Millers College of Nursing 2151 Consulate Drive Suite, 10 & 11 Orlando, FL 32837
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1 Congratulations on your decision to pursue your degree in nursing. The Millers College of Nursing offers a career pathway to the Bachelor of Science in Nursing. The pathway provides learning activities that build your knowledge and experience in patient care. As you begin the application process, please ensure that you have read all of the information and instructions. If you have questions during any point of the application process, our admissions team is available to answer them. Millers College of Nursing 2151 Consulate Drive Suite, 10 & 11 Orlando, FL 32837
2 Table of Contents Identification Academics References Student Consent Graduation Requirement Recommendation Form Transcript Request Checklist for Admissions
3 MILLERS COLLEGE OF NURSING APPLICATION Please mail your completed application package to: Millers College of Nursing 2151 Consulate Drive Suite, 10 & 11 Orlando, FL PLEASE USE INK TO COMPLETE ALL SECTIONS SECTION I - IDENTIFICATION FIRST NAME: LAST NAME: MI: SOCIAL SECURITY #: FORMER NAME(S) STREET ADDRESS: CITY: STATE: ZIP CODE: DATE OF BIRTH: HOME PHONE: CELL PHONE: WORK PHONE:
4 SECTION I- IDENTIFICATION (Continued) START TERM FALL (October) SPRING (April) ETHNICITY: Are you Hispanic or Latino? Yes No Select one or more of the following that best describes you: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander Caucasian GENDER: Female Male VETERAN: Yes No Are you eligible for V.A. educational benefits? Yes No U.S. CITIZENSHIP: Native Naturalized COUNTRY OF CITIZENSHIP: Not a U.S. Citizen: If a permanent immigrant, enter the alien registration number shown on your I-551 (You must provide USCIS documents and a copy of your driver s license) EMERGENCY CONTACT: Same Address Same Phone NAME: RELATIONSHIP: HOME PHONE: CELL PHONE: WORK PHONE:
5 SECTION II - ACADEMICS HIGH SCHOOL INFORMATION Which of the following have you completed? Standard High School Diploma State issued High School Equivalency (GED) High School Diploma earned outside of the U.S. (All foreign documents/transcript must be evaluated and translated for advising purposes.) PLEASE COMPLETE THE FOLLOWING INFORMATION: HIGH SCHOOL ATTENDED GRADUATION DATE CITY STATE COUNTY GED Recipients Only: Student must show verification of passing the GED upon submission of application. NAME OF GED AGENCY DATE ISSUED CITY STATE ZIP CODE COUNTY
6 SECTION - ACADEMICS (Continued) COLLEGE/UNIVERSITY INFORMATION List in chronological order every career school, college and university you have attended prior to enrolling at Miller s College of Nursing. All foreign documents/transcript must be evaluated and translated for advising purposes. College City State Years NOTE: If the number of colleges exceeds the space provided above, please attach a separate sheet. Send all transcripts in an official, sealed envelope to the Office of Admissions: Millers College of Nursing 2151 Consulate Drive Suite, 10 & 11 Orlando, FL 32837
7 TOEFL If your native language is not English, provide your scores for the Test of English as a Foreign Language (TOEFL). Section 1 Section 2 Section 3 Date(s) Taken Date(s) Scheduled The scores you provide are unofficial. Testing services must send official copies of test scores directly to Millers College of Nursing. SECTION IV - REFERENCES List the names and addresses of two people in your field of study and/or expertise (e.g., a professor, a supervisor) from whom you have requested letters of reference. Both references must be either from an instructor or direct supervisor. No personal references will be accepted. Reference information must be provided on Millers College of Nursing form included with this application and should be returned in envelopes that have been sealed and signed by the people you have named as references. See Recommendation Forms on pages Name of Reference Position/Title Address, Phone Number &
8 Academic Discipline Have you ever been dismissed from, disciplined by or placed on probation by a college or university? No Yes If so, please explain: Honors and Awards List any honors and/or distinctions you have received and the dates they were received. How did you first learn about Miller s College of Nursing? Who or what most influenced your decision to apply to Miller s College of Nursing?
9 SECTION V - STUDENT CONSENT I consent and agree to uphold the policies of this institution. I further agree to have any transcripts, test scores and GED test scores released to Miller s College of Nursing and all information provided is true and correct. In addition I give Millers College of Nursing permission to send me admissions information and materials to the address provided on this application. Student Signature: Date: Background Check Millers College of Nursing does not discriminate on the basis of race, color, ethnicity, national origin, religion, creed, sex, age, martial status, parental status, physical disability, learning disability, political affiliation, veteran status, or sexual orientation. FDLE criminal background checks will be conducted by Millers College. A Level II background check FBI /FDLE must also be completed by your local police department as part of the application process. All applicants are responsible for paying the cost of the backgrounds checks and are advised to begin the process well in advance of submitting the application package to the college. Your application cannot be processed without it. Tuition The cost of the program is $18, not including the $ application fee. Expenses included in the tuition are one uniform set, student activity fees, malpractice insurance and lab fees. Additional uniforms may be purchased by the student. Equipment is not included in the tuition cost. Tuition and fees are subject to change. Please refer to the Admissions Office each term for current tuition and fee information.
