class with lab with approval from Nursing Department Division director with a C or above as a prerequisite to the nursing program. 5. Have a retention grade point (GPA) of 2.50 on a 4.0-point scale. 6. Pass all support and nursing courses with a C grade. Page 2 of 20

3 7. Meet the minimal physical qualifications (included with this handbook) or receive written approval for ADA accommodations. 8. Meet and maintain the following Oklahoma Board of Nursing s requirements for licensure: The Redlands Community College Nursing Program is approved by the Oklahoma Board of Nursing. Graduates of this state-approved program are eligible to apply to take the National Council Licensure Examination (NCLEX) for (registered or practical) nurses. Applicants for Oklahoma licensure must meet all state and federal requirements to hold an Oklahoma license to practice nursing. In addition to completing a state-approved nursing education program that meets educational requirements and successfully passing the licensure examination, requirements include submission of an application for licensure, a criminal history records search, and evidence of citizenship or qualified alien status. Applicants for practical nurse licensure must also hold a high school diploma or a graduate equivalency degree (G.E.D.) [59 O.S & 567.6]. To be granted a license, an applicant must have the legal right to be in the United States (United States Code Chapter 8, Section 1621). In addition, Oklahoma law allows a license to be issued to U.S. citizens, U.S. nationals, and legal permanent resident aliens; and to applicants who present, in person, valid documentary evidence of: 1. A valid, unexpired immigrant or nonimmigrant visa status for admission into the United States; 2. A pending or approved application for asylum in the United States; 3. Admission into the United States in refugee status; 4. A pending or approved application for temporary protected status in the United States; 5. Approved deferred action status; or 6. A pending application for adjustment of status to legal permanent residence status or conditional resident status. Applicants who are United States citizens, nationals, or legal permanent resident aliens must submit with their application and fee a notarized Evidence of Status Form: Part A and a photocopy of documentation verifying their citizenship status, as indicated on the Evidence of Status Form: Part A; or Applicants who are not United States citizens, nationals, or legal permanent resident aliens must submit in person at the Board office an Evidence of Status Form: Part B and original qualified alien documentation, with their application, OSBI Criminal History Records Search, and fee. The original documentation will be verified, copied, and notarized. The status will be verified on an online system through the Department of Homeland Security (the SAVE system). Qualified aliens will only be eligible to receive a license or certificate marked Temporary, valid for the time period of their authorized stay in the United States, or if there is no date of end to the time period of their authorized stay, for one year. The Board has the right to deny a license to an individual with a history of criminal background, disciplinary action on another health-related license or certification, or judicial declaration of mental incompetence [59 O.S ]. These cases are considered on an individual basis at the time application for licensure is made, with the exception of felony charges. An individual with a felony conviction cannot apply for licensure for at least five years after completion of all sentencing terms, including probation and suspended sentences, unless a presidential or gubernatorial pardon is received [59 O.S & 567.6]. A candidate for a license to practice as a registered nurse or licensed practical nurse shall submit to the Oklahoma Board of Nursing certified written evidence that the applicant has never been convicted in this state, the United States or another state of any felony, unless five (5) years have elapsed since the date of the criminal conviction or the termination of any probation or other Page 3 of 20

