Allan Hancock College 2016 Licensed Vocational Nursing Program Application Period: April 1 st June 30 th, 2015

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1 *This application is for applicants who currently possess an LVN waitlist number* It is the students responsibility to have their COMPLETED application packet turned in to the Health Sciences Department (Room M132) no later than June 30 th, 2015 including mailed applications. Incomplete applications received after June 30 th, 2015 will not be considered. If the office is closed, you may slide your application packet under the door. INFORMATION SECTION Dear Waitlisted Vocational Nursing Student: Thank you for your interest in our licensed vocational nursing program commencing in January. To be considered for the LVN program, you must meet the following requirements by June 30 th : 1. Be currently licensed through the California Department of Health Services (DHS) or Board of Vocational Nursing and Psychiatric Technicians (BVNPT) as a DHS Certified Nurse Assistant or California BVNPT Psychiatric Technician. Attach a copy of your current and valid CNA Certificate or Psychiatric Technician License. If you recently completed NATAP (Nursing Assistant Training and Assessment Program), attach a copy of your test results. 2. All updated transcripts and contact information on file with the Health Sciences office. 3. Submit a completed LVN program reapplication with the Health Sciences office located at Allan Hancock College, 800 South College Drive, Room M 132, Santa Maria, CA Reminder - seating Procedure for the RN Program Students seated in the LVN program in January 2016 at Allan Hancock College who have completed all RN prerequisites and the following additional requirements by June 30, 2016 will be eligible for RN priority placement in the 2017 RN class: ADN & BRN degree Requirements (speak with a counselor for specifics x3285) All Registered Nursing applicants need to meet merit based admission requirements in addition to prerequisite courses. 5. Merit based admission criteria: All Registered Nursing applicants need to meet merit based admission requirements (all AHC LVN students will take this test at the end of the LVN program) in addition to prerequisite courses. Screening of applications will include looking at overall GPA, Number of Science Repetitions (Anatomy, Physiology and Microbiology), and score obtained on the Merit Based Admissions Test. Any student with more than 4 attempts in science prerequisite courses is ineligible to apply for the Allan Hancock College ADN program. AHCRN = (Cumulative GPA) (Merit Based Admission Test) (Core Biology Repetitions) For your convenience, the merit based admission criteria table is available on the nursing webpage ( Any student not meeting the admission criteria will have an opportunity to meet with the RN Program Director to develop an individual plan for remediation. We advise students that may not qualify to meet with the Director as soon as possible. The remediation plan will need to be completed prior to the end of the application period to be eligible for that year. 6. All LVN re-applicants will need to return their acceptance statement by the deadline given to secure their position on the waitlist. Those not responding by the deadline will forfeit their place in the program. 7. Once accepted into the LVN program, a current CPR certification must be maintained by the student throughout the nursing program. Only American Heart Association Healthcare Provider or American Red Cross Professional Rescuer cards will be accepted. ** Please remember to make a copy of your entire application packet prior to turning it in. Copies will not be made at the Health Sciences Office. Copy machines can be found at the library or at campus graphics. 1

2 12. Notification of LVN reapplication status will be mailed by July 31, Please do not call AHC for application status as information cannot be released over the phone. The students who have been accepted into the January program will be sent a packet (October) to be completed before the start of the LVN program. This includes a physical exam and immunizations completed with proof of titers or boosters. Documentation will be required for the following immunizations: Tuberculin skin test (expires annually on date given). Positive PPD requires a standard negative chest film with medical consultation. (Expires every 2 years) Diphtheria, Pertussis, and Tetanus Toxoid (DPT) Measles, Mumps, Rubella (MMR) Hepatitis B Vaccine Varicella (chicken pox) Flu Vaccine Allan Hancock College Health Sciences office is NOT responsible for lost or misdirected applications. Please photocopy your whole packet and hand deliver (slide packet under door if it is closed) or send original by certified mail via U.S. Postal Service to: Allan Hancock College ATTN: Health Sciences Office, M South College Drive Santa Maria, CA It is the responsibility of the applicant to notify Allan Hancock College Health Sciences office, in writing, of any changes in candidate status, address, or phone number. Copies of all required documents and documentation of mailing should be kept in case that proof of completion by the filing deadline is needed. Applications received in the office after June 30 th will not be considered. *IMPLICATIONS FOR NURSING LICENSURE BY A STATE REGULATORY BODY Please note that fingerprinting is required for licensure as a California Vocational Nurse. Persons who have been convicted of a felony are subject to close scrutiny by the Board of Vocational Nursing on an individual basis. The board may refuse to issue a license even after successful completion of the NCLEX-PN if a background check reveals a significant infraction. Specific policy regarding procedures of the Board of Vocational Nursing is available from that Board. Call (916) , should you have any questions or concerns about such policy. ** Please remember to make a copy of your entire application packet prior to turning it in. Copies will not be made at the Health Sciences Office. Copy machines can be found at the library or at campus graphics. 2