10 Graduation Requirements Bachelor of Science in Nursing Degree Responsibility for meeting the requirements for graduation with a Bachelor of Science Degree in Nursing rests with the student. To be awarded a Bachelor of Science degree from Millers College of Nursing, a student must do the following: 1.Thirty-six (36) credits of General Education courses Area 1: Communications 9 Credits Area 2: Humanities 6 Credits Area 3: Mathematics 6 Credits Area 4: Science 6 Credits Area 5: Social Science 6 Credits Area 6: Electives 6 Credits 2. Nineteen (19) credits of pre-requisite nursing courses Anatomy & Physiology I 4 Credits Anatomy & Physiology II 4 Credits Essentials of Nutrition 3 Credits Microbiology 4 Credits Chemistry 3 Credits Medical Terminology 1 Credits
11 RECOMMENDATION FORM Section I: To be completed by applicant. Proposed Year/Term of Admission: Applicant Name Last Name First M.I. Maiden Name Under the Family Educational Rights and Privacy Act of 1974, students enrolled in Miller s College of Nursing have access to their educational records including letter(s) of evaluation. However, student may waive their right to see such letter(s) of evaluation, in which case the letter(s) will be held in confidence. If the applicant has not signed the waiver below, he or she may request to see the letter(s) after enrollment into Miller s College of Nursing. Applicant Signature: Date: Section II: To be completed by the evaluator: The above-named individual is applying to Miller s College of Nursing. Please rank the applicant in the categories below by placing an X in the appropriate box, and provide a written statement on the following page and mail to: Miller s College of Nursing - Office of Student Affairs Consulate Drive, Orlando FL Marginal Below Average Average Above Average Excellent Unable to Rate Ability to Learn Originality, intellectual capacity Logic/analytical ability Written expression Oral expression Perseverance towards goals Ability to perform independent study Leadership ability Teamwork Ability to perform under stress
12 Recommend with confidence Recommended Recommended with reservations Do not recommend Signature: Date: NAME: TITLE: INSTITUTION/DEPARTMENT: ADDRESS: CITY: STATE: ZIP CODE: PHONE: RELATIONSHIP TO APPLICANT LENGTH OF TIME KNOWN:
13 RECOMMENDATION FORM Section I: To be completed by applicant. Proposed Year/Term of Admission: Applicant Name Last Name First M.I. Maiden Name Under the Family Educational Rights and Privacy Act of 1974, students enrolled in Miller s College of Nursing have access to their educational records including letter(s) of evaluation. However, student may waive their right to see such letter(s) of evaluation, in which case the letter(s) will be held in confidence. If the applicant has not signed the waiver below, he or she may request to see the letter(s) after enrollment into Miller s College of Nursing. Applicant Signature: Date: Section II: To be completed by the evaluator: The above-named individual is applying to Miller s College of Nursing. Please rank the applicant in the categories below by placing an X in the appropriate box, and provide a written statement on the following page and mail to: Miller s College of Nursing - Office of Student Affairs Consulate Drive, Orlando FL Marginal Below Average Average Above Average Excellent Unable to Rate Ability to Learn Originality, intellectual capacity Logic/analytical ability Written expression Oral expression Perseverance towards goals Ability to perform independent study Leadership ability Teamwork Ability to perform under stress
14 Recommend with confidence Recommended Recommended with reservations Do not recommend Signature: Date: NAME: TITLE: INSTITUTION/DEPARTMENT: ADDRESS: CITY: STATE: ZIP CODE: PHONE: RELATIONSHIP TO APPLICANT LENGTH OF TIME KNOWN:
15 TRANSCRIPT REQUEST Educational Institution Department Date of Request Street Address City State Zip Phone Fax Full Name at Time of Enrollment Maiden Name (if applicable) Date of Birth Dates of Attendance This is my request and authorization for you to mail official transcripts to: Millers College of Nursing 2151 Consulate Drive Suite, 10 & 11 Orlando, FL If you have any questions regarding this form, please contact our admissions representatives at (407) Thank you for your attention to this matter Student Signature Fee Enclosed
16 Checklist for Admissions APPLICATION DOCUMENTS Completed Application: $50.00 application fee certified check or money order made payable to Millers College of Nursing. Identification: Florida Driver s license, Social Security Card, Green Card or Citizenship Papers Official Transcripts: High School/GED and all post-secondary transcripts Letters of Recommendation: Two professional letters of recommendation TEST SCORES TEAS Version V 70% Composite GPA: Overall 2.5 CPR Card Personal Statement: On a separate page, please submit a typed statement indicating your objectives in undertaking the BSN program of study, your special interest, your plans, and your current strengths and areas for development. Include significant life experiences, accomplishments or special courses that may enhance the strength of your application. Resume MEDICAL & BACKGROUND CHECK PAPERWORK Physical TB test MMR Hep B Fit test Drug test Proof of fingerprints
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