MJC ASSOCIATE DEGREE NURSING MULTICRITERIA SCREENING PROCESS ADVISING RECORD (MSPAR)

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1 Name: W#: Phone#: Date: Address: MJC ASSOCIATE DEGREE NURSING MULTICRITERIA SCREENING PROCESS ADVISING RECORD (MSPAR) Applied for admission to MJC (prior to submitting transcripts or program application) Assessment tests taken TEAS test taken Date: Location: Score: Math competency met: Eligibility for 00-level MATH course or Completion of Math or higher or Bachelor s degree or higher DATE: Bio or and Chemistry - prerequisites to core biology classes. LVN - Provided copy of LVN license with IV certification If no, skip next three lines. LVN Program WASC Accredited Challenged LVN Boards Nurse LVN Transition Course taken at MJC A B C D E CRITERIA Academic degrees or diplomas, or relevant certificates held by an applicant. Any relevant work or volunteer experience. Academic degree from a regionally accredited college or university - Select one Total Possible Points: 00 Criterion Areas A E = A = () BA/BS Degree or higher Official transcript. () AA/AS Degree Official transcript. Licensed/certified healthcare worker - Select one from each category if applicable B = () Licensed vocational nurse (LVN), licensed psychiatric technician (LPT), registered respiratory therapist (RRT), certified respiratory therapist (CRT), paramedic, Copy of current license. radiology technician, ultrasound technician, dental hygienist. () Certified nurse assistant (CNA), home health aide (HHA), certified medical assistant (CMA), emergency medical technician CA certification or national registry (EMT), certified hemodialysis tech (CHT). () Certified dental assistant (CDA), registered dental assistant (RDA), phlebotomist () Electrocardiogram (ECG) technician, medical assistant, nurse assistant, scribe, ward or unit clerk or clerk in a health clinic, surgical technician, obstetric technician, veterinary technician. Relevant Work Experience Healthcare work experience (see B above) 00 hours in the years prior to May of application year Volunteer Experience Volunteer work 00 hours in the years prior to May of the application year Military healthcare work experience Corpsman/medic TOTAL POINTS FOR CRITERION AREAS A E = Copy of current certificate. Copy of current certificate Criterion C SDF or letter of employment verification or proof of training/experience within the last five years. C = D = E = Criterion C and D Supporting Documentation forms Criterion C Supporting Documentation Form Criterion D Supporting Documentation Form Copy of Defense Department Form DD-. Honorable Discharge Required Revised -- ml /lr

2 CRITERIA Grade Point Average (GPA) in relevant coursework (Prerequisite Courses) All prerequisites must be completed for letter grades. Criterion Areas A E = Official transcript with final grades posted by the application deadline. For all out-of-district course work, must provide course descriptions from catalog and copies of catalog covers for the years the courses were taken. Natural Sciences GPA (Anatomy or equivalent, Microbiology 0 or equivalent, Physiology 0 or equivalent) All courses must be completed with a grade of C or better. A = 0 MJC uses semester units. If you have transferred quarter units from another school, they must be converted to semester units before calculating the GPA.* A =, B =, C = A Anatomy - Microbiology - Physiology - Total Units Total points Total points Total Units = Combined GPA *Quarter unit to semester unit conversion information: Quarter Units Semester Units = 0. =. = =. =. = =. =. = 0 =. =. = =. =. = <.0 Disqualified B Deduction for substandard grades (D, F, NC/NP) or Ws in Natural Sciences (Anatomy or equivalent, Microbiology 0 or equivalent, Physiology 0 or equivalent) in the years prior to the application year. or more Maximum Deduction for B = Disqualified Revised -- ml /lr