3 LICENSED VOCATIONAL NURSING PROGRAM ESTIMATED STUDENT FEES Pre-Enrollment Expenses PHYSICAL EXAM private physician IMMUNIZATIONS Hep B Series, Varicella, DPT, MMR, Flu Vaccine, TB TOTAL ESTIMATED COSTS TO ACHIEVE LICENSED VOCATIONAL NURSING LICENSE $5, (excluding variable costs) Prices are subject to change Variable Cost Variable Cost BACKGROUND CHECK Corporate Screening $48.00 DRUG SCREENING Roblar $30.00 AHC STUDENT ID CARD WITH PICTURE $2.00 NURS 310 Pharmacology Fall tuition (3 student fees, textbook estimate $ CPR CARD CPR for healthcare providers EMS 306 (½ unit) + $4 material fee + $15 textbook (AHC) $42.00 (AHC) SKILLS KIT $85.00 IDENTIFICATION NAME PIN $6.00 UNIFORM (One Set (Vest, Pants, Shirt)) $ SHOES (Estimated) $70.00 WATCH (Not digital, must have seconds hand) $30.00 STETHOSCOPE (Prestige Medical/Littman s recommended) $30.00 ANEROID SPHYGMOMANOMETER (Prestige Medical/Littman s recommended) $30.00 COMPUTER INTERNET (Mandatory)/PRINTING SUPPLIES $ Spring Semester Total is estimated excluding variable costs $ TUITION (17.5 $46/unit for residents) $ PARKING $20.00 HEALTH FEE, STUDENT CENTER FEES PLUS STUDENT REPRESENTATION FEE ($19+$10+$1) $30.00 REQUIRED SPRING TEXTBOOKS $ (est.) MISCELLANEOUS SUPPLIES flash drive, notebooks, pens, paper, scissors, etc. $ Summer Semester Total is estimated $ TUITION (10 $46/unit for residents) $ PARKING $10.00 HEALTH FEE, STUDENT CENTER FEES PLUS STUDENT REPRESENTATION FEE ($16+$10+$1) $27.00 REQUIRED SPRING TEXTBOOKS $ (est.) MISCELLANEOUS SUPPLIES flash drive, notebooks, pens, paper, scissors, etc. $ Fall Semester Total is estimated $ TUITION (16.5 $46/unit for residents) $ PARKING $20.00 IV THERAPY (3 $46, Textbook) $200 HEALTH FEE, STUDENT CENTER FEES PLUS STUDENT REPRESENTATION FEE ($19+$10+$1) $30.00 REQUIRED FALL TEXTBOOKS $ (est.) MISCELLANEOUS SUPPLIES flash drive, notebooks, pens, paper, etc. $ State Licensure Fees Total is estimated $ APPLICATION FOR LICENSURE $ FINGERPRINTING $70.00 NCLEX PRE-TEST (Usually held in Fall semester) $40.00 Total is estimated $