4 requirements imposed on the applicant by the sentencing court, whichever shall last occur, or a presidential or gubernatorial pardon for the criminal offense has been received [59 O.S ]. Therefore, applicants for licensure in Oklahoma with one or more felony convictions cannot apply for licensure for at least five years after completion of all sentencing terms, including probation and suspended sentences, unless a presidential or gubernatorial pardon is received. The applicant must submit the following information to the Board: 1. Application for licensure and licensure fee 2. A signed letter from the applicant describing the location and circumstances of the offense, date, court action taken and current status 3. OSBI criminal history search not more than three (3) months old 4. If applicable, certified copies of the Affidavit of Probable Cause, Information Sheet, Charges, Judgment and Sentence, and verification that the sentencing requirements are complete (these documents may be obtained from the courthouse in the county in which the arrest took place). Please ensure that the copies are certified, e.g., they are stamped with the court seal. Failure to submit the above information in a timely manner may result in a delay in processing the application. After Board staff reviews this information, the applicant will be notified of any additional action that must be taken. The applicant may be required to appear before the Board. Additional documentation that may be requested prior to this appearance, includes, but is not limited to, letters of reference from a clinical faculty member, the director/dean of program, a probation officer, employer or others. OBN Policy/Guideline #E-05, Information for Bulletins and Catalogues of Nursing Education Programs, last revision 11/07 Pre-Admission Exam (Testing of Essential Academic Skills TEAS V) The TEAS V exam ( includes math, reading, English, and science. It is strongly advised that students take the beginning science courses prior to taking the TEAS exam. Students are also strongly advised to utilize the study guides suggested for this exam available at RCC bookstore and the ATI website noted above. To take the exam, students must pay $35.00 in the RCC business office and bring the receipt to the nursing office to choose an exam date. Exam dates are also noted on the RCC website ( Students must allow 4 hours to take the exam. Results will be immediately available. Students must complete the exam with a score of 65%. If not successful, the student may repeat the TEAS exam with a suggested time frame of 45 days between tests. Scores may not be older than 1 year at the time of application submission. Page 4 of 20

5 Calculation of selection points Nursing Admissions Information Criteria Measure Points Awarded Nursing Pre-admissions examination score % % % % Grade points in required science courses Grade points in other required courses A grade B grade C grade A grade B grade C grade College retention grade point average For 13 or more earned credit hours For 6 12 earned credit hours per credit hour 6 per credit hour 4 per credit hour 4 per credit hour 3 per credit hour 2 per credit hour Attendance at Redlands Community College 30 or more hours 25 Successful completion of Associate s Degree 5 Successful completion of Bachelor s Degree 10 Successful completion of Master s Degree 15 Basic and Intermediate EMTs and others with health care related training All Basic and Intermediate EMTs and others with health care related training (i.e. CNA, military medic, CMA, PTA, OTA) will be required to follow the traditional admission process and enter the nursing program beginning with Fundamentals of Nursing. Advanced Placement Plan LPN s and licensed Paramedics placement in Adult Health is contingent on following requirements and available positions. LPN s LPNs who graduated from accredited or non-nlnac accredited Nursing/Allied Health programs. Licensed practical nurses who meet admission and nursing program requirements may qualify to receive 6 hours of nursing course credit for NURS 1115/1121 Fundamentals of Nursing for their nursing education: 1. Currently hold an Oklahoma license and have practiced at least one year as a LPN. Proof of licensure is required. 2. All prerequisite for admission and to nursing program apply to LPNs. 3. Required to successfully complete Role Transition, a 3 credit hour non-clinical course that provides content to assist with advanced placement and successful completion of the program. 4. Competency Requirements: Successful completion of following classes with at least a C (a) CHEM with lab (b) Role Transition course and (c) TEAS V test with a 65% or Page 5 of 20

6 higher score (NURS 2103) are required prior to enrollment in NURS 1223/1211 Adult Health Problems or NURS 1233/1241. Paramedics Paramedics who graduated from accredited or non-nlnac accredited Nursing/Allied Health programs. Licensed paramedics who meet admission and nursing program requirements may qualify to receive 6 hours of nursing course credit for NURS 1115/1121 Fundamentals of Nursing for their nursing education: 1. Currently Oklahoma licensure and practice at least one year as a License paramedic. Proof of licensure is required. 2. All prerequisite for admission and to nursing program apply to License paramedic. 3. Required to successfully complete Role Transition, a 3 credit hour non-clinical course that provides content to assist with advanced placement and successful completion of the program. 4. Competency Requirements: Successful completion of following classes with at least a C (a) CHEM with lab (b) NURS 2103 Role Transition course and (c) TEAS V test with a 65% or higher score are required prior to enrollment in NURS 1223/1211 Adult Health Problems or NURS 1233/1241 PCN Nursing. Transfer Students Transfer students who meet admission and nursing program requirements may apply to the Redlands Community College Nursing Program. To be considered as a transfer student, the applicant must have completed nursing courses within the past year that will substitute for nursing major course(s) at RCC. Courses accepted as equivalent to required nursing courses must have been earned at a regionally-accredited institution of higher learning (college or university). The course content must equate to nursing major course(s) offered at Redlands Community College. The applicant is required to meet with the Nursing Advisor and to submit evidence of equivalency (i.e. course syllabus) as requested. The last 15 credit hours must be earned at Redlands Community College in order to meet RCC degree requirements. Page 6 of 20

