PRACTICAL NURSING PROGRAM RICHFIELD, EPHRAIM, NEPHI

PRACTICAL NURSING PROGRAM RICHFIELD, EPHRAIM, NEPHI ADMISSION PACKAGE 1 Updated: 09/2013

Dear Prospective Student, Thank you for your interest in our nursing program here at Snow College. We believe that we have one of the best LPN programs around and are very confident about the quality of education we provide for our students. It has received full accreditation status from the Accreditation Commission for Education in Nursing Inc. (ACEN). Our nursing program is held at Snow College Richfield s main campus as well as our outreach sites: Ephraim West Campus and Nephi campus, housed at CVMC. Caring instructors teach concurrently with video conferencing technology and live instruction. Each classroom has microphones allowing students from each campus to participate in all lectures and discussions. We can accept up to 40 student; 20 on the Richfield campus and 20 between the Ephraim and Nephi campuses. All 40 students are filled from the same applicant pool. Students from all campuses will travel about six times a month to these different sites for labs and activities. Please follow the specific directions as outlined in the admission procedures and mail your complete application to Snow College - Richfield, c/o Melissa Blackner Allied Health Department, 800 West 200 South, Richfield, Utah 84701. All applications must be submitted no later than April 15 th for the Fall LPN nursing class which begins the third week of August. All applications will be reviewed and scored appropriately. The top forty applicants that score the highest will be sent a letter indicating acceptance to the program. All letters should be received before the middle of June. It is your responsibility to inquire on the status of your file, to ensure that it is complete before April 15th. We are here to help you achieve your goal of becoming an LPN. If you have any questions or need help with your application please feel free to call us. Sincerely, Amber Epling, MSN RN Director/Assistant Professor Allied Health Department (435)893-2228 amber.epling@snow.edu Melissa Blackner Administrative Assistant (435)893-2232 melissa.blackner@snow.edu 2

ALLIED HEALTH DEPARTMENT The Mission of Snow College Richfield Allied Health Department is threefold: 1) To educate students for health care fields. 2) To inspire them to love learning. 3) To lead them to serve others. Through quality instruction the Allied Health Department will also facilitate the development of integrity, responsibility, the need of lifelong learning, and community services as health care providers. 3

Practical Nursing Program Admission Procedures Snow College is committed to providing equal educational opportunities to all students regardless of age, color, gender, marital/parental status, national origin, physical disability, race or religion in compliance with federal law. The Snow College nursing program gives preference to students living in the Snow College six county service areas. These areas include Sevier, Piute, Wayne, Sanpete, Millard, and Juab Counties. Application deadline for Fall Semester is April 15 th. Please follow this checklist when applying. Application to Snow College. (If you are currently enrolled at Snow College, this part can be skipped.) Acceptance to Snow College is required prior to submitting an application to the Snow College Nursing Department. An online application must be done at www.snow.edu/welcome/admissions/application. There is a $30.00 non-refundable application fee. Follow instructions to the end, submitting any documents that are required. A $15.00 readmission fee is required if you have previously attended Snow College and have been away for more than one semester. A complete LPN nursing application packet includes the following: 1. LPN Application. A completed Practical Nursing Program Application form. A Word document is available online at www.snow.edu/alliedhealth, if you would like to type your application. Applications must be postmarked before April 15 th for consideration to our program. 2. Non-refundable Nursing Application Fee of $25.00. We will accept a check or money order made out to Snow College or send a copy of your receipt. Please do not send cash. 3. Two References. References from a previous or current employer or teacher, not a friend or relative, are required and must be received by Melissa Blackner from the individual you select as a reference by April 15 th of the current year. Only two references will be accepted. Print two copies of the APPLICANT STRUCTURED REFERENCE FORM pages 11-12. The applicant completes the specified information on page 11, and then sends both pages to the individuals you have selected as a reference. References are asked to provide the information requested on pages 11 and 12. They are then asked to mail the completed form as per instructions on page 11 prior to April 15 th. You can contact Melissa at any time to see if she has received your reference letters. 4. Official Transcripts. Transcripts from ALL colleges/universities where you have taken any prerequisite/support/suggested courses. (Unofficial transcripts from Snow College will be accepted). Transcripts need to be mailed to Allied Health Department c/o Melissa Blackner by April 15 th. 5. CNA License. A copy of current CNA State Licensure is required by April 15 th. Mail your completed LPN nursing application form to: Snow College Richfield Allied Health Dept. c/o Melissa Blackner 800 West 200 South Richfield, Utah 84701 4