3 CRITERIA C D E English 0 is required for all students entering the ADN program. Points will be awarded for the highest grade for English 0 or 0 or 0. If an Advanced Placement (AP) score is used to meet the English 0 prerequisite, you will only receive credit for a C grade. English 0 or English 0 may be taken for letter grade to raise the English score. A B C <.0 Disqualified GPA for remaining three prerequisites. (Psychology 0 or and Sociology 0 or 0 or or 0 or or or Anthropology 0 and Communication 00 or 0 or 0 or 0.) All courses must be completed with a grade of C or better. The highest grade for each of the three will be used to calculate the GPA. If an Advanced Placement (AP) score is used to meet the Psychology 0 prerequisite, you will only receive credit for a C grade. Psychology may be taken for letter grade to raise this GPA. MJC uses semester units. If you have transferred quarter units from another school, they must be converted to semester units before calculating the GPA.* A =, B =, C = Psychology - Sociology - Communication - Total Units Total points Total points Total Units = Combined GPA *Quarter unit to semester unit conversion information: Quarter Units Semester Units = 0. =. = =. =. = Highly recommended courses MFDNTR Nutrition or equivalent MNURSE : Introduction for Nursing Majors (MJC) or CGUIDE 0: Guidance for Nursing Majors (Columbia) 0 C = D = <.0 Disqualified 0 E = MDAST : Medical Terminology or equivalent TOTAL POINTS FOR CRITERION AREAS A E = Life experiences or special circumstances of an applicant, including but not necessarily limited to the following. Select only one if applicable. A Disabilities. B Low family income. Criterion Areas A-H = Documented learning disability or proof of participation in or eligibility for Disability Support Program and Services (DSPS). Proof of eligibility for or proof of receipt of financial aid, e.g. BOGG fee waiver, Cal Grant, Pell Grant or other federal grant, or CalWorks. Revised -- ml /lr

4 CRITERIA C First generation of family to attend college. D Need to work. E Disadvantaged social or educational environment. F Difficult personal and family situations or circumstances. G Refugee status. H Veteran status. TOTAL POINTS FOR CRITERION Areas A-H = Proficiency or advanced level coursework in a language other than English. Credit for languages other than English shall be received for languages that are identified by the state Chancellor s office. Language: TOTAL POINTS FOR CRITERION = Assessment/readiness test results Test of Essential Academic Skills (TEAS) Version V A student has three opportunities to take the TEAS with a minimum score of %. Points will be awarded for the highest of the first three scores. You may obtain a TEAS study guide by logging on to and clicking on shop online under products. Study guides are also available in the MJC and Columbia College libraries. The TEAS is available in the MJC Testing Center, but you must preregister online through ATI Testing. Whole numbers only will be used. TEAS scores with decimals will not be rounded up. Criterion = Criterion = Paragraph explaining the educational background of your parents. Paycheck stub from the period of time you were enrolled in prerequisite coursework or Criterion D Supporting Documentation Form from employer verifying employment while completing prerequisite coursework. If Criterion C Supporting Documentation Form was submitted for the period of time in which you were enrolled in prerequisite coursework, the Criterion C Supporting Documentation Form can be used to document Criterion D. Proof of participation in or eligibility for Extended Opportunity Programs & Services (EOPS). Paragraph explaining the situation or circumstances. Documentation or letter from U.S. Citizens & Immigration Services (USCIS) verifying your refugee status. Copy of Defense Department Form DD-. Honorable discharge required. Criterion Supporting Documentation Form Proficiency in a Language other than English or official transcript from a US regionally accredited college verifying four semesters of one foreign language with a grade of C or better for each semester. Official TEAS score from ATI Testing. TEAS Tutoring Referral Form < ineligible/must retest TOTAL POINTS FOR CRITERION = 0 UNOFFICIAL TOTAL FOR CRITERIA = /00 Revised -- ml /lr

5 Advisories: Program cost Clinical clearance Health clearance Background check Drug screen BLS Support system Recommendations: AS Degree: Additional Requirements for Associate of Science Degree Activities.0 units Humanities.0 units Guidance class 0. units One course (minimum ½ unit) recommend Guidance 0 Additional Requirements for the CSU-GE Transfer Pattern Area A: English 0: units Any course from the A. category will satisfy CSU GE transfer (A. category) requirements however, CSU Stanislaus nursing program prefers English 0. Area B: Chemistry : units (B. category) Area B: Math : Statistics units (B. category) OR Soc 0 units Sociology 0 - Intro to Statistics for Social & Behavioral Sciences Area C: units The transfer requirement in this category is a total of units. Three units from area C.., units from area C.., and additional units from areas C. or C.. Area D units The transfer requirement in this category is a total of units. Six units have been fulfilled with units from the D.0 or D. category and units from the D. category. The remaining units should come from the D. category (recommend History 0) or from the D. category (recommend Political Science 0). Faculty Signature Faculty Phone Number and Student Signature Revised -- ml /lr Date