7 International students If you attended high school, college, or both in a country other than the United States, you must set up an advising appointment with the International Student Services advisor to determine any further steps that must be taken to determine your grade point average and transfer credits. All foreign academic credentials must be evaluated by World Education Services and submitted to the Department of Nursing on or before the application deadline. Students are responsible for fees associated with this review. International Student Services Student Services Department 1300 S Country Club Rd El Reno, Oklahoma World Education Services Bowling Green Station PO Box 5087 New York, NY / fax Page 7 of 20

8 Submitting an application Application Deadline: a. Traditional Application- Fall semester Fundamentals of Nursing first semester (first Friday in March) b. Advanced Placement Application- Spring semester Adult Health second semester (December 1 st ) Persons meeting admission requirements must: Submit all required documentation (as listed below) prior to the application deadline: Students must provide transcripts of ANY coursework completed at other institutions of higher learning. 1. Nursing Pre-Admission exam (TEAS V) with results of 65% or higher. 2. Verification of acceptance to Redlands Community College. 3. Application for RCC nursing program 4. Official transcripts from high school, GED certification, technology center, college, or university attended. 5. Provide proof of US citizenship, national status, or legal permanent resident alien status. Notification of Acceptance: Students who are admitted into the nursing program will be notified by April 10 th for fall admission and by December 15 th for Spring admission. Students who have been accepted for admission must notify nursing office of plans to attend by April 15 for first semester or December 20 for second semester of each year or they will be moved to an alternate list. To be able to enroll in the nursing program, the admitted student must submit the following forms (found at by July 1st: 1. Completed Report of Physical Examination 2. Completed Report of Vaccination Status 3. Completed Oklahoma State Bureau of Investigation (OSBI) Criminal History Information Request less than 3 months prior to admission 4. Group One US Background check completed (no form needed from student) 5. Current American Heart Association Basic Life Support for Healthcare Providers card (issue date no earlier than June of current year) Failure to submit the materials by the specified deadline will be considered an automatic withdrawal from the nursing program. Readmission and Retention Policies A student who withdraws or fails any nursing major course may submit a letter requesting readmission. Readmission may be requested one time only and must be within one year of failure or withdrawal. An Admissions Committee representative will review all letters requesting readmission and may request an interview with the student. The number of students to be readmitted is determined based on course enrollments. Students will be notified about admission Page 8 of 20

9 status at the earliest possible date prior to the beginning of the semester for which the individual is requesting. Students are admitted in the August and January, except for returning RCC students. No transfers or new admissions will be allowed at mid-semester. If at any point minimal physical qualifications and/or annual requirements are not met, the student will be withdrawn. Nursing courses are divided into theory and laboratory/clinical components. A satisfactory standard of performance must be maintained in both components of each nursing course. A student with unsatisfactory performance in either theory or laboratory/clinical, a passing grade will not be assigned to either component. All students in the nursing program must maintain a C in all required support and nursing courses. All LPN students must maintain their license in good standing throughout the RCC nursing program. Enrollment in the nursing program may be discontinued if the student s personal conduct (i.e. ethical, legal, moral) is incongruent with a nursing career. This includes, but is not limited to: 1. Participation in academic cheating 2. Plagiarism 3. Unauthorized possession of examinations 4. Falsification of personal, client, and/or agency records 5. Illegal possession, sale, or distribution of drugs 6. Illegal possession of weapons 7. Theft 8. Charges and/or conviction of felony 9. Excessive absenteeism 10. Failure or refusal to cooperate with mandatory drug testing 11. Any other conduct incompatible with professional behavior Contact Us If you have any questions or concerns regarding our admissions requirements, the application process, or your application, please feel free to contact us and set up an advising appointment S Country Club Rd El Reno, OK Redlands Community College Department of Nursing cathie.sales@redlandscc.edu fax RCC: Nursing Reviewed: 02/12 Revised: 02/12 Page 9 of 20

