KILGORE COLLEGE ASSOCIATE DEGREE NURSING (RN) PROGRAM CHECKLIST & APPLICATION. (Please proceed in order according to your current academic standing.

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1 KILGORE COLLEGE ASSOCIATE DEGREE NURSING (RN) PROGRAM CHECKLIST & APPLICATION (Please proceed in order according to your current academic standing.) 1. Apply for admission to Kilgore College (Meningitis vaccine required for all students younger than 22 years old.) 2. Apply for Financial Aid 3. Request official transcripts (College/University). For College/University other than Kilgore College; please send two (2) sets of official transcripts to: 1. Registrar s office, Kilgore College 2. Associate Degree Nursing Department, Kilgore College (include with your Application Packet) 4. Applicant must be TSI Complete. 5. Complete KC New Student Orientation (Transfer students with 12 or more transferable credit hours are not required to attend New Student Orientation, if applicable.) 6. Register for required support courses (pre-requisites): CHEM 1406 or 1411 w/lab BIOL 2420 w/lab (Microbiology) BIOL 2401 w/lab (A&P I) ENGL 1301 (English Comp I) BIOL 2402 w/lab (A&P II) PSYC 2314 (Life Span) Language Philosophy & Culture 3 hours - to be selected from one of the following: (ENGL 2322, 2323, 2326, 2332, 2333; HIST 2311, 2312, 2321, 2322; PHIL 1301) Additional points will be given to Students for each pre-requisite that has been successfully taken at Kilgore College. Successfully complete support courses with a C or higher and a minimum Science GPA of 2.75 and Overall GPA of 2.75 for these seven (7) support courses (pre-requisites). All Science courses must have been completed within 7 years, when applying to ADN RN Program. Any Science course that exceeds the 7 year mark of completion, will need to be re-taken prior to submitting your Nursing Application. This only applies to the four (4) Science Courses. All 7 pre-requisite grades and all attempts at pre-requisite courses (within 7 years) will be averaged to get the Overall GPA, with a minimum 2.75 GPA. (Points will be deducted after the 1 st Withdraw; this includes all pre-requisites.) If you are currently enrolled or will be enrolled, and will have completed the course by the start of the semester for which you are applying, please indicate that on the Nursing Application. Students currently registered for a support Science course (during fall or spring semesters) should apply for Priority Registration at about a month into the semester for a chance to register for their next Science course earlier than the general student population. Follow the instructions exactly on the KC Priority Registration Request; or your Registration Request will not be considered. BCIS or computer literacy exam Required to graduate Kilgore College can be taken while attending RN program.

2 7. Additional Courses (not required for an AAS in Nursing, but required from Kilgore College to receive an AA or AS Degree. A ½ point will be given for each completed with a C or better): ENGL 1302 MATH 1342 Creative Art PSYC 2301 RNSG1201 HIST 1301 HIST 1302 GOVT 2305 GOVT 2306 MDCA 1313 HECO or BIOL 1322 SPCH 1315 or Register for the Nursing Entrance Exams (Exam dates are limited, please register early) Nurse Entrance Exams may only be taken twice per calendar year. (Nurse Entrance Exams cannot be older than 5 years.) You may take either the TEAS-V or the HESI-A2. You are also required to take the Weaver Reading/Nelson Denny. You may only test twice per calendar year. 1. TEAS-V Exam (scheduled through the KC Testing Center) Minimum Passing Scores: 65% for each; Math, Reading and English Cost: $65.00 make payment at Kilgore College Cashier 2. HESI A2 Exam (scheduled by contacting the Nursing Department via [email protected]) Minimum Passing Scores: 79% Reading, 78% Math, 78% English Composite Cost: $65.00 make payment at Kilgore College Cashier (Testing starts 8 weeks before Application deadline and ends 1 week prior to deadline date.) 3. Weaver Reading/Nelson Denny Exam (schedule by contacting the Nursing Department via [email protected]) (Reading Comprehension & Vocabulary Minimum Passing Score: JA/13 th grade level) Cost: $30.00 make payment at Kilgore College Cashier (Testing starts 8 weeks before Application deadline and ends 1 week prior to deadline date.) 9. Apply for Admission to the A.D.N. Program Please read the following: Application Packet to Include: 1. Completed Associate Degree Nursing (RN) Application (rev. date April 2015) 2. Official transcript(s) for all Colleges/Universities; including Kilgore College official transcript. 3. HESI-A2 or TEAS-V test results (print out) 4. Weaver Reading test results (print out) 5. A typed, 1-page, double spaced Essay that explains your interest in the ADN (RN) Program. 6. Two (2) Application Reference Forms. Applicant completes the top portion of form, the person completing the Reference form needs to mail the form to the Associate Degree Nursing Department and must be received before the deadline. At least one Reference must be from an employer or a teacher. (It may be beneficial to supply your References with a stamped self-addressed envelope.) 5. Submit your Application Packet in a sealed envelope to the Nursing Department (HSC G13) no later than the deadline date listed below: Application Deadline: Fall Semester (March 1st) Spring Semester (July 1 st )

