Associate Degree Nursing LVN-RN Program

Associate Degree Nursing LVN-RN Program

Dr. Mary Moses Center for Health Sciences

Application for Admission

Information must be TYPED! Please complete each section for your application to be considered.

The information you submit on this application is used for the Board of Nursing. If this information is to change during the application process it must be sent to nursing@grayson.edu with subject line: BON Information Change.

Date Applied:*

MM/DD/YYYY

Desired Entry Semester/Year:*

SSN:*

###-##-####

GC Student ID#:*

D.O.B.:*

MM/DD/YYYY

First Name:*

Middle Name:

Last Name: *

Mailing Address: *

Primary Telephone #: *

Phone

Secondary Telephone #:

Phone

The email address that you provide to the Board is required in order to schedule fingerprinting for your criminal background check.

The email address you provide to the Board is subject to release to the public pursuant to the Texas Public Information Act.

Viking Email Address: *

Personal Email Address: *

LVN License #: *

Expiration Date: *

Emergency Contact Name: *

Relationship: *

Address: *

Phone #: *

Phone

NOTE: With respect to the admission and education of students; with respect to the availability of student loans, grants, scholarships and job opportunities; with respect to the employment and promotion of teaching and non-teaching personnel; and with respect to the student and faculty activities conducted on the premises owned or occupied by the College, Grayson College shall not discriminate either in favor of or against any person on account of race, creed, color, gender, national origin, age, religion, or disability. GC does not discriminate on the basis of sex in the educational programs or activities it operates. Inquiries concerning the application of Title IX and its implementing regulations may be referred to the Title IX Coordinator of the Office of Civil Rights. Title IX Coordinator is the Vice President of Student Services.

Grayson College

Associate Degree Nursing Program (LVN-RN)

VERIFICATION STATEMENT

I acknowledge that I have read and understood the following information regarding application eligibility requirements, selection, and acceptance into the Grayson College Associate Degree Nursing Program:

Degree Plan*

Physical & Mental Capabilities*

Clinical Participation Eligibility (Criminal Background Check)*

Eligibility for Licensure*

Technology Requirements*

Transcripts & Academic Requirements*

HESI Admissions Assessment Exam Requirements*

Required Immunizations & Health Documents*

Selection Process & Point System*

Final Acceptance Requirements*

Deadlines & Important Dates/Mandatory