10 Physical Requirements for Admission/Progression in the Nursing Program Check if able to meet the following requirements: Standing/Walking: Standing and walking is required for majority of time spent in the clinical area (4-8 hours). Standing in one position is required while performing certain aspects of patient care. Walking occurs on vinyl, tile, linoleum, or carpeted floors. Sitting: Sits while charting or entering data into computer. May also sit while receiving/giving verbal report at start/end of shift. May also sit during breaks and meal period. Total sitting is less than two hours for each eight-hour shift, depending on clinical assignment. Lifting: Regularly lifts medical supplies, medications, patient supplies, patient charts, weighing up to ten pounds. Also lifts CPR equipment and other medical equipment weighing up to 45 pounds. Required to assist in lifting and transferring patients of varying weights and is expected to request assistance when lifting, ambulating, and repositioning patients. Must be able to support at least 75 pounds to reposition, transfer, and ambulate patients safely. Carrying: Frequently carries medical supplies and other items weighing up to 45 pounds. Occasionally carries certain medical equipment weighing up to 50 pounds. Pushing/Pulling: Pushing/pulling pounds is required when administering patient therapy and care, as well as when pushing equipment such as oxygen tanks and monitors, and when transporting patients in wheelchairs, beds, or gurneys. Pushing required at 3.5 pounds of pressure when administering CPR. Full manual dexterity of both upper extremities required. Climbing: No significant climbing is required, may be required to climb a step stool. Bending: Required when administering patient care. Must be able to bend to touch floor to remove environmental hazards. Reaching: Reaching above head required when performing aspects of care such as hanging and adjusting IV bags. Squatting/Kneeling: Required when operating medical equipment and performing aspects of patient care, such as CPR. Twisting: Twisting at waist required when bathing patients and performing other procedures. Speaking: Must be able to clearly speak English to communicate, assess, and educate patients/families. Must also be able to communicate verbally with physicians and other professionals involved in patient care. Hearing: Must have normal hearing (aids permitted) in order to perform physical assessments, including listening with a stethoscope for bowel, heart, and lung sounds. Must also be able to hear to detect subtle yet critical information regarding patient condition including alarms and to communicate with physicians and other professionals involved with patient care. Normal hearing required for discussion with others by telephone. Page 10 of 20

11 Visual Acuity: Required within normal limits (glasses or contacts permitted) for monitoring equipment, reading medical data, preparing and administering medications and injections, performing physical assessments of patients including subtle changes in color. Depth Perception: Required for fine tasks such as administering injections, sterile catheter insertions (urinary, IV), nasogastric tube insertions. Fine Motor Skills: Must have fine motor skills of all fingers and be able to grasp and control medical equipment and to perform precise procedures such as sterile dressing changes. Must be able to grasp objects such as a pen to prepare handwritten reports. Tactile Sensation: Must be able to assess patients through palpation with fingers and hands, must be able to distinguish between warm/cold and be able to feel vibrations. Smell: Must have normal sense of smell to detect odors indicating unsafe conditions or changing patient status. Driving Required: Students are responsible for their own transportation to and from clinical agencies. I AM ABLE TO MEET ALL PHYSICAL REQUIREMENTS AS DESCRIBED ABOVE I AM UNABLE TO MEET ALL PHYSICAL REQUIREMENTS AS DESCRIBED ABOVE COMMENTS: MY SIGNATURE BELOW INDICATES THAT ALL INFORMATION ON THIS FORM IS ACCURATE AND TRUE Applicant Signature Date For office use only: Discussed with student Referred to ADA Officer ADA approval received ADA denial received Page 11 of 20

