DEPARTMENT OF HEALTH PROFESSIONS
(RN) NURSING APPLICATION PACKET FOR 2015 APPLICANTS
Name: __________________________ Contact Number: _________________________
Applying to the nursing program at Lawson State is a competitive process and is based on set
criteria. Students are ranked and selected based on their academic achievements and compete
against other applicants.
Thus, meeting minimum qualifications does not guarantee acceptance. We wish all students success
in applying for the program.
Please select ONE of the following:
Birmingham Campus
RN (Registered Nurse) Program
 Summer Day
 Fall Day
Note: If applying to the Birmingham Campus return your application to the Ethel Hall Health Professions Building on the
Birmingham East Campus
Bessemer Campus
RN (Registered Nurse) Program
 Fall Evening
Note: If applying to the Bessemer Campus return your application to the “A” Building room 110 on the Bessemer Campus.
Application Deadlines: March 15, 2015 (by 5:00 CST) and June 1, 2015 (by 5:00 CST). Lawson
State Community College admits students to its RN day program two times per year, every
summer and fall. Lawson State Community College admits students to its RN evening
program one time per year, every fall.
It is the policy of the Alabama State Board of Education and Lawson State Community College, a postsecondary institution under its control, that no person shall, on
the grounds of race, color, sex, religion, national origin, disability or age, be excluded from participation in, be denied the benefits of, or be subjected to discrimination
under any program, activity, or employment.
THE ALABAMA COMMUNITY COLLEGE SYSTEM
Lawson State Community College
(ADN) NURSING PROGRAM APPLICATION
APPLICATION DEADLINES FOR 2015 ADMITTANCE:
March 15, 2015 by 5:00 pm (CST) and June 1, 2015 by 5:00 pm (CST)
Today’s Date: _______________
I. PERSONAL DATA (PLEASE PRINT)
Last Name: _________________________ First: _______________________ MI: ______
Maiden: ____________________
Social Security Number/ID Number:__________ _________________________________
Mailing Address: __________________________________________________________________________________________
City: _________________________ State: __________ Zip Code: ______________ Telephone: ___________________________
Cell Phone:__________________________________________
E-mail address: ______________________________________
II. EDUCATION
High School Graduation Year:_______ High School Name:________________________________________________________
GED (if applicable): ____________________________________________ Date completed: _____________________________
Are you currently taking college courses? Yes _____ No _____ If yes, what college____________________________________
List all colleges attended and the year (s) attended
Have you ever participated in academic dishonesty (cheating) and have been disciplined for such an offense at a previous
college? Yes______ No______ If yes, name the institution_____________________________________________________
Have you previously been admitted to a Nursing Program? Yes _____ No _____ If yes, state reason for withdrawal.
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Do you hold a current Alabama LPN license? Yes _____ No _____
Have you taken the TEAS Test more than TWICE within a 12 month period? Yes _____ No _____
If yes, list all test dates: ____________________________________________________________. Please note that the
institution will not consider more than TWO TEAS test results in one calendar year. The highest of the two will count.
NOTE: An official TEAS Transcript must be submitted to the Office of Admissions and received and a copy of the report
must be attached to this application. Failure to provide the Admissions Office (by this application deadline) with your
official TEAS transcript or not attaching your TEAS scores to this application will disqualify your application.
III.
Attach the following to this application. Check off each block indicating that you have attached both reports.


IV.
Unofficial copies of High School and College Transcripts from all colleges attended (including Lawson State),
if applicable, must be submitted for consideration. Failure to attach all transcripts will disqualify your
application.
Copies of TEAS scores (Submit official TEAS Transcripts to the Admissions Office prior to making
application). Failure to contact TEAS testing services and have your TEAS Transcripts sent to Lawson State’s
Admission office by the application deadline, will disqualify your application. Official TEAS Transcripts must
be on file in the Admission Office and a copy of that report must be submitted with this application. Again,
failure to do both will disqualify the applicant.
Check the box below indicating that you have read the attached Essential Functions listing and confirm that, if
accepted into the program, you can fulfill all the required Essential Functions.

I have read the Essential Functions and confirm that I CAN carry out all functions as described.