3 Please contact us with any questions: Laura Mulanax Health Science Academic Advisor Kathy Stone Support Specialist, Associate Degree Nursing THE STUDENT SELECTION PROCESS IS BASED ON A POINTS SYSTEM & QUALIFIED APPLICANT INTERVIEW PROCESS.

4 KILGORE COLLEGE ASSOCIATE DEGREE NURSING (RN) PROGRAM APPLICATION (rev.04.15) Deadline: March 1 st for Fall Admission and July 1st st for Spring Admission. (Application to Kilgore College ( is required before completion of the Nursing Application) STUDENT IS APPLYING FOR: Fall (year) Spring (year) RN Program LVN to RN Track (PRINT OR TYPE): SS# KC Student ID: NAME: Last First Middle/Maiden (Any other names records may appear) MAILING ADDRESS: (Street or P.O. Box) City State Zip Code HOME #: CELL #: BUSINESS #: (Attach Additional Paper if Needed): 1. Are you currently enrolled in college? yes no. If yes, where? 2. Please provide the name(s) and attendance dates of all previously attended colleges 3. Have you ever been accepted into a Nursing Program? yes no if yes, where/when 4. Do you hold any health related license(s) or certificates? (Not CPR) yes no If yes, list licensure number and explain: 5. Have you had a Criminal Background Check done with TBON? yes no (If yes, please attach copy of the Blue Card or your Declaratory Order to this application.) Students must have a grade of C or higher in the following courses and a minimum Overall GPA of 2.75 in these courses before entering the nursing program. If you are currently enrolled or will be enrolled, and will have completed the course by the start of the semester for which you are applying, please indicate that below. Science courses must be completed within the prior 7 years of the semester you are applying for. All science grades and attempts at Science courses (within 7 years) will be averaged into the Science GPA, minimum requirement 2.75 GPA. (Points will be deducted for Withdraws; beginning after the 1 st Withdrawal.). This also applies to the other 3 pre-requisite courses. Support Courses (Pre-Requisites): Description: A B C D F W Currently Enrolled CHEM 1406 or 1411 Chemistry for HS or Gen. Chemistry I BIOL 2401 Anatomy & Physiology I BIOL 2402 Anatomy & Physiology II BIOL 2420 Microbiology ENGL 1301 English Composition I PSYC 2314 Life Span PHIL 1301; ENGL 2322, 2323, 2326, Language, Philosophy & Culture 2332, 2333; HIST 2311, 2312, 2321, 2322 (3 hrs. to be selected from one course) If you have COMPLETED any of the following courses and passed with a C or higher, please indicate below in order to receive points CREATIVE ARTS MATH 1342 HIST 1301 GOV 2305 SPCH 1315 or 1318 RNSG 1201 ENGL 1302 PSYC 2301 HIST 1302 GOV 2306 HECO or BIOL 1322 MDCA You are REQUIRED to take BCIS or pass the Computer Literacy Exam in order to graduate - Score 7. Required Entrance Exam: TEAS-V ( ) or HESI A2 ( ) Score: READ MATH ENG 8. Required Entrance Exam: Weaver Reading Score: Reading Comp Vocabulary Nelson Denny Score: 9. Submit printed copies of your Entrance Test Scores; TEAS-V or HESI-A2 and Weaver Reading with your Nursing Application. 10. Include all Official Transcripts with your ADN (RN) Application Packet; including Kilgore College Official Transcript. 11. Include your Essay (1 page double-spaced typed document explaining your interest in the ADN (RN) Program.) 12. Have 2 completed Reference Form s mailed to the Associate Degree Nursing Department prior to the Application deadline. 13. Submit your completed Application Packet in a sealed envelope to the Associate Degree Nursing Department before the deadline. PLEASE READ AND SIGN THE FOLLOWING: Kilgore College does not discriminate on the basis of race, color, religion, national origin, sex, handicap, marital status, or veteran status. I hereby certify that the information contained in this Application Packet is true and complete to the best of my knowledge. I understand that any misrepresentation or falsification of information is cause for denial of admission or expulsion from the college. Signature of Applicant: Date:

