PRACTICAL NURSE PROGRAM
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].
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