RIVERSIDE CITY COLLEGE, School of Nursing

D

Application for FALL 2020 DUE December 2, 2019

Submit completed application to: nursing@rcc.edu Receipt of application will be sent within two weeks

Check the box for each program you are applying for:

Associate Degree (RN) 2 year Advanced Placement VN-RN 30 unit VN-RN Transfer

*Last *First Middle *Name:

*RCC Student ID# Required:Do you have a valid Social Security Number – (Required): Yes NoIf offered a space in the program, a copy of your valid Social Security card will be required.

Previous Name(s):

Phone number w// Email address (This will be the email address used to communicate with you

NOTE: Failure to list all previous colleges or failure to submit updated official transcripts by the end of the current application deadline; (DEC 2Σ нлм9) will invalidate your nursing application.

If you have previously submitted official transcripts, you DO NOT need to resubmit them. You may check Web Advisor to see if your transcripts are on file.

List All Schools Attended

Have you ever been enrolled in another Associate Degree (Registered Nursing) Program? Yes No

If yes, indicate Name of School: Applicants who have failed a Nursing program within the last 10 years are NOT eligible.

Do you have a bachelors or higher degree from the USA?: Bachelor’s? . No Degree From which United States, Regionally Accredited institution did you earn your degree?

Concurrent Enrollment ADN/BSN Petition

*RCC Student I

DO Nl

Yes No

Yes No

Do any of the following life experiences or special circumstances apply to you?

Yes No *Disabilities*Low family income*First generation of family to attend college*Need to work*Disadvantages social or educational enviro nment*Difficult personal and family situations or circumstances*Refugee

Are all of your prerequisites completed (Anat & Physio, Microbio, Lifespan Psych and Chem)?

Applicants missing or still in progress their courses have less chance of acceptance.

Are all of your Associate's Degree general educational requirements (English, American Inst, Social & Behavior Sci, Speech/Comm, Critical Thinking, Math & Humanities) completed? Applicants missing or still in progress with courses have less chance of acceptance.

Concurrent Enrollment ADN/BSN applicants only - Have you completed all Cal State University transfer requirements (IGETC/GSU GE certification)? All CSU requirements must be complete at time of application for ADN/BSN eligibility. See page 5 (last page) for more information.

Yes No

Only ATI TEAS-TEAS 6 is accepted. Applicants with the highest science grades will be invited to take the TEAS at RCC. If you are not invited, take the TEAS elsewhere then submit the TEAS to RCC by January 17, 2020. Our code with ATI is RIVERSIDE CC ADN. The TEAS is required for the 2 year ADN and the ADN/BSN concurrent enrollment, not the VN-RN.

DEMOGRAPHIC DATA: ŦƻNJ Řŀǘŀ ŀƴŀƭȅǎƛǎ ƻƴƭȅΣ ƴƻǘ ŀ ŦŀŎǘƻNJ ƛƴ ŀŘƳƛǎǎƛƻƴǎ Date of Birth (DOB):

Ethnicity: American Indian or Alaskan Native Black, non-Hispanic Filipino Hispanic White, other than Hispanic Pacific Islander Asian Other Unknown

Gender: Female Male

NoAre you a current Licensed (LVN) in California? Yes

Did you graduate from the RCC LVN Program? Yes No

LVN License#:

Have you completed Nursing 18?

Documentation from your supervisor or human resources department showing 1000 or more hours of employment required by Dec 2, 2019.

VN-RN applicants must contact the School of Nursing to be authorized to enroll in NRN-18. After NRN-18 is completed VN-RN students must pass the Advanced Placement exam to be eligible for VN-RN.

Associate Degree Nursing

Pre-Nursing CoursesThe form below must be completed to the best of your knowledge and submitted with this application in order for your application to be complete.

You must fill out this page if you are applying for the 2 year ADN program, VN-RN, 30 unit option or transfer. Petitioning students may skip the sections below and proceed to emailing the form to nursing@rcc.edu

Please indicate the courses that you believe you have completed or courses you are currently enrolled in .