12 Form adapted from New Mexico State University at Carlsbad Nursing Program Handbook, Fall 2008 Notice of Nondiscrimination Statement Redlands Community College does not discriminate on the basis of race, color, national origin, sex, disability, age, religion, or status as a veteran, in any of its educational programs, activities, policies, practices, or procedures, including, but is not limited to, admissions, employment, eligibility for financial aid, and educational services, in accordance with Titles VI and VII of the Civil Rights Act of 1964, Executive Order as amended, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, the Age Discrimination Act of 1975, the Civil Rights Act of 1991, and other federal laws and regulations. The following person has been designated to handle inquiries regarding the College s nondiscrimination policies and procedures for students, employees, and others: Personnel Coordinator Redlands Community College 1300 S. Country Club Road El Reno, OK (405) RCC: Nursing Reviewed: 02/12 Revised: 02/12 Page 12 of 20

13 Two Year Graduation Plan (All nursing courses must be taken in sequential order) Summer CHEM 1215 or 1315 General Chemistry I w/ lab 5 ** CHEM 1214 or 1314 General Chemistry with Lab 4 Total 4 or 5 First Semester (Fall) * NURS 1115/1121 Fundamentals of Nursing/Clinical Experience 6 ZOOL 2134 Anatomy w/ lab 4 ENGL 1113 English Composition I 3 PSY 1113 Elements of Psychology 3 Total 16 Second Semester (Spring) * NURS 1223/1211 Adult Health Problems/Clinical Experience 4 * NURS 1233/1241 Parental Child Nursing/Clinical Experience 4 ZOOL 2144 Physiology w/ lab 4 ENGL 1213 English Composition II 3 PSY 2163 Developmental Psychology 3 Total 18 Third Semester (Fall) * NURS 2137/2131 Complex Adult Health/Clinical Experience 8 MICR 2134 Introduction to Microbiology w/ lab 4 SOC 1113 Introduction to Sociology 3 POLS 1113 U.S. Government 3 Total 18 Fourth Semester (Spring) * NURS 2243/2241 Care of the Psychiatric Patient/Clinical Experience 4 * NURS 2255/2261 Leadership and Management in Nursing/Clinical 6 Experience HIST 1483 or 1493 US History to 1877, or US History, 1877 to Present 3 Total 13 Program Total 69 or 70 * Students applying through the Advanced Placement pathways must have all shaded courses complete prior to starting the program. ** 4 hour Chemistry with lab approval required See Nursing Advisor Page 13 of 20

14 Part-Time Graduation Plan (All nursing courses must be taken in sequential order) Summer CHEM 1215 or 1315 General Chemistry I w/ lab 5 ** CHEM 1214 or 1314 General Chemistry I w lab Total 4 or 5 First Semester (Fall) ZOOL 2134 Anatomy w/ lab 4 ENGL 1113 English Composition I 3 PSY 1113 Elements of Psychology 3 SOC 1113 Introduction to Sociology 3 Total 13 Second Semester (Spring) ZOOL 2144 Physiology w/ lab 4 ENGL 1213 English Composition II 3 PSY 2163 Developmental Psychology 3 POLS 1113 U.S. Government 3 Total 13 Summer MICR 2134 Introduction to Microbiology w/ lab 4 Total 4 Third Semester (Fall) * NURS 1115/1121 Fundamentals of Nursing/Clinical Experience 6 Total 6 Fourth Semester (Spring) * NURS 1223/1211 Adult Health Problems/Clinical Experience 4 * NURS 1233/1241 Parental Child Nursing/Clinical Experience 4 Total 8 Summer HIST 1483 or 1493 US History to 1877, or US History, 1877 to Present 3 Total 3 Fifth Semester (Fall) * NURS 2137/2131 Complex Adult Health /Clinical Experience 8 Total 8 Sixth Semester (Spring) * NURS 2243/2241 Care of the Psychiatric Client/Clinical Experience 4 * NURS 2255/2261 Leadership and Management in Nursing/Clinical Experience 6 Total 10 Program Total 69 or 70 * *4 hour Chemistry with lab approval required See Nursing Advisor Page 14 of 20