PRACTICAL NURSING PROGRAM REQUIREMENTS Pre-application requirements: Must be completed before April 15 th. Please send documentation with your application. Complete one of the three: a. Math 1010, passed with a grade of C (2.0) or better or b. ACT score of 23 or higher in math (send HS transcript for proof of this) or c. ACCUPLACER test, must have a score of 90 or greater in Algebra CNA license- a copy of current state certification is required by April 15 th. Prerequisite courses: Must be completed before nursing program begins in August. Anatomy with Lab.. BIOL (2320, 2325) Physiology with Lab.. BIOL (2420, 2425) Microbiology with Lab.BIOL (2060, 2065) English.ENGL (1010) All prerequisite classes must be completed with a grade of C (2.0) or better. An OFFICIAL transcript of the prerequisite classes completed must be sent to Melissa by April 15 th. These four classes are the only classes used in figuring your prerequisite GPA. If you have not completed a prerequisite course by April 15 th, a grade of C will be used to figure your GPA. Support courses: Can be taken with LPN courses simultaneously. It is your responsibility to find your own class. Nutrition..HFST1020 *Fall Semester Psychology.. PSY1010 *Spring Semester It is recommended that support classes, Psychology PSY (1010) and Nutrition HFST (1020), be completed before entrance into the LPN program due to the intense LPN course work. Extra points are given to those applicants who have these courses completed by April 15 th. Both classes require a minimum grade of C (2.0). Because of the April 15 th deadline, if these classes are taken spring semester, no extra points will be given. Suggested courses: Highly recommended but not required. Chemistry with Lab..CHEM (1110,1115) Medical terminology NURP (1000) or HESC (1050) Human Growth and Development Life Span HFST (1500) Drug Dosages and Calculations NURP (1101) Extra points will be given if the suggested classes are completed before April 15 th. A minimum grade of C (2.0) is required in all suggested courses. Medical Terminology and Drug Dosages online classes require a minimum of B (3.0) grade to be considered for extra points in the application process. Because of the April 15 th deadline, if these classes are taken spring semester, no extra points will be given. You can contact the Advisement Office located at Snow College Richfield campus (435-893-2211) or Snow College Ephraim campus (435-283-7313) for information about prerequisite courses. You may also take the above classes at any other accredited college or university. 5