I have read the Essential Functions and would like to reveal that I CANNOT carry out the Essential Functions.
If you CANNOT carry out the Essential Functions, please explain in detail below. If more space is needed, please type out a
statement and attach it to this application. Label it: Essential Functions
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
I understand that completion of this application is a component of the student profile and does not in itself grant admission to the nursing
program. I understand this application must be updated if I am not selected. I certify that the information given in this application is true
and correct. I understand that providing false information may be deemed sufficient reason to dismiss the student and/or refuse admission.
Minimum admission standards include:
1. Unconditional admission to the college.
2. Receipt of completed application for the nursing program(s) by stated deadline.
3. A minimum of 2.50 GPA based on the following criteria:
o Student has undergraduate level credit hours: Compute the GPA based on the most recent 24 hours of undergraduate credit hours;
o Student that has 24 or more credit hours at the graduate level: Compute the GPA based on the most recent 24 hours of graduate level
credit hours- undergraduate level credit hours are ignored;
o Student that has less than 24 hours at the graduate level: Compute the GPA based on the most recent 24 hours of undergraduate credit
hours – graduate credit hours are ignored
o For students who have completed any college course work; high school credits will not be used in calculating GPA except as required
in the Early College Enrollment Program.
o For students who have completed no college course work the final cumulative high school GPA should be a 2.5 or higher OR
successfully passed the GED exam.
4. Associate Degree Program nursing applicants must also have a GPA of 2.5 on a 4.0 scale in BIO 201, BIO 202, and MTH 100 or higher.
5. Associate Degree nursing applicants must be Eligible for English 101 and Math 100 or Higher.
6. Eligibility for BIO 201 during the first term of associate degree and practical nursing.
7. Good standing with college.
8. Meeting the essential functions required for nursing.
9. Completion of the Test of Essential Academic Skills (TEAS) is required. (Please attach documents.)
Admission to the nursing program is competitive, and the number of students is limited by the college. Meeting minimal requirements does
not guarantee acceptance. Your signature below indicates that you have been truthful in completing this application, and it also indicates that you
are fully aware that meeting minimal admission requirements does not guarantee program acceptance.
_______________________________________________
Applicant’s Signature
Please return to:
Day Applicants
Lawson State Community College
Attn: Department of Health Professions
3060 Wilson Road
Birmingham, AL 35221
(205) 929-6329
____________________________________
Date
Evening Applicants
Lawson State Community College – Bessemer Campus
Attn: Department of Health Professions
1100 9th Ave SW
Bessemer, AL 35022
(205) 929-3461
Note: Applications must be returned to the campus to which you are applying. If applying to Bessemer please return to Bessemer and if applying to
Birmingham please return to Birmingham.
For Office Use Only
Date received: ________________________________________
Initials: ___________________________
LAWSON STATE COMMUNITY COLLEGE
DEPARTMENT OF HEALTH PROFESSIONS
ASSOCIATE DEGREE NURSING PROGRAM
Applicant Point System
Calculation of Points for Students Meeting Minimum Admission Standards: Ranking Scores Calculated as Follows:
1. Test for Academic Skills (TEAS)-Maximum 150
Points are awarded using the adjusted individual total score to percentile rank conversion on the TEAS exam (example: 56.7%
correct = 85 points). Please see the TEAS V Score Conversion Chart. Note: The TEAS V (or current versions) scores
cannot be more than 3 years old.
NOTE: Only official TEAS scores will be accepted as long as the score has been recorded within a three year period. Retest
scores are only considered if the retake of the TEAS has occurred after 12 months (1 year) from the original test date.
2. Selected Coursework (maximum 90 points for first attempt courses only)
Points for grades in selected college course work are awarded as follows:
A=30 Points, B= 20 Points, C= 10 points in the following courses:
Grade
Points
BIO 201 Anatomy & Physiology I
_____
_____
BIO 202 Anatomy & Physiology II
_____
_____
BIO 220 Microbiology
_____
_____
Repeated Biology Courses (second attempt)
Points for second attempt course work (repeated courses) are awarded as follows:
A=15 Points, B=10 Points, C=5 points
A second attempt is determined based on whether or not the course has been repeated due to failure or withdrawal from the
course.
