practical nurse program - Northwest Mississippi Community College

PRACTICAL NURSE PROGRAM
APPLICATION INFORMATION
Dear Prospective Student,
Thank you for your interest in the Northwest Mississippi Community College Practical Nursing Program located
on the Senatobia Campus, Benton-Marshall Campus, DeSoto Campus, and Oxford Campus. The PN program
accepts applications from January through April 30 each year for the fall semester.
The Oxford Campus also begins a new class each January. PN applications for this class (spring semester) will
be accepted from June through mid-October each year.
The PN program is a twelve-month course, which begins each August and January for Oxford. A campus-wide
schedule is followed with regard to holidays, semester registration, and breaks.
Admission criteria for acceptance into the program:
• You must include a new/updated application to Northwest.
• You must make application to the Practical Nursing Department. (see deadlines above)
• You must have a high-school diploma or GED equivalency.
• You must provide proof* of a composite score of 16 or higher on the enhanced ACT.
*PROOF REQUIRED: OFFICIAL HIGH SCHOOL TRANSCRIPT OR ACT PRINTOUT OF SCORES.
• You must be 18 years of age or older.
• You must be physically sound and have no felonious or criminal record.
• After these requirements are met, you will then be eligible to take the TEAS (a nurse entrance
test).
• There is a $50.00 cash fee for the TEAS test.
• Testing begins in February for the fall semester and mid-SEPTEMBER for the SPRING SEMESTER at
the Oxford Campus.
• Call Rhonda Still, 662-562-3366 (Senatobia or Benton-Marshall), or Brenda Holmes, 662-238-7952
(Oxford) after mid-January to schedule a testing date and time for the fall class and mid-August to
schedule a testing date and time for the Oxford Campus spring class. Dr. Tim Williams, 662-2806127, at the DeSoto Campus will be mailing notifications of TEAS test dates and times.
• Practical Nursing candidates who score at or above the program average (62) for math and reading
on the TEAS will be considered for admission.
All admission applications for the PN program must be submitted to the Practical Nursing Departments of
each respective campus. The mailing address is listed on the Practical Nurse Program Application.
Admission Policy
Practical Nursing (PN) – Students desiring to enter the PN program will
be selected based on the following criteria:
1. Applicants must be at least 18 years of age.
2. Applicants must have a high school diploma or GED equivalency.
3. Applicants must submit a new or updated Northwest application and
a PN application to the campus they are planning to attend.
4. Applicants must have an enhanced ACT composite score of 16 or
greater and must send proof of their ACT score to Northwest’s
Registrar’s Office. PROOF REQUIRED: Official high school transcript or
ACT printout of scores.
5. Once a prospective student has all required documentation on file
with the PN Program, an opportunity to sit for the Test of Essential
Academic Skills (TEAS) can be scheduled by calling Brenda Holmes at
662-238-7952.
* The Practical Nursing Program accepts applications from mid-January
through April 30 of each year. Testing begins each February.
** The LYTC-Oxford Campus also accepts applications from June
through mid-October for students planning to attend Spring semester.
Testing begins for this class in September.
Persons interested in applying for the Practical Nursing program at the
Oxford campus should make application to the following address:
ATTN: PN Program
NWCC/Lafayette-Yalobusha Technical Center
1310 Belk Drive
Oxford, MS 38655
ESTIMATED COST OF PN PROGRAM
FIRST SEMESTER:
TUITION …………………………………………………… $1,125.00
BOOKS & KIT……………………………………….…….. 1,250.00
CPR (First Aid) …………………………………………..
35.00
UNIFORMS ……………………………………………….
350.00
INSURANCE …………………………………………….
15.00
TOTAL FIRST SEMESTER ……….……………………………………………….$2,775.00
SECOND SEMESTER:
TUITION …………………………………………………… $1,125.00
TOTAL SECOND SEMESTER ……….………….……………………………….$1,125.00
SUMMER SEMESTER:
TUITION …………………………………………………… $1,125.00
TOTAL THIRD SEMESTER ……….………………………………………..…. $1,125.00
TOTAL ESTIMATED COST OF PN PROGRAM …………………………..……….$5,025.00
Northwest Mississippi Community College
PRACTICAL NURSING
Advisors: Kitchens, Williams, Shawn, Hill
The Practical Nursing Program prepares the individual to assist in providing general nursing care
requiring basic knowledge of the biological, physical, behavioral, psychological, and sociological sciences;
and of nursing procedures which do not require the skills, judgment, and knowledge required of a
registered nurse. This care is performed under the direction of a registered nurse, licensed physician, or
dentist.
Students that complete the program requirements, 3 semesters, as identified by the Mississippi
Department of Education, will be eligible to apply for PN licensure. The graduate of the program
functions as a provider of care and a member of a profession.
