Danville Area Community College 2000 East Main St, Danville, Illinois Telephone

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1 Application Fee: $50.00 Check or Money Order payable to: DACC APPLICATION FOR **Level I** ADMISSION Spring 2016 ADN/RN NURSING EDUCATION Applications must be received by the following deadlines: Fall admission is May 20 th by 12pm Spring admission is October 20 th by 12pm (Note: Spring admissions are only taken during even years) In the event this date falls on the weekend, the applications will be accepted the following Monday at 12 pm. Danville Area Community College 2000 East Main St, Danville, Illinois Telephone Home Phone Cell Phone Student ID Number Current Address Please Print Name: Last First M Address: List any previous names: Citizenship or Visa U.S. Citizen/Permanent Resident In U.S. on a Visa Visa Expiration Date: Type of Visa: Country of Citizenship:

2 Applying for Student Visa Undocumented immigrants qualified under DACA I understand that any false or misleading statements made by me on this application will prevent my acceptance into the program or will be cause for dismissal if accepted. I understand and accept that after being admitted to the program, I must pass a physical examination approved by Danville Area Community College. I understand that I will be asked to authorize the release of my health and demographic information to the clinical sites utilized by the nursing program. As required by the clinical affiliates, students must undergo criminal background checks before entering the program. This form will be sent to you upon your acceptance to the program. I also understand that if the results of the background check prevent me from participating at the clinical sites, I will not be able to enter the program. If you have any questions relative to interpretation of any part of this application, please contact the Office Assistant for Health Care Professions (Angel Fellers or afellers@dacc.edu) or the Director of the Nursing Program (Christine Ullom or cullom@dacc.edu). Date: Signature: Return to: Danville Area Community College Mary Miller Complex Health Care Professions Office Assistant 2000 East Main Street Danville, Illinois 61832

3 CHECKLIST FOR SUBMITTING APPLICATION 1. Applied to Danville Area Community College 2. Applied (5 total pages) to the Nursing Program 3. $50.00 Application fee made payable at the DACC cashier s office. The Health Professions Office cannot accept payment of any type. Once payment is made at the cashier s office, a receipt of the payment is to be submitted with this application. 4. Provided proof of residency: Copy of valid Driver s License, State Identification Card, or a Voters Registration Card with your address 5. Completed TEAS Test (Official Transcript from ATI student account must be submitted to the school of nursing with the application) 6. All Official Transcripts must be sent to the Records office at DACC. You are responsible for obtaining copies of the official transcripts from the Records office and submitting those copies with this application, including any transcripts from DACC. 8. Provided proof of active unencumbered health care related licenses/certificates 9. Completed Point System Criteria Table Please initial next to the number above, or note N/A for those items that are not applicable, once the item has been completed. (Documentation is required for each section of this checklist.)

4 POINT SYSTEM CRITERIA Description of Criteria 1. Points are given for overall high school GPA unless the student has completed 9 credit hours of college courses then the college GPA will be used. If the student has attended multiple colleges, the GPA scores will be averaged. (GPA is based on a 4 point scale - ex: GPA of 3.5 will get 3.5 points) (MAXIMUM POINTS = 4) 2. Points will be awarded for highest achieved ACT score. (SAT score/transcripts will be accepted and converted by the Nursing Director) (MAXIMUM POINTS = 4) a = 4 points b = 3 points c = 2 points d = 1 point 3. Points will be awarded for the Test of Essential Academic Skills (TEAS ) Academic Preparedness Category. Students will be allowed to take the TEAS a maximum of 2 times in an application period, with a minimum of 30 days between attempts. Students must achieve a Proficient level in order to be eligible to apply to the nursing program. Students are encouraged to use the TEAS study guide to prepare for the test. (MAXIMUM POINTS = 4) a. Exemplary (90.7%-100%) = 4 points b. Advanced (78.0% %) = 3 points c. Proficient (58.7% %) = 1.5 points 4. Two points will be awarded for active health care related licenses/certificates (MAXIMUM POINTS 2) a) Massage Therapist b) Surgical Tech c) CNA d) Rad Tech e) Respiratory Therapist f) EMT/Paramedic g) Chiropractor h) Sono Tech i) LPN Documentation Required for point verification If ACT scores are not present on high school transcript, information to make an online request for your ACT score can be found at A copy of ATI transcript for the TEAS Test printed from your ATI account. If you have questions for how to print your TEAS transcripts, you can call ATI at Proof of active health care related licenses/certificates (licensure will only be accepted if one has never been disciplined) Maximum points earned by applicant (students may calculate based on records and certification)

5 5. Points will be awarded for completion and grade in each of the general education requirement core science courses (BIOL 136, BIOL 137, BIOL 140 AND the recommended BIOL 102 science course if the course 1 has been taken multiple times, all of the previous grades will be averaged for point allocation. Any course with more than one Withdraw will have the consecutive Withdraws counted as 0 points and averaged into the total course points. 1 Required science courses will only be averaged if taken within the past 5 years. Required science courses taken >5 years from application deadline will not be accepted or averaged into the overall points. Recommended courses, such as BIO 102 will be averaged even if the course is >5 years old.) (MAXIMUM POINTS = 8) a. Grade A = 2 points b. Grade B = 1 point c. Grade C =.5 point d. Grade D or F = 0 points POINT SYSTEM CRITERIA BIOL 136 = BIOL 137 = BIOL 140 = BIOL 102 = 6. Points will be awarded for completion and grade in each of the recommended general education courses (BOFF 140, HITT 115, HLTH 102 if the course has been taken multiple times, all of the previous grades will be averaged for point allocation) (MAXIMUM POINTS = 3) a. Grade A = 1 point b. Grade B =.5 points c. Grade C =.25 points d. Grade D or F = 0 points 7. Proof of residency must be submitted with your application (official definition of residence and description of District 507 boundaries are available in the Registration and Student Services offices) (MAXIMUM POINTS = 1) a. Applicants who are legal residents of Community College District 507 and US citizens = 1 point b. Applicants who are residents of the Indiana 7-county special tuition area = 0.5 point BOFF 140 = HITT 115 = HLTH 102 = Copy of valid Driver s License, State Identification Card, or a Voters Registration Card with your address TOTAL SCORE