POINT SYSTEM All applications will be reviewed and scored on the same point system. Based on this system, the top forty applicants will be accepted in to our program. POINTS ARE GIVEN BASED ON THE FOLLOWING: o Living in the Snow College Service Area. This includes Sevier, Piute, Wayne, Sanpete, Millard, and Juab Counties. POINTS POSSIBLE 2 o Completed over 85% of prerequisites from Snow College. 1 o Being on the previous year s alternate list. 2 o Applying the previous year with a complete application and not being accepted. (A completed application includes: a complete LPN application, two reference letters, all prerequisite courses completed by the April 15 th deadline, and a CNA license. All information needs to be received by the April 15 th deadline.) 1 o Having all pre-application & prerequisite courses completed by April 15 th. 2 o Prerequisite GPA (Anatomy/Lab, Physiology/Lab, Microbiology/Lab, & English). 3.85 to 4.00 = 11 pts. 2.95 to 3.09 = 5 pts. 3.70 to 3.84 = 10 pts. 2.80 to 2.94 = 4 pts. 3.55 to 3.69 = 9 pts. 2.65 to 2.79 = 3 pts. 3.40 to 3.54 = 8 pts. 2.50 to 2.64 = 2 pts. 3.25 to 3.39 = 7 pts. 2.33 to 2.49 = 1 pt. 3.10 to 3.24 = 6 pts. Below 2.33 = 0 pts. 11 o Support courses (Nutrition & Psychology) completed by April 15 th. 2 o Suggested courses (Chemistry, Human Growth & Development, Drug Dosages & Calculations, Medical Terminology,) completed by April 15 th. o Work Experience. Working, or has worked, as a(n): Certified Nursing Assistant (CNA) : {>5 yrs= 3 pts}, {2-5 yrs= 2 pts}, {1 yr= 1pt} Certified Medical Assistant (CMA): {>5 yrs= 3 pts}, {2-5 yrs= 2 pts}, {1 yr= 1pt} Emergency Medical Technician (EMT): { >5 yrs= 3 pts}, {2-5 yrs= 2 pts}, {1 yr= 1pt} Other Certified Health Occupation = 2 pts. Nursing Assistant = 1 pt. o Two Reference Letters and LPN Application. Points for the application will be given based on writing skills, extracurricular activities, awards, honors, scholarships, ect. 2.5 6 15 Please remember, it is your responsibility to inquire on the status of your file; including confirmation that all your information is received before April 15 th. 6

NURSING PROGRAM Upon acceptance to the program students MUST have: Physical examination Proof of current immunizations: Tdap, MMR, Varicella or positive antibody titer, Hepatitis B, negative two-step TB test or chest x-ray, and flu shot. Drug screen Background check LPN CLASS SCHEDULE The LPN program starts the end of August. Classes are held Monday thru Friday, generally from 9:00 a.m. to 3:00 p.m., with a one hour lunch break. Clinicals start the last week of January, continuing through February and March. Graduation will be at the end of the Spring Semester. FALL SEMESTER NURP 1102 Fundamentals of Nursing 5:3:6 NURP 1103 Pharmacology 2:1:3 NURP 1106 Pediatric-Maternity Nursing 1 2:2:1 NURP 1114 Caring for the Adult 1 4:3:3 HFST Principles of Nutrition (if not completed) 3:3:0 SPRING SEMESTER NURP 1115 Caring for the Adult 11 4:2:12 NURP 1108 Mental Health Fundamentals 2:2:0 NURP 1107 Pediatric Maternal Nursing 11 3:3:3 NURP 1109 Professional Transition for the Practical Nurse 2:2:3 PSY 1010 General Psychology (if not completed) 3:3:0 Total credits fall: 16 Total credits spring: 14 Total credits for year: 30 **STUDENTS ARE REQUIRED TO JOIN HOSA (Health Occupations Students of America). Students are required to participate in State competitions with other schools demonstrating their knowledge in the health field. There is a National Competition every year that is optional for the students. Some fundraising is involved. Students must register for all nursing courses offered each semester. All courses must be completed with a grade of C (2.0) or better before the student advances to the next semester. NURP 1102 Class Fee: $45. (Name badge and supply fee) NURP 1114 Class Fee: $20. (HOSA fees) NURP 1109 Class Fee: $50. (NCLEX Predictor Test) **SEE COLLEGE FEE TABLE FOR INFORMATION ON TUITION COST **To apply for Financial Aid over the internet: www.fafsa.ed.gov or call: (435)283-7133 or 7129. 7