15 Licensed healthcare practitioner (HCP) to complete this portion of the form. Please list the date of all vaccinations or titers for the following. Noting a history of chickenpox is not sufficient for the purpose of this record. Hepatitis B vaccination waiver available from nursing office upon request. Mark N/A in columns if refused or contraindicated. LAST NAME FIRST NAME M.I. DATE OF BIRTH ( ) - ( ) - HOME PHONE CELL PHONE ADDRESS CITY STATE ZIP If student must get a booster for MMR or Varicella, the Titer must be repeated in 90 days. Vaccination Hepatitis B #1 1 Hepatitis B #2 Hepatitis B #3 MMR MMR Booster (if applicable) Varicella Varicella Booster Tetanus 2 Polio Hepatitis A Vaccination Date Copy of record attached? Titer Date, Result & Interpretation Copy of lab work attached? HCP OR FACULTY SIGNATURE PRINTED NAME/TITLE You will not be allowed to begin classes until all required paperwork is received in the nursing office. You must submit the original copy of this report, but please keep a copy for your personal records. 1 The date that each of the three Hepatitis B vaccinations was received must be listed. If the series is not complete when you submit this report, you must bring updated immunization records to the administrative assistant after each injection. The first injection in the series must be completed one week before the start of classes. 2 Tetanus, polio, and Hepatitis A vaccinations are recommended, but not required. Page 15 of 20

16 You will not be allowed to begin classes until all required paperwork is received in the nursing office. You must submit the original copy of this report, but please keep a copy for your personal records. Student to complete this portion of the form. LAST NAME FIRST NAME M.I. DATE OF BIRTH ( ) - ( ) - HOME PHONE CELL PHONE ADDRESS CITY STATE ZIP Licensed healthcare practitioner 3 (HCP) to complete this portion of the form. Vital Signs Temperature Pulse Resp Blood Pressure Tuberculosis skin testing An intradermal test for tuberculosis is required annually and must be completed after May 15th each year. First time testing requires a two-step testing process. Attach a copy of test results to this form. Date Result 1st test 2nd test Health status Do you consider this student to be in satisfactory health to pursue a career in nursing? If not, why? Recommendations Do you have any recommendations for this student? (e.g. follow-up appointments, referrals, any limitations that may affect ability to perform clinical safely and effectively) HCP SIGNATURE PRINTED NAME/TITLE DATE OF EXAMINATION ADDRESS CITY STATE ZIP 3 A licensed healthcare practitioner is anyone whose job description includes performance of physical examinations or health appraisals. Page 16 of 20

17 Pre-Admission Candidates Date: Traditional Application (Fall only) Advanced Placement Application Transfer Student (see advisor) Check List for Admission to the Nursing Program 1. Copy of Nursing Pre-Admission exam (TEAS V) with results of 65% or higher. 2. Verification of acceptance to Redlands Community College. 3. Application for RCC nursing program 4. Official transcripts from high school, GED certification, technology center, college, or university attended. 5. Provide proof of US citizenship, national status, or legal permanent resident alien status. 6. Please submit all required documents in a 9 by 11 envelope. Personal date Use upper case block letters. Use black ink and correct errors with white correction fluid. Differentiate between the letter O and the number zero by using an Ø for zero. STUDENT ID NUMBER (OR SOCIAL SECURITY NUMBER) LAST NAME - FIRST NAME MIDDLE NAME PREVIOUS NAME(S) UNDER WHICH TRANSCRIPTS/RECORDS MAY BE RECEIVED MAILING ADDRESS CITY STATE ZIP+4 - HOME/CELL/WORK TELEPHONE NUMBER / - Home / Cell / Work Page 17 of 20