Repeating a biology course (within 48 months of making application) that has already been passed (with a grade of “C” or
better) is also considered a second attempt and will be assessed accordingly. A=15 Points, B=10 Points, C=5 points.
Repeating a biology course after 49 months is not considered a repeat course. As a result, students will be assessed under
the normal point scale: A=30 Points, B= 20 Points, C= 10
NOTE: See Repeated Course Appeal Process information if you withdrew or failed a course due to a devastating
situation/emergency that impacted your life at the time and led to the failure or withdraw. The Selection Committee does have
a review process that will consider your case. If the appeal is approved internally, the biology course will count for the full
points. A=30 Points, B= 20 Points, C= 10. Keep in mind, though, that appeals are not guaranteed (to be approved) and are
reviewed on a case-by-case basis only and judged by their legitimacy and worthiness only.
3. Additional points (Maximum 11) – Students may be awarded up to 11 points as determined by the College.
The points will be awarded as follows:
Points for the grade in the HPS 103 Foundation Competencies for Health Sciences/Nursing Academy Course:
A = 11 points
B = 7 points
C=5 point
D/F= 0 points
HPS 103 Foundation Competencies for
Health Sciences/Nursing Academy Course
Grade
Points
______
______
Total Points Awarded
Earned
Maximum Possible
1 TEAS Score
150
2 Selected Course Work
90
3 Additional Points
11
Total
251
LAWSON STATE COMMUNITY COLLEGE
DEPARTMENT OF HEALTH PROFESSIONS
ASSOCIATE DEGREE NURSE CURRICULUM
First Term
Dpt
Crs
Course Title
Theory
Lab
Clinic
Preceptor
Course
MTH
100
Intermediate College Algebra
3
0
0
0
3
BIO
201
Anatomy and Physiology I
3
1
0
0
4
NUR
102
Fundamentals Of Nursing
3
2
1
0
6
NUR
103
Health Assessment
0
1
0
0
1
NUR
104
Introduction To Pharmacology
0
1
0
0
1
9
5
1
0
15
Lab
Clinic
Preceptor
Course
Term Total
Second Term
Dpt
Crs
Course Title
Theory
ENG
101
English Composition I
3
0
0
0
3
BIO
202
Anatomy and Physiology II
3
1
0
0
4
NUR
105
Adult Nursing
5
1
2
0
8
NUR
106
Maternal And Child Nursing
4
0
1
0
5
12
2
3
0
20
Lab
Clinic
Preceptor
Course
Term Total
Third Term
Dpt
Crs
Course Title
Theory
PSY
200
General Psychology
3
0
0
0
3
BIO
220
Microbiology
2
2
0
0
4
NUR
201
Nursing Through the Lifespan I
3
0
2
0
5
8
2
2
0
12
Lab
Clinic
Preceptor
Course
Term Total
Fourth Term
Dpt
SPH
Crs
106, 107
or 116
Course Title
Theory
Speech
3
0
0
0
3
PSY
210
Human Growth and Development
3
0
0
0
3
NUR
202
Nursing Through the Lifespan II
3
0
3
0
6
9
0
3
0
12
Lab
Clinic
Preceptor
Course
Term Total
Fifth Term
Dpt
Crs
Course Title
Humanities Fine Arts Elective
Theory
HUM
Select ONE humanities course from STARS Guide for course
selection options
3
0
0
0
3
NUR
203
Nursing Through the Lifespan III
4
0
2
0
6
NUR
204
Role Transition for the Registered Nurse
2
0
0
2
4
9
0
2
2
13
Term Total
Program Totals:
Total Credit Hours:
72 Hours
Total Contact Hours:
1680
General Education:
30 Hours
Nursing Hours:
42 Hours
NURSING PROGRAMS
ESSENTIAL FUNCTIONS
The Alabama Community College System endorses the Americans' with Disabilities Act. In accordance with College policy,
when requested, reasonable accommodations may be provided for individuals with disabilities.