FIRST SEMESTER
SEMESTER HOURS
PNV 1213, Body Structure & Function
PNV 1426, Fundamentals of Nursing
PNV 1437, Fundamentals of Nursing
Lab/Clinical
Total
THIRD SEMESTER
2013-2014
3
6
7
16
SEMESTER HOURS
PNV 1715, Maternal-Child Nursing
PNV 1813, Mental Health Concepts
PNV 1914, Nursing Transition
Total
SECOND SEMESTER
5
3
4
12
SEMESTER HOURS
PNV 1614, Medical/Surgical Nursing
PNV 1622, Medical/Surgical Nursing
Clinical
PNV 1634, Alterations in Adult Health
PNV1642, Alterations in Adult Health
Clinical
PNV 1524, IV Therapy & Pharmacology
Total
4
2
4
2
4
16
Phone (662) 238-7952
PRACTICAL NURSE PROGRAM APPLICATION
ALL PRIOR FILES ARE INACTIVE. THE REQUIREMENTS FOR APPLICATION
MUST BE COMPLETED IF YOU ARE RE-APPLYING.
Applications for the fall semester will be accepted from January through April 30 each year.
Applications for the spring semester will be accepted from June through mid-October each
year.
NAME_____________________________________________________________________
Last
First
Middle
Maiden
MAILING
ADDRESS__________________________________________________________________
Street
City
State
Zip
EMAIL ADDRESS _________________________________ DOB ___________________
TELEPHONE______________________________ ________________________________
Home Number
Business or Cell Number
Have you taken the ACT? (Circle) Yes No If yes, composite score___________________
(Minimum 16 ACT required - YOU MUST PROVIDE PROOF OF SCORE - H.S. Transcript
or ACT printout)
High School_______________________________________ Year Graduated____________
If you hold a GED Certificate, date received _____________________________________
Please circle yes or no for the following questions. These are questions that will be on the
NCLEX PN (State Board Exam).
1. Yes No
Have you been convicted of any criminal offense in any state or federal court (other
than minor traffic violations)?
2. Yes No
Have you been convicted of a felony?
3. Yes No
If yes, have you been issued a Certificate of Relief from Disabilities by the Prisoner
Review Board?
4. Yes No
Have you had or do you now have any disease or condition that interferes with
your ability to perform the essential functions of your profession, including
any disease or condition generally regarded as chronic by the medical
community, i.e., (1) mental or emotional disease or condition; (2) alcohol or
other substance abuse; (3) physical disease or condition, that presently
interferes with your ability to practice your profession?
5. Yes No
Have you been denied a professional license or permit, or privilege of taking a
an examination, or had a professional license or permit disciplined in any way
by any licensing authority in Mississippi or elsewhere?
6. Yes No
Have you ever been discharged other than honorably from the armed service or
from a city, county, state or federal position?
Note: Providing false information on this application may cause the applicant to be
excluded from acceptance into the PN Program.
______________________________________________
Applicant’s Signature (Legal Name)
Return completed application to:
ATTN: PRACTICAL NURSING
Lafayette-Yalobusha Technical Center
1310 Belk Drive
Oxford, MS 38655
________________________
Date
Application for admission
Registrar’s office
4975 Hwy 51 north
P.O. Box 7047
Senatobia, ms 38668
Social Security Number: _______ - _____ - _________
Phone Number: (
) - _________ - _____________
E-mail: _____________________________________________________@________________________________________
Intended Major: __________________________ Major Code: _____________
Campus you plan
to attend:
Senatobia DeSoto Oxford Online
(mark one)
(See reverse for codes)
Degree Seeking
Non-degree Seeking*
*Non-degree seeking students are not eligible for financial aid.
Personal Information
Name:____________________________________________________________________________________________________
Last
First
Middle
Maiden
Physical Address:__________________________________________________________________________________________
Street
City
State
Zip
County
Mailing Address: __________________________________________________________________________________________
if different from physical
Street or P.O. Box
Date of Birth: ___/___/____
City
State
Zip
City/State/Country of Birth: _______________________ MS Resident?
Yes
Race/Ethnicity: Are you Hispanic/Latino?
Gender:
County
Male Female
No
Yes
No
What is your race? (You may choose more than one)
___White ___ Black or African American
U.S.Citizen?
Yes
___ Asian ___ American Indian or Alaska Native ___ Native Hawaiian or Other Pacific Islander
No
Family Information
**If you choose guardian, you must mail in official guardianship documents.
Choose One: ___ Parent ___ Guardian** ___Spouse
Name: ______________________________________________
Last
First
Mailing Address: ___________________________________________________________________________________
Street or P.O. Box
High School information
City
State
Zip
If any of your transcripts are from out of state, you must provide proof of residency.
Official high school transcript or GED and ACT scores (see NWCC catalog for exceptions) are required for admission to be complete.
High School: _________________________________________________________ Graduation Date: ___________________
(Month/year)
Location: ___________________________________
City
State
GED Information
Do you have a GED diploma? If yes, graduation date: _________ State where GED was completed: _______
Yes
(Month/Year)
No
college transcripts are required for admission to be complete.