18 Pre-admissions examination You must attach a copy of your score report to the application. Applications will not be accepted without a report. DATE OF EXAM SCORE COPY ATTACHED? (MARK X ) / / 2 0. % YES NO Educational data Official copies of all high school, technical school, and college transcripts are required for every institution attended. If you are currently enrolled in classes, you must submit an updated transcript after this semester s grades are posted. High School/GED School Name Location Dates Attended Degree/Certificate Earned Technical School College/University 1 College/University 2 College/University 3 College/University 4 Work experience List your work experience for the past 10 years, in order, beginning with the most recent. Include any volunteer work that you may have done in a health care agency. Most Recent Second Third Fourth Fifth Employer Name & Address Dates Employed From To Position Healthcare licensure/certification List any professional licenses currently held. LPN/LVN Type of License/Certification State License/Certificate Number Expiration Other Page 18 of 20

19 Eligibility for licensure Yes No Have you ever been arrested for or convicted of any offense (misdemeanor or felony) in any state, territory, or country, including expunged offenses, with the exception of minor traffic violations? (Minor traffic violations do not include DUI.) Yes No Have you ever had disciplinary action taken against your nursing license or certificate, any health-related license or certificate, or any application for a nursing or health-related license or certificate in any state, territory, or country? If you answered yes to either question above, please explain. Yes No Were you born in the United States? If you answered no above, please explain. The Redlands Community College Nursing Program is approved by the Oklahoma Board of Nursing. Graduates of this state-approved program are eligible to apply to write the National Council Licensure Examination (NCLEX) for (registered or practical) nurses. Applicants for Oklahoma licensure must meet all state and federal requirements to hold an Oklahoma license to practice nursing. In addition to completing a state-approved nursing education program that meets educational requirements and successfully passing the licensure examination, requirements include submission of an application for licensure, a criminal history records search, and evidence of citizenship or qualified alien status. Applicants for practical nurse licensure must also hold a high school diploma or a graduate equivalency degree (G.E.D.) [59 O.S & 567.6]. To be granted a license, an applicant must have the legal right to be in the United States (United States Code Chapter 8, Section 1621). In addition, Oklahoma law allows a license to be issued to U.S. citizens, U.S. nationals, and legal permanent resident aliens. Other qualified aliens may be issued a temporary license that is valid until the expiration of their visa status, or if there is no expiration date, for one year. Applicants who are qualified aliens must present, in person, valid documentary evidence of: 1. A valid, unexpired immigrant or nonimmigrant visa status for admission into the United States; 2. A pending or approved application for asylum in the United States; 3. Admission into the United States in refugee status; 4. A pending or approved application for temporary protected status in the United States; 5. Approved deferred action status; or 6. A pending application for adjustment of status to legal permanent resident status or conditional resident status. Page 19 of 20

20 The Board has the right to deny a license to an individual with a history of criminal background, disciplinary action on another health-related license or certification, or judicial declaration of mental incompetence [59 O.S ]. These cases are considered on an individual basis at the time application for licensure is made, with the exception of felony charges. An individual with a felony conviction cannot apply for licensure for at least five years after completion of all sentencing terms, including probation and suspended sentences, unless a presidential or gubernatorial pardon is received [59 O.S & 567.6]. OBN Policy/Guideline #E-05, Information for Bulletins and Catalogues of Nursing Education Programs, last revision 11/07 MY SIGNATURE BELOW INDICATES THAT ALL INFORMATION ON THIS FORM IS ACCURATE AND TRUE APPLICANT SIGNATURE DATE PLEASE SUBMIT ALL REQUIRED DOCUMENTS IN A 9 BY 11 ENVELOPE. Page 20 of 20