PRACTICAL NURSING PROGRAM APPLICATION SNOW COLLEGE RICHFIELD ALLIED HEALTH DEPARTMENT 800 W. 200 S. RICHFIELD, UT 84701 Date: Badger ID#: PERSONAL INFORMATION Please print all information Name: Last First Middle Preferred Former Name(s): Home Phone: (List all names found on transcripts) E-mail address: DOB: Cell Phone: Badger E-mail: @badgermail.snow.edu All email contact will be through Badger e-mail Permanent Address: Mailing Address: Number and Street (or R.D.) City State Zip Number and Street (or R.D.)/P.O.Box City State Zip Person to be notified in case of emergency: Name: Address: Telephone: Number and Street (or R.D.) City State Zip Would you prefer to attend class on the Richfield, Ephraim or Nephi Campus? Please mark: 1 st, 2 nd and 3 rd choice (all campuses are filled from the same applicant pool): Richfield: Ephraim: Nephi: ACADEMIC BACKGROUND List ALL colleges and universities you have attended, including Snow College. Please send official transcripts from ALL colleges and universities you have attended where you have completed any prerequisite, support, or suggested courses to the Nursing Department. Unofficial transcripts from Snow College will be accepted. Name of Institution -List schools in order attended with most recent first- Location City & State: Entrance Date: Exit Date: Degree Obtained: 8

List below any prerequisite/support courses you are currently enrolled and when you expect to complete them: Provide information concerning high school or other secondary schools you attended: Or the year you passed your GED: WORK EXPERIENCE If you have any health-related education or employment background, give facts including copies of certificates, name of employer, your title, duties performed, and starting and ending dates. (Preference may be given for verified certification and experience in a health related field. Example: CNA, EMT Home Health Aide, etc.) Name of Employer -List in order with most recent first- Title Duties performed Begin Date mm/yy End Date mm/yy WRITING SKILLS If extra space is needed, answers may be completed on a separate sheet of paper. Write an account of: (1) any leadership, community or service positions you have held, including dates, (2) your reasons for selecting nursing as a career, (3) any special reasons for desiring to enter this college, and (4) your plans and aspirations for the future. List extracurricular activities, awards, honors, scholarships, student government, etc.: 9

ADDITIONAL INFORMATION Have you applied for admission to Snow College? Yes No Have you applied to this program before? Yes No Date: Have you been an alternate for this program? Yes No If yes, what year? When do you desire to enter this school? Date: Are you prepared to meet the necessary commitment, time and money, of the Snow College nursing program? Yes No Satisfactory progress through the nursing program requires attendance in both theory and clinical sections. Will you commit yourself to the prescribed hours, course of study and policies of the Department of Nursing? Yes No Please indicate the general state of your health: Good Fair Poor Are you aware of any reason why you would not be able to perform the essential physical and mental requirements of nursing school? Yes No If yes, give pertinent details: Have you been convicted of a class A (drugs) misdemeanor or felony since the age of 18? Yes No If yes, give dates, details, and penalties for each occurrence, including dates of all probationary periods: I do hereby certify that the statements in this application are true and complete to the best of my knowledge. I also give my permission for the Nursing Department to look up my student information. Signed: Date: Permanent address: How long have you lived at this address: 10

