BEAUFORT COUNTY COMMUNITY COLLEGE Allied Health Programs Admission Packet

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1 BEAUFORT COUNTY COMMUNITY COLLEGE Allied Health Programs Admission Packet Student Enrollment Cohorts: 2014 Applicant Signature Date

2 BEAUFORT COUNTY COMMUNITY COLLEGE Fall 2014 Allied Health Programs Application Packet Requirements Associate Degree Programs Application Period Start Dates Associate Degree Nursing August 1, January 31, 2014 Fall Semester, 2014 Chemistry requirement satisfied by January 31, Medical Laboratory Technology August 1, 2013 April 30, 2014 Fall Semester, 2014 Chemistry requirement satisfied by May 20, Diploma Programs Practical Nursing August 1, January 31, 2014 Fall Semester, 2014 For Licensed Practical Nurses Seeking Advanced Placement to ADN Program LPN to RN Transition August 1, 2013-October 1, 2013 Unrestricted LPN license required. Chemistry requirement satisfied by AND October 1, Completion of accredited PN Program Prerequisites: BIO 168 and 169, January 2014 within the last two years or 12 months of work experience within the past 2 years. ENG 111, PSY 150, MAT elective completed by October 1, Only complete packets will be accepted and must include: 1. GENERAL BCCC APPLICATION ON FILE Can be completed online or in written form. 2. ALLIED HEALTH APPLICATION COMPLETED Program Admission Request/Applicant Contact Information, Course Completion Sheet, and Statement of Understanding 3. HIGH SCHOOL or COLLEGE CHEMISTRY (N/A Practical Nursing Program) Must be completed and transcripts due by program application deadline. Exception: MLT program Must be completed and transcripts are due by May PLACEMENT TESTING SCORES OR DOCUMENTATION OF TESTING WAIVER See packet instructions for acceptable documentation. 5. OFFICIAL TRANSCRIPTS ON FILE High school/ged and college transcripts with course descriptions must be submitted prior to your appointment with the Allied Health Admissions Coordinator. 2.0 Minimum GPA in program of interest required. Advanced Standing/Transition Applicants ONLY o WORK VERIFICATION FORM for LPN to RN Work verification form must be submitted if LPN did not graduate within the last two years. IMPORTANT Once the above items are completed, contact Phylicia Bridgers, Allied Health Admissions Coordinator, at or for an appointment (August 1, 2013-January 31, 2014) to review the application packet. Application packets must be submitted by appointment unless prior arrangements are made due to distance or hardship. Applicants forfeit the opportunity to review applications that are not submitted in person. Applicants are advised to make a copy of their completed application prior to submission.

3 Beaufort County Community College Allied Health Programs Request for Admission Check the statement that best describes your application request. I am applying for the Associate Degree Nursing (ADN) Program Fall 2014 Admission Entry Level *Readmission/Transfer to the I am applying for the Practical Nursing (PN) Program Fall 2014 Admission Entry Level *Readmission/Transfer to the Semester Semester I am a Licensed Practical Nurse (LPN) and I am applying for the Associate Degree Nursing (ADN) Program January 2014 I am applying for the Medical Laboratory Technology (MLT) Program Fall 2014 Admission Entry Level *Readmission/Transfer to the Semester *Deadlines: 2 nd Semester = October 1 3 rd Semester = March 1 4 th Semester (Fall) = June 1 PLEASE PRINT CLEARLY Contact Information Name: Student ID # Mailing Address: City State Zip Phone: Cell: Home: Other: Applicants are responsible for maintaining a current address and phone number with the Allied Health Admissions Office and in the Registrar s Office. All correspondence from the Allied Health Admissions Coordinator will be to the address and phone numbers listed above. Chemistry (Not Required for PN Applicants) ADN program: must be completed within 8 years and transcripts due by January 31,2014 MLT program: must be completed within 5 years and transcripts due by May 20, Grade Date (N/A PN) 2005 or later (ADN) Name of School 2009 or later (MLT) In Progress at Name of School For Office Use Verified In Progress

4 Verification of Minimum Placement Test Scores Page 4 PT SCORES R SS M AL OR Attach copy if completed other than BCCC Date TESTING WAIVER CHECKLIST (check all that apply) Official transcript required Student receives transfer credit for: Student receives transfer credit for developmental courses: ENG 090 RED 90 ENG 111 College Level MAT DMA 30 DRE 098 Math 60 ENG 090 Student has taken SAT or ACT with the following scores: SAT > 450 (each) Reading Writing Math ACT>18 (composite) Date Student holds an associate s degree or higher: Name of Institution AAS BS/BA For Office Use Testing or Waiver Verified Education List High School and Colleges Attended High School/GED College Currently Attending Colleges Previously Attended Transcript On File Yes or NO For Office Use Verified Transcripts (include course descriptions if applicable) ALL TRANSCRIPTS AND COURSE DESCRIPTIONS MUST BE SUBMITTED TO THE ADMISSIONS OFFICE PRIOR TO YOUR MEETING WITH THE ALLIED HEALTH ADMISSIONS COORDINATOR. Transcripts for non-core courses in progress must be forwarded to the Allied Health Admissions Coordinator/BCCC, PO Box 1069, Washington, NC by the following deadlines in order to receive the quality points for these courses: LPN to RN Transition Program October 1, 2013 ADN and PN Programs January 31, 2014 MLT Program May 20, 2014