Physical, cognitive, psychomotor, affective and social abilities are required in unique combinations to provide safe and
effective nursing care. The applicant/student must be able to meet the essential functions with or without reasonable accommodations
throughout the program of learning. Admission, progression and graduation are contingent upon one's ability to demonstrate the
essential functions delineated for the nursing programs with or without reasonable accommodations. The nursing programs and/or its
affiliated clinical agencies may identify additional essential functions. The nursing programs reserve the right to amend the essential
functions as deemed necessary.
In order to be admitted and to progress in the nursing program one must possess a functional level of ability to perform the
duties required of a nurse. Admission or progression may be denied if a student is unable to demonstrate the essential functions with or
without reasonable accommodations.
The essential functions delineated are those deemed necessary the Alabama Community College System nursing programs.
No representation regarding industrial standards is implied. Similarly, any reasonable accommodations made will be determined and
applied to the respective nursing program and may vary from reasonable accommodations made by healthcare employers.
The essential functions delineated below are necessary for nursing program admission, progression and graduation and for
the provision of safe and effective nursing care. The essential functions include but are not limited to the ability to:
1) Sensory Perception
a) Visual
i) Observe and discern subtle changes in physical
conditions and the environment
ii) Visualize different color spectrums and color
changes
iii) Read fine print in varying levels of light
iv) Read for prolonged periods of time
v) Read cursive writing
vi) Read at varying distances
vii) Read
data/information
displayed
on
monitors/equipment
b) Auditory
i) Interpret monitoring devices
ii) Distinguish muffled sounds heard through a
stethoscope
iii) Hear and discriminate high and low frequency
sounds produced by the body and the
environment
iv) Effectively hear to communicate with others
c) Tactile
i) Discern tremors, vibrations, pulses, textures,
temperature, shapes, size, location and other
physical characteristics
d) Olfactory
i) Detect body odors and odors in the environment
2) Communication/ Interpersonal Relationships
a) Verbally and in writing, engage in a two-way
communication and interact effectively with others,
from a variety of social, emotional, cultural and
intellectual backgrounds
b) Work effectively in groups
c) Work effectively independently
d) Discern and interpret nonverbal communication
e) Express one's ideas and feelings clearly
f)
Communicate with others accurately in a timely
manner
g) Obtain communications from a computer
3) Cognitive/Critical Thinking
a) Effectively read, write and comprehend the English
language
b) Consistently and dependably engage in the process of
critical thinking in order to formulate and implement
safe and ethical nursing decisions in a variety of
health care settings
c) Demonstrate satisfactory performance on written
examinations including mathematical computations
without a calculator
d) Satisfactorily achieve the program objectives
4) Motor Function
a) Handle small delicate equipment/objects without
extraneous movement, contamination or destruction
b) Move, position, turn, transfer, assist with lifting or lift
and carry clients without injury to clients, self or
others
c) Maintain balance from any position
d) Stand on both legs
e) Coordinate hand/eye movements
f) Push/pull heavy objects without injury to client, self or
others
g) Stand, bend, walk and/or sit for 6-12 hours in a
clinical setting performing physical activities requiring
energy without jeopardizing the safety of the client,
self or others
h) Walk without a cane, walker or crutches
i) Function with hands free for nursing care and
transporting items
j) Transport self and client without the use of electrical
devices
k)
l)
m)
n)
o)
Flex, abduct and rotate all joints freely
Respond rapidly to emergency situations
Maneuver in small areas
Perform daily care functions for the client
Coordinate fine and gross motor hand movements to
provide safe effective nursing care
p) Calibrate/use equipment
q) Execute movement required to provide nursing care
in all health care settings
r) Perform CPR and physical assessment
s) Operate a computer
5) Professional Behavior
a) Convey caring, respect, sensitivity, tact, compassion,
empathy, tolerance and a healthy attitude toward
others
b) Demonstrate a mentally healthy attitude that is age
appropriate in relationship to the client
c) Handle multiple tasks concurrently
d) Perform safe, effective nursing care for clients in a
caring context
e) Understand and follow the policies and procedures of
the College and clinical agencies
f) Understand the consequences of violating the student
code of conduct
g) Understand that posing a direct threat to others is
unacceptable and subjects one to discipline
h) Meet qualifications for licensure by examination as
stipulated by the Alabama Board of Nursing
i) Not to pose a threat to self or others
j) Function effectively in situations of uncertainty and
stress inherent in providing nursing care
k) Adapt to changing environments and situations
l) Remain free of chemical dependency
m) Report promptly to clinicals and remain for 6-12 hours
on the clinical unit
n) Provide nursing care in an appropriate time frame
o) Accepts responsibility, accountability, and ownership
of one's actions
p) Seek supervision/consultation in a timely manner
q) Examine and modify one's own behavior when it
interferes with nursing care or learning
Upon admission, an individual who discloses a disability can request reasonable accommodations.