APPLICANT STRUCTURED REFERENCE FORM SNOW COLLEGE SCHOOL OF PRACTICAL NURSING 800 West 200 South - Richfield, Utah 84701 TO THE APPLICANT: PLEASE COMPLETE THIS AREA ONLY!!! (PLEASE PRINT) APPLICANT NAME: BADGER ID: ADDRESS: Student Waiver: Pursuant to recent federal law, a student admitted to this School of Practical Nursing is entitled to inspect this evaluation in his or her file unless the student signs a waiver of his/her right of access. However, Snow College does not require a waiver as a condition for admission to, receipt of financial aid from, or receipt of any other services or benefits from said school. Applicants submitting names of individuals for letters of recommendation therefore, are free to determine whether or not they wish to waive their right to examine such evaluations. Waiver: The Family Educational Rights and Privacy Act permit us to request, but not require that you waive your right to inspect this evaluation after completion. The right is initiated if you are enrolled as a student at Snow College and the evaluation is maintained in your file after your enrollment. When considering signing this waiver, be advised that the information contained on this form will be used to evaluate you as an applicant for admission to the Snow College School of Practical Nursing. APPLICANT SIGNATURE: 11 PHONE: Please sign your name and date this document as proof that you elect to waive your rights of access to review this information. TO THE EVALUATOR: DATE: ***********************APPLICANT DO NOT WRITE BELOW THIS LINE *********************** We appreciate your willingness to complete this reference based on the applicant s performance as your student and/or employee. Comments will be reviewed by faculty members of the Snow College School of Practical Nursing and used to attain a better understanding of the applicant. Your cooperation in completing and returning this form is greatly appreciated. Please return both pages in a sealed envelope with your signature across the sealed, back flap of the envelope. Send the envelope to the following address by April 15 th. Snow College Richfield Allied Health Department, c/o Melissa Blackner 800 West 200 South Richfield, Utah 84701 Evaluators should (1) rate each statement independently, and (2) avoid a tendency to rate on general impressions. One characteristic might influence the rating of all characteristics. The following questions or statements identify a variety of traits, skills, attitudes, etc. Please indicate the degree on which each quality is a characteristic of the applicant by (1) reading the statements carefully, and (2) reading the comments in each category. If you do not feel you have enough information to rate the applicant on a particular item, please circle NA (not apply), next to the item. 1. Problem-Solving: Ability to identify and solve problems: Poor Average Excellent 2. Sense of Responsibility: Ability to complete tasks and duties, honors commitments: Doesn t complete responsibility Average Always completes tasks; accepts responsibilities; consistent; dependable 3. Maturity: Conducts self in mature, adult manner: Immature, childish Average Mature, adult behavior 4. Attitude: Based upon your experience with this person, what type of attitude does this candidate project toward life, school, job, etc.? Very negative Average Very positive 5. Creativity: Does this person display a degree of creativity? Very little Average Exceptionally creative

6. Stress/Anxiety Response: Deals with stressful, anxiety-producing situations: Ineffective, comes unglued Average Excellent 7. Motivation/Drive: Extent to which individual applies self: Uninspired Average self-starter/a hard worker 8. Appearance: Extent to which standard of appearance is met Untidy, poorly groomed Average Well groomed 9. Health: Extent to which health or physical disability problems affect performance: Health problems interfere frequently Average Health seldom interferes with activities 10. Acceptance of Personal Feedback: Please rate the person s ability to handle constructive criticism and positive feedback: Resents, rejects, doesn t respond Average Seeks, utilizes, responds effectively 11. Communication Skills: Ability to communicate with peers, coworkers, teachers, etc.: Expresses self poorly Average Excellent expression; fluent 12. Integrity: Extent to which this person displays an ethical code: Cheats, bluffs, untruthful, blameless Average Always honest, admits error, truthful, trustworthy 13. 14. Interpersonal Relationships: Ability to cooperate and get along with peers, co-workers, teachers, employers, etc.: Inappropriate behavior; generally antagonizes Maintains satisfactory relationships Outstanding ability to work well with others What would you identify as the person s strengths and weaknesses? (Additional comments may be placed on a separate page.) A. Strengths: B. Weaknesses: 15. Select one of the following: I highly recommend this person I recommend this person I DO NOT recommend this person EVALUATOR INFORMATION: (Please Print) Name: Position: Phone: Length of time you have known applicant: (months) Capacity you have known applicant: (employer, supervisor, teacher) Signature: Date: Thank you for your participation. Please return this form to the address indicated above in a sealed and signed envelope. 12

SCHOLARSHIP APPLICATION FOR THE LPN PROGRAM Name: The department gives out several scholarships each year to deserving practical nursing students. Applicants must have a cumulative 3.0 GPA and a 3.0 GPA for the nursing pre-requisites. If you are interested in a nursing scholarship, please write a short paragraph below describing your financial needs. (This form must be submitted with your application to Melissa Blackner by April 15 th.) 13