5 Course Completion Sheet Page 5 In pencil, fill in the grade and college attended for all attempted courses listed below: Put a check by those courses that are in progress. Include all attempted courses for all allied health programs listed. This sheet must be complete prior to your meeting with the Allied Health Admissions Coordinator. If you do not know your grades you will need to purchase an official transcript. Name Date ADN and M L T general education, non-core courses HRS GRADE QP College In progress ACA 111 COLLEGE STUDENT SUCCESS (OR 115,118, 122) X = ENG 111 EXPOSITORY WRITING 3 ENG 112 ARGUMENT-BASED RESEARCH (OR 113 or 114) 3 PSY 150 GENERAL PSYCHOLOGY 3 HUMANITIES/FINE ARTS ELECTIVE 3 Options: ART 111, 114,115,116,117 DRA111, HUM 110,115,120,121,122,150,160, MUS 110,112,210 REL 110, 211, 212, ENG 131, 231, 232, 241, 242 ASL 111 CHI 111 COM 110 DAN 110 FRE 111,112 GER 111,112 ITA 111,112 JPN 111,112 LAT 111,112 PHI 210,220 SPA 111,112 Additional ADN general education, non-core courses HRS GRADE QP College In progress *BIO 168 ANATOMY & PHYSIOLOGY I (BIO 165) Year 4 X Is this a first or second attempt? BIO 169 ANATOMY & PHYSIOLOGY II (BIO 166) Year 4 CIS 113 COMPUTER BASICS (OR CIS 111{2CH} OR CIS 110 {3CH}) PSY 241 DEVELOPMENTAL PSYCHOLOGY 3 MATH Elective: Options: MAT 110, 115, 121, 140, 141, 155, (with labs when applicable) Additional MLT general education, non-core courses HRS GRADE QP College In progress *BIO 163 ANATOMY & PHYSIOLOGY 5 X Is this a first or second attempt? CHM 151 GENERAL CHEMISTRY I 4 CHM 152 GENERAL CHEMISTRY II 4 CIS 111 Basic PC Literacy (2CH) OR CIS 110 {3CH}) MAT 115 MATHEMATICAL MODELS (Or MAT 161, MAT 110) 3 Practical Nursing general education, non-core courses HRS GRADE QP College In progress ACA 111 COLLEGE STUDENT SUCCESS (115 or 118) X *BIO 163 BASIC ANATOMY & PHYSIOLOGY( BIO 168 & 169) Is this a first or second attempt? *MAT 110 MATHEMATICAL MEASUREMENTS Year 3 ENG 111 EXPOSITORY WRITING 3 PSY 110 LIFE SPAN DEVELOPMENT [ C required](psy 150 & 241) 3 *MUST BE WITHIN 5 YEARS (2009 OR Later) All courses must be completed with a grade of C or better for credit toward graduation requirements. 12 semester hours of courses listed are needed to use college GPA in place of high school. Do not include CHM or Developmental Courses in these 12 hours For Office Use Only****************************************************************************************** TOTAL CREDIT HOURS TOTAL QP Entry Level Transition/Readmit/Transfer HS GPA or Col GPA BONUS POINTS NUR 1 Course QUALITY POINTS GPA POINTS GPA POINTS CHEMISTRY POINTS CHEMISTRY POINTS TOTAL POINTS TO DATE This form serves as a worksheet pending official evaluation of courses and calculation of points.

6 Verification of Work Experience Page 6 LPN to RN Advanced Placement/Transition Program Applicants Credit may be awarded for NUR 111 and 117 with verification of completion of a regionally accredited Practical Nursing Program within two years of application date (official transcript required) or verification of 12 months of employment within the past 2 years as a LPN functioning in a role requiring practical nursing skills. Name SSN# ************************************************************************ The person named above is applying to the ADN Transition Program at Beaufort County Community College. Verification of work experience as a LPN is required for admission purposes. Please complete the information requested below. I verify that the applicant was employed at (name of agency or institution) during the period from to for a total of years and months as a Licensed Practical Nurse. Employer s name, please print (Signature of employer) (Address) (Date) (Phone Number) ************************************************************************************* The person named above is applying to the ADN Transition Program at Beaufort County Community College. Verification of work experience as a LPN is required for admission purposes. Please complete the information requested below. I verify that the applicant was employed at (name of agency or institution) during the period from to for a total of years and months as an LPN. Employer s name, please print (Signature of employer) (Address) (Date) (Phone Number)