RCCD Course Listing Equivalent Course you completed Which college? Completed or in progress? Grade

Anatomy & Physiology 2A or Bio 50A

Anatomy & Physiology 2B or Bio 50B

Microbiology 1

Chemistry 2A, 3 or 1A

Psychology 9 (Lifespan Development)

English 1A

Communication (speech) 1 or 9

American Institutions (US history or US poli-sci)

Sociology 1 or Anthropology 2

Humanities (arts, foreign language, world hist, etc)

Critical Thinking (Eng-1b, Reading 4, Phil 11, 32 or Statistics)

Statistics

Please save the completed application to your PC using the latest Adobe Acrobat Reader software. Save this application to your computer using the following naming format: "YourLastName_YourFirstName_YourRCCDStudentID.pdf" After saving the application, attach it to an email then send it to nursing@RCC.edu Apple computers do not always work with this application. Do not use Google chrome to fill out the application. Some devices or broswers do not format the application correctly.

By submitting this application, I certify that all the information contained in this application is true and correct to the best of my knowledge and I

understand that I am responsible for turning in all Official Transcripts to the Admissions & Records office before the end of the current application

deadline. I also understand that I am responsible for submitting copies of my Vocational Nursing License (LVN/LPN) and/or copy of

my California Certified Nursing Assistant (CNA),tŀNJŀƳŜŘƛŎΣ 9a¢Σ wŜǎLJƛNJŀǘƻNJȅ ¢ƘŜNJŀLJȅ and proof of work hours to the School of Nursing office by the end of the current application deadline.

You must have the latest version of Adobe Acrobat Reader (free) in order to save and submit this application; https://get.adobe.com/reader/

This page ONLY for Concurrent Enrollment ADN/BSN applicants. ALL RCC Nursing and CSU transfer requirements must be complete by the end of the application period in order to qualify for Concurrent Enrollment with California State

University San Bernardino.

This program allows students to complete ADN and BSN coursework at the same time. The BSN degree is earned 6 months after the ADN. The ADN/BSN concurrent enrollment program is currently not open to the VN-RN program. A minimum “C” grade is required in each college course. Applicants holding a US Bachelor's degree are waived from the CSU General Education requirements.

GradeAREA 1 - ENGLISH COMMUNICATION - 3 courses required, one each from Group A, B and C.

English Composition (ENGLISH 1A or equivalent)

Course: _______________ College: ________________________________

Critical Thinking - English Composition (ENGLISH 1B, Comm 2 or 3, Phil 11 or 32 or Reading 4)

Course: _______________ College: ________________________________

Oral Communication (COMM 1 or 9 or equivalent) (interpersonal or public speech)

Course: _______________ College: ________________________________

AREA 2 - MATHEMATICAL CONCEPTS & QUANTITATIVE REASONING (Statistics)Course: _______________ College: ________________________________ Advanced Placement/International Baccalaureate:

AREA 3 - ARTS AND HUMANITIES (At least 3 courses, with at least one from the Arts and one from the Humanities. 9 semester or 12 - 15 quarter units)

ARTS (Music, dance, theater, art, etc)

Course: _______________ College: ________________________________

HUMANITIES (Foreign languages, philosophy, literature, humanities, etc)

Course: _______________ College: ________________________________

One additional HUMANITIES or ARTS courseCourse: _______________ College: ________________________________

AREA 4 - SOCIAL and BEHAVIORAL SCIENCES (At least 3 courses from at least two academic disciplines. 9 semester or l2 - l5 quarter units)

LIFESPAN DEVELOPMENT (Psych 9 or equivalent)Course: _______________ College: ________________________________ :

Sociology 1 or Anthropology 2 or equivalent

Course: _______________ College: ________________________________ Other Social/Behavioral Science course (Anthropology, Admin of Justice, Political Science, Sociology, Psychology, etc) Course: _______________ College: ________________________________

AREA 5 - PHYSICAL and BIOLOGICAL SCIENCES

Anatomy & Physio 1

Course: _______________ College: ________________________________

Anatomy & Physio 2

Course: _______________ College: ________________________________

Microbiology

Course: _______________ College: ________________________________

Chemistry

Course: _______________ College: ________________________________

US CONSTITUITION & AMERICAN IDEALS - (US History and Poli Sci 1 (both courses required)US Hist Course: _______________ College: ________________________________

PoliSci 1 Course: ________ College: ________________________________

Please save the completed application to your PC using the latest Adobe Acrobat Reader software. Use the following naming format: "YourLastName_YourFirstName_YourRCCDStudentID.pdf" After saving the application, attach it to an email, then send it to nursing@RCC.edu Apple computers do not always work with this application. Do not use Google chrome to fill out the application. Some devices or broswers do not format the application correctly.