College Information All official
Have you ever attended NWCC? Yes
List all colleges previously attended:
No
Dates attended: _____________________________________________
Name at time attended: ______________________________________
Last
First
Failure to list complete and accurate information could result in the cancellation of your enrollment.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
What semester do you plan to attend NWCC? ___ Fall ___Spring ___ Summer What year? _____________________
X Applicant’s Signature: ________________________________________________________________________________
Date: _______________________
I certify the information I have provided on this application is accurate and that I have not intentionally withheld information requested.
I further understand that falsification of information is a basis for denying admission or for immediate termination of enrollment. My
signature above also authorizes the release of my transcripts from all schools previously attended to Northwest’s Registrar’s office.
CODES FOR MAJORS
ASSOCIATE OF ARTS DEGREE
205
120
405
704
220
218
708
416
410
415
213
712
515
305
345
130
510
105
Accountancy
Animal Science
Art
Biology
Business & Computer Teacher
Education
Business Administration
Chemistry
Communications/Public
Relations
Communications/Broadcasting
Communications/Journalism
Computer/Management
Information Systems
Computer Science
Criminal Justice
Elementary Education
Exercise Science
Forestry
General College Curriculum
General Agriculture
724
340
505
417
784
420
423
605
240
131
788
720
744
347
730
732
734
716
710
General Science
Health & Physical Education
Liberal Arts
Marketing Communications/PR
Mgmt
Mathematics
Music, Music Education, Music
Performance
Music Business/Industry
Nursing (Associate Degree)
Office Administration
Outdoor Recreation & Mgmt
Physics
Pre-Architecture
Pre-Clinical Laboratory Sciences
Pre-Communicative Disorders
Pre-Cytotechnology
Pre-Dental
Pre-Dental Hygiene
Pre-Engineering
Pre-Forensic Chemistry
127 Pre-Health Information
Management
742 Pre-Health Sciences
726 Pre-Horticulture
718 Pre-Landscape Architecture
722 Pre-Landscape Contracting
736 Pre-Medical
748 Pre-Nursing (BSN)
752 Pre-Occupational Therapy
738 Pre-Optometry
756 Pre-Pharmacy
760 Pre-Physical Therapy
764 Pre-Radiological Sciences
768 Pre-Veterinary Medicine
770 Pre-Veterinary Medical Technology
520 Psychology
342 Recreation
307 Secondary Education
535 Social Work
425 Theatre
ASSOCIATE OF APPLIED SCIENCE
6005 Accounting Technology
6022 Agricultural Business & Mgmt
Tech/Animal Husbandry
6010 Agricultural Tech/John Deere
Tech
8014 Automotive Technology
8014 Automotive Tech/Chrysler
College Auto Program
6012 Aviation Maintenance Tech
6045 Business & Marketing
Management Tech
6098 Cardiovascular Technology
6030 Civil Engineering Technology
6032 Civil Engineering Tech/PreSurveying/Geomatics MSU
6052 Drafting & Design Engineering
Tech/Arch Eng
6025 Early Childhood Education
Technology
6070 EMT-Paramedic
6085 Funeral Service Technology
6035 Graphic Design Technology
6079 Health-Care Data Technology
8015 Heating, Air Conditioning &
Refrigeration Tech
6065 Hotel & Restaurant Mgmt Tech
6056 Industrial Electronics
Engineering Tech
6038 Information Systems Tech/
Computer Networking
6041 Information Systems Tech/
Computer Programming
6009 Microcomputer Technology
6014 Office Systems Technology
6090 Paralegal Technology
6099 Paralegal Tech/Pre-Paralegal
Studies UM 2+2 Option
6093 Respiratory Therapy
6092 Surgical Technology
7005 Precision Manufacturing and Machining Technology
8036 Cosmetology/Nail Technician
Option
6071 EMT-Basic
8062 Health Care Assistant
6013 Office Systems Technology (OneYr Certificate)
8060 Practical Nursing
8070 Welding And Cutting
CAREER CERTIFICATE
6031 Civil Engineering Technology
(One-Yr Certificate)
8005 Collision Repair Technology
8075 Commercial Truck Driving
8035 Cosmetology
AFFIRMATIVE ACTION—Northwest Mississippi Community College does not discriminate on the basis of race, color, national origin, sex, religion, age, disability or status as a veteran or disabled veteran in employment, programs, or provision of services. Compliance with Section 504 of the Rehabilitation
Act of 1973 and the Americans with Disabilities Act is coordinated by Mr. Michael Dottorey, Disability Support Services Coordinator, McLendon Student
Center, P.O. Box 5555, Highway 51 North, Senatobia, Mississippi 38668, telephone number 662-562-3309, email address mldottorey@northwestms.
edu. Compliance with Title II of the Age Discrimination Act and Title IX of the Education Amendments of 1972 is coordinated by Mr. Gary Mosley, Vice
President for Fiscal Affairs, James P. McCormick Administration Building, P.O. Box 7017, 4975 Highway 51 North, Senatobia, Mississippi, 38668, telephone number 662-562-3216, email address [email protected].