7 Admission Allied Health Programs Ranking System Page 7 Admission to allied health programs with limited enrollment is competitive and based upon the selection of those candidates who possess the ability to succeed in a demanding academic program. The number of qualified applicants accepted will be determined by available clinical facilities. Each applicant will be evaluated and awarded points using the criteria below. Those applican ts with the highest rank will be selected to continue in the admissions process including a physical, immunization records, and CPR requirements. If two or more students have the same rank, GPA will be considered. Application date will be the determining factor if rank and GPA are the same. Academic Performance (142 points) Cumulative quality points from the non-core general education courses. To calculate quality points, multiply the number of credit hours for each course by the quality point value assigned to the grade earned (A=4, B=3, C=2,D=1,F=0). PN applicants may take additional courses from the ADN list for extra points. Bonus points for an A or B in BIO 168 or BIO 163 A = 30 points B = 20 points ½ points for retake of BIO course in less than 5 years High school students who apply for entry in the fall following graduation with no college credit receive their Academic Performance Points from the numerical grade from the courses below. The total will be divided by 3.5 (400/3.5 = 114 possible points) Algebra I Geometry English IV Biology GPA (200 points) A grade point average of 2.0 for courses in the program of interest from all colleges attended in addition to BCCC. Use HS GPA if the student has completed less than 12 semester hours. If completed at least 12 semester hours of non-core general education courses, the GPA from those courses will be used. Divide GPA by.02. Chemistry (30 points) N/A for PN Program A = 30 points B= 20 points C= 10 points Readmission and Transfer into Allied Health Programs Ranking System Readmission and transfer into allied health programs with limited enrollment is competitive and based upon the selection of those candidates who possess the ability to succeed in a demanding academic program. The number of qualified applicants accepted will be determined by available clinical facilities. Each applicant will be evaluated using the criteria below and awarded points. Those applicants with the highest rank will be selected to continue in the admissions process. If two or more students have the sa me rank, GPA will be considered. Nursing application date will be the determining factor if both rank and GPA are the same. Academic Performance (200 points) Grade from first semester Nursing or MLT course. A = 200 points B = 150 points C = 100 points GPA (200 points) A grade point average of 2.0 for courses in the major courses is required for a student to enter, progress, re-enter, or graduate. GPA from the first semester noncore, general education courses for the program. Divide GPA by.02. Chemistry (100 points) N/A PN Program A = 100 points B= 90 points C= 80 points

8 Allied Health Programs Statement of Understanding Page 8 Clinical Requirement for Criminal Background Check and Drug Screening Most clinical sites require a criminal background check and/or drug testing at the student s expense prior to participation in clinical training. Denial of access to a clinical site due to criminal background or drug testing results will stop progression in the program due to failure to meet the standards required by the clinical facility. In addition, criminal background checks and drug testing may be required after graduation by examination boards, state licensing boards and employing agencies. A graduate may be disqualified from examination eligibility, state licensure, and or/employment. Clinical Experience Allied health programs include clinical experiences that may be scheduled at various times (i.e early morning, late afternoon, or weekends). Personal requests are not accepted regarding preference for clinical times/sites. Travel is required to various clinical sites (i.e. New Bern, Greenville, Plymouth, or other areas) accommodations cannot be made for individual needs for transportation. Flexibility of schedule is a must on clinical days for nursing students. Patient Confidentiality Students are expected to keep all patient information confidential. Discussion of clinical experiences takes place only in clinical conferences or private conversations with the instructors. Students will be required by clinical agencies to complete requirements addressing the Health Insurance Portability Act (HIPAA). Immunization, Physical Forms, and CPR Certification Admission to allied health programs is dependent upon physical and emotional health compatible with the ability to perform essential functions (including physical requirements, data collection, and communication) and the ability to provide safe patient care. The health and safety of students, faculty and patients associated with student activities must be safeguarded. Therefore, documentation of a physical and all required immunizations must be completed before students are assigned to clinical sites. The Associate Degree and Practical Nursing Programs also require proof of current certification in CPR infant, child, and adult resuscitation, as well as the use of automated external defibrillators. (AEDs). Expenses (See estimate at the end of this document for more detail.) Allied health programs have additional expenses beyond tuition and books that will be the responsibility of the student. Students should prepare for the following expenses while enrolled in an allied health program: Malpractice insurance, criminal background check and drug testing, clinical uniform/shoes, laboratory/clinical supplies, clinical travel, and physical and immunizations. Required expenses for employment may include the cost of credentialing exams and licensing fees. Transcripts Transcripts for non-core courses in progress must be forwarded to the Allied Health Admissions Coordinator by January 31, 2014 for the ADN, and PN Programs, October 1, 2013 for Transition Program, and May 20, 2014 for MLT Program in order to receive quality points for courses in progress at the time of application. ****************************************************************************************************** I understand that completion of this application does not grant admission to the nursing program. I certify that the information given in this application is true and correct. I understand that providing false information is sufficient reason to refuse the application. 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. Signature Date For Office Use Only Date Application Received:

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