4 A completed application packet consists of: 1. Application filled out in its entirety. 2. Official transcripts: if coursework was taken outside of Allan Hancock College for Spring 2014, Summer 2014, Fall 2014 and Spring 2015 from all U.S./foreign colleges/universities. All college coursework must be completed at time of application; no in progress courses will be accepted. 3. Your unofficial AHC transcripts. This can be printed from your myhancock account, it is the my unofficial transcript link on the Student tab. You can also submit your Official AHC transcript in place of the printout. You are required to turn in one or the other, but not both. 4. Copy of California CNA Certification (or NATAP test results) or Psychiatric Technician License (Note: CNA certification/psych. Tech License must be current at the time of application and remain current throughout the program.) I acknowledge and understand the following: I understand that if I had any courses in progress at AHC during last application period, I will submit final grades to the Health Sciences Department with the reapplication via unofficial AHC transcripts. All other college course work official transcripts must be submitted to Admissions and Records and attached with this reapplication. I understand that by turning in this reapplication, all pre-requisite courses have been completed and no other course work is required or will be accepted for the LVN program. I understand that I will be notified by of my status by July 31, Information WILL NOT be released prior to this date or over the phone. I understand that I must meet the Merit Based Admission Criteria at the end of the LVN program in order to be considered for the RN program - Screening of applications will include looking at cumulative GPA, number of science repetitions (no more than 4 attempts in science pre-requisite courses to apply for the Allan Hancock College ADN program) (Anatomy, Physiology and Microbiology), and score obtained on the merit based admissions test (PN Predictor taken at the end of LVN program). The Health Sciences Department will not make copies; it is my responsibility to make copies before turning in my application. I must notify Health Sciences office immediately of change to my address and/or telephone number. Questions may be directed to the Health Sciences office by calling (805) , ext or (from Lompoc and Santa Ynez Valley) , ext or you may your questions to: tawnya.karstrom@hancockcollege.edu FINANCIAL AID: It is the responsibility of all applicants to check with the Financial Aid Office regarding loans, scholarships, state and federal grants. If you have not already applied DO IT NOW! 4

5 Application Deadline for Application is JUNE 30, Applications are reviewed after the deadline. Status notification will be ed by July 31, Please type or print clearly. We will not accept illegible applications. This application may only be used for the 2015 Licensed Vocational Nursing waitlisted students. I. Personal Information Full Name: Last First Middle Waitlist Number Other names that may appear on transcripts (use commas to separate, if providing more than one) Permanent Address: Mailing address: (if different from above) Street City Zip Street City Zip Primary Phone # Secondary Phone# Social Security # Birth Date AHC Student # Address (Mandatory) II. Admission Information Certificate/License Information Certification Number Expiration Date Psychiatric Technician License License Number Expiration Date You may hand deliver your packet to the Health Sciences office (M132) on the Main Campus or mail to: Attn: Health Sciences Department, 800 S. College Drive, Santa Maria, CA Please slide under the door if the door is closed. 5

6 Application III. List ALL Courses taken outside of AHC for Spring/Summer/Fall 2013 and Spring 2014 I have not taken any college courses since the last application period. I have only taken courses at AHC since the last application period. Attach a copy of your unofficial transcript. I have taken courses outside of AHC since the last application period (if checked, fill out table below and submit Official Transcript with all grades posted. If you need more room, please attach additional sheets. Indicate courses completed (if C grade or better): Course College/University (outside of AHC) # of Units Grade Allan Hancock College counseling office will determine equivalency if applicable IV. Current Spring 2015 Enrollment (leave blank if it does not pertain) Course College/University (outside of AHC) # of Units I thereby affirm, under penalty of dismissal, that all information supplied on this application is complete and accurate SIGNATURE: DATE: You may hand deliver your packet to the Health Sciences office (M132) on the Main Campus or mail to: Attn: Health Sciences Department, 800 S. College Drive, Santa Maria, CA Please slide under the door if the door is closed. 6

7 For Office Use Only Last Name AHC Student # H Application and Prerequisites Completed: Completed Program Application Official College Transcripts from all other colleges if applicable Copy of current CNA or Psychiatric Technician License Exp Date: AHC Unofficial Transcripts Previous waitlist number Notes Staff Verification Dates and Initials: 7