Coordinated Program Entry Form - Nursing (AAS), NMNEC

Pre-Registration Screening Form

Before Submitting This Form

Please read the screening criteria and guidelines (https://editwww.

cnm.edu/programs/coordinated-program-entry/screening-criteria-andguidelines) for the Coordinated Entry Programs.

Please read the instructions (https://edit-www.cnm.edu/programs/coordinatedprogram-

entry/cpe-programs/nursing-aas-nmnec-concentration)

for the Nursing(AAS), NMNEC Concentration Pre-Registration Screening Form.

You cannot "save" your work and return to it later.

Submission of your form does not guarantee you a seat in the program. Screening forms will not be considered for students who have not been admitted to CNM.

NOTE: Students who want to be considered for the CNM-UNM Dual Degree Program must also submit a application to the UNM College of Nursing through NursingCAS (http://www.nursingcas.org/).

When you click "submit" a screen will appear that will notify you that your form was submitted successfully. You will also receive an email confirmation to your CNM email account.

Students will be notified within 14 business days of submitting their form.

Need Help?

If you have any questions about this form, please call (505) 224-4111 or email: cpe@cnm.edu before submitting.

Program*

Nursing (AAS), NMNEC

CNM Student ID*

Last Name*

First Name*

Primary Phone*

Please include area code when entering phone number (XXX) XXX-XXXX

Phone

Student CNM Email*

NOTE: This is the ONLY way we will contact you regarding your screening form. Make sure the address is working properly and check your account frequently. If you are experiencing any difficulties, contact Information Technology Services (ITS) at (505) 224-4357.

VA National Education for Employees Program VANEEP*

(Current VA Employees ONLY)

Select

Substitutions/Transcript Issues*

Please note if you have received an Official Substitution for any of the required coursework for the Nursing Program.

Select or enter value

HESI Test Date*

Enter the date you successfully completed the HESI exam. Enter the testing date in which you scored at least a 75% in all six areas: Reading, Vocabulary, Grammar, Math, Biology and Chemistry. If you met this requirement on more than one testing date, choose the exam with the highest cumulative score. Exam dates must be from the past year. Future test Dates are NOT acceptable. Results must be no later than the date of screening form submission.

Information and Acknowledgements

For each of the following statements click the box to acknowledge you understand that you have met/will meet the following requirements. If you have any questions on any of these statements, please contact (505) 224-4111 or email: cpe@cnm.edu before submitting this form.

I understand that I must meet the minimum requirements for this program as listed below:*

Minimum GPA requirements (2.0 cumulative and 2.75 calculated), Required Prerequisite Courses (finished or in progress), Minimum HESI scores.

I understand that there are limited seats for this program. I am responsible for registering for courses at the assigned date and time given to me if I am approved for registration.*

Enrollment in this program is not guaranteed.

I understand that failure to submit transcripts or meet program requirements will delay the approval of my Pre-Registration Screening form. I also understand that it is my responsibility to resolve any holds that may appear on my student account.*

I understand the information listed regarding re-entry into Term 1 of the CNM Nursing program. It is my responsibility to review my unofficial transcripts through myCNM for previous NRSG course attempts.*

I understand and verify that I meet the technical requirements to participate in the clinical education portion of this program and understand that if reasonable accommodations are needed I am to contact the Disability Resource Center.*

I understand that if I register for this program, I must complete pre-clinical requirements by a deadline.*

I understand that admittance into this clinical program is dependent upon acceptable results from a New Mexico Department of Health Background Screening, Urine Drug Screening and proof of specific immunizations.*

I understand that if I have identified myself as a VANEEP Applicant, the CNM Nursing office will share my acceptance status with the United States Department of Veterans Affairs.*

I understand that I am responsible for securing my seat by meeting payment deadlines. If you are dropped from your courses due to non-payment, we will not be able to re-add you back into the program classes.*

I understand that I must become familiar with the School of Health, Wellness, and Public Safety Handbook.*

Signature*

My signature confirms that I have read and agreed to all of the terms and conditions required to qualify to register for this program.

Send me a copy of my responses

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