5 KILGORE COLLEGE ASSOCIATE DEGREE NURSING (RN) PROGRAM REFERENCE FORM APPLICANT COMPLETE THE UPPER PORTION OF THIS FORM ONLY APPLICANT NAME (Please Print): Under the Federal law entitled the Family Educational Right and Privacy Act of 1974, students are given the right to inspect their records, including letters of recommendation. While we shall consider all letters of recommendation carefully, we believe that in many instances letters written in confidence in the long run are of greater use in assessment of a student s qualifications, abilities, and promise. I do do not waive my right to review the content of this form. Applicant signature: Date Only the Person Completing Reference Form is to Respond Below The Applicant whose name appears above is requesting that you complete this reference form in regard to his/her Application to the Associate Degree Nursing (RN) Program. Please take the time to respond to the questionnaire as honestly as possible. Circle only one choice in each Category. This Applicant will not be considered for the Associate Degree Nursing (RN) Program unless this reference form is returned. Please advise the Applicant if you will not be returning it. Please mail the completed form prior to July 1st to: How long have you known this person? Kilgore College Associate Degree Nursing Program 1100 Broadway Kilgore, TX, <6 months 6-12 months 1-3 years >3 years In what capacity have you known the Applicant? (please circle) Friend / Acquaintance / Teacher / Counselor / Pastor / Employer / Co-worker Non-Healthcare Healthcare Profession Profession Rate this Applicant s behavior in the following Categories by circling the appropriate phrase: DEPENDABILITY / ATTENDANCE Frequently absent or late - rarely calls if either Never absent or late Occasionally absent or late - sometimes calls Rarely absent or lateusually calls INITIATIVE / MOTIVATION / ENTHUSIASM Seldom needs direction and prompting; frequently initiates own activity Self-motivated; asks appropriate questions and requests learning opportunities Relies on direction for all actions Occasionally initiates own activity, needing occasional direction Page 1 of 2

6 MATURITY Occasionally acts immaturely Acts maturely most of the time Frequently acts immaturely Very mature in all actions NEATNESS / GROOMING Consistently displays poor hygiene and grooming Always neat and well groomed ATTITUDE / PERSONALITY / INTERPERSONAL SKILLS Displays evidence of difficulty getting along with people REACTION TO STRESS Displays good coping skills under stress CAPACITY FOR PROBLEM-SOLVING Needs freq. guidance and direction for problem solving COMMUNICATION SKILLS Frequently uses poor terminology in verbal and written ORGANIZATION / WORK HABITS Gets along well most of the time with most people Easily upset by stressful situations Independent thinker Occasionally uses poor terminology in verbal and written Occasionally displays poor hygiene and grooming Makes an attempt to get along but easily swayed or angered Needs freq. direction and assistance during stressful situations Needs occasional guidance and direction for problem solving Always uses proper terminology in verbal and written Usually neat and well groomed Always gets along with coworkers, supervisors, and subordinates Handles stress but shows some signs of distress during or immediately after stress Usually able to problem-solve independently needing minimal guidance Usually uses proper terminology in verbal and written Occasionally disorganized; requires excessive time to complete tasks Completes tasks in timely manner even though disorganized Disorganized; does not complete tasks Well organized in work habits; productive In your opinion, is this Applicant suited for a career in the healthcare field? Yes or No Comments (May use back if needed): Signature Printed Name Date Phone Position/Title Business/Company Page 2 of 2