Individuals will be asked to provide documentation of the disability in order to assist with the provision of
appropriate reasonable accommodations. The respective College will provide reasonable accommodations
but is not required to substantially alter the requirements or nature of the program or provide
accommodations that inflict an undue burden on the respective College. In order to be admitted one must
be able to perform all of the essential functions with or without reasonable accommodations. If an
individual's health changes during the program of learning, so that the essential functions cannot be met
with or without reasonable accommodations, the student will be withdrawn from the nursing program. The
nursing faculty reserves the right at any time to require an additional medical examination at the student's
expense in order to assist with the evaluation of the student's ability to perform the essential functions.
Requests for reasonable accommodations should be directed to: Renee Herndon, ADA Coordinator on the
Bessemer Campus at 929-3419 or Philana Suggs, ADA Coordinator on the Birmingham Campus at
929-6449.
Repeated Course Appeal Packet
Appeals Must Be Submitted at the Time of Application
Late Appeals will not be accepted
Under what circumstances do you use this form? If you failed or withdrew from Biology 201, 202 or 220
due to some catastrophic event (i.e., extended hospitalization, major accident, etc…) that was beyond your
control, you may consider completing this appeal process. In that way, the committee can better determine
if the failure or withdrawal was due to academic reasons or other reasons beyond the student’s control.
Each appeal is weighed, judged and assessed and approved or disapproved on a case-by-case basis.
There are no guarantees and individuals completely an appeal should not feel that simply completely this
process will guarantee approval. It does not. Every case and every circumstance is different.
What happens if my appeal is approved? If your appeal is approved, the Committee will award the Biology
course you are appealing with the full credit of points (A-30, B-20, C-10). If you appeal is not approved, the
Committee will award you Biology course with the standard repeat points (A-15, B-10, C-5).
Will the decision be shared with me? The Selection Committee does not send that information out because
the selection process is a private process. However, if you would like to find out at a later date, you can
always make an appointment to meet with the Associate Dean of Nursing. During that time, full disclosure
of the Committee’s decision regarding your appeal will be shared with you. The Associate Dean will only
discuss whether or not the appeal was granted. No discussion beyond that will be permitted. This should
be a fact-finding mission on your part only.
Students are only eligible for one appeal per application process. Several appeals will not be considered.
APPEAL PACKET (MUST BE SUBMITTED AT THE TIME OF APPLICATION)
PART I: Student Information
Name:____________________________________
What repeated biology course you would like to appeal: ___________________________
What is the name of the instructor who taught the course:__________________________
Where did you take this course (institution)?_____________________________________
PART II: Appeal Information (please attach)
1. Submit a 1000-1500 word justification of the appeal. The justification must be
typed, double-spaced (use Times Roman font, 12 pt. only). In your description
of the situation, outline for the committee the circumstances which you believe
were catastrophic enough that caused you to withdraw or fail your Biology
course.
2. Attach evidence that supports your claim. Failure to provide evidence of your
claim will void you appeal automatically. Please note that evidence submitted
can and will be reviewed and double-checked for authenticity. Submitting
false claims to the Committee will automatically disqualify you from entering
the program.
3. Attach a statement from the instructor who can vouch for your situation.
Statements must be written by the instructor and signed. If the instructor is
not a Lawson State instructor, the instructor must provide contact information
so the Committee can reach him or her for follow-up call if they have any. If
you cannot provide this statement, skip this section and submit your appeal
without the support of the instructor.
If you have any questions, as it relates to the appeal process, please email
[email protected].
NOTE: All appeals are judged based on a standard rubric of assessment.