Nursing Application for Current Students

This application is designed for students who are currently enrolled at Clinton Community College in a non-nursing major and who seek admission to the nursing program for the fall semester. If you have questions, please contact the Office of Admissions at 518.562.4170.

Admissions Plan

*How do you plan to take courses?

*Are you applying for full-time or part-time study?

Full-time (12+ credits)

Part-time (less than 12 credits)

Student Information

*Clinton Student ID

*First Name

Preferred First

Middle Name

*Last Name

Suffix

Former Name

*Birthdate

Contact Information

*Permanent Address:

Country

Street

City

Region

Postal Code

Home Phone

Mobile Phone

*Email Address

Additional Colleges Attended

Number of colleges you attended while enrolled at Clinton Community College

Institution #1

*College Name

*Level of Study

*Start Date

*End Date

*Credits/Hours Earned

Graduation Date

Degree Granted

Institution #2

*College Name

*Level of Study

*Start Date

*End Date

*Credits/Hours Earned

Graduation Date

Degree Granted

Institution #3

*College Name

*Level of Study

*Start Date

*End Date

*Credits/Hours Earned

Graduation Date

Degree Granted

If any previous college programs were not completed, indicate a reason why:

Applicants who have attended another school of Nursing, RN or LPN, and left prior to completion must request a letter from the Nursing Program Director be sent to the Nursing Program Director of Clinton Community College indicating the circumstances under which the student withdrew.

Previous History with Clinton Community College

*Have you previously applied to the nursing program at Clinton Community College?

Yes

No

*Have you ever been enrolled in Clinton's nursing program?

Yes

No

*Have you been dismissed from Clinton or any other college for disciplinary reasons (not including academic dismissal)? An affirmative response to this question will not automatically prevent admission, but applicants will be asked to provide additional information.

Yes

No

*Please give the approximate date(s) of each incident, explain the circumstances and reflect on what you learned from the experience. You may use up to 400 words.

Health-Related Experience

*Do you have any prior health-related work experience (Nurse aid, EMT, medic, etc)?

Yes

No

Describe the work, including length of service:

List other educational, travel, and/or community service experience.

*Essay

Please respond with an account of (1) your experiences and activities since you last attended school, if more than six months have elapsed, (2) all the things you have accomplished that have given you the greatest satisfaction, (3) what you most enjoy doing in your leisure time, (4) your reasons for selecting Nursing as a career, (5) any special reasons for desiring to enter this school, and (6) your plans and aspirations for the future. Include any data or facts relative to your application which you feel are important and may not have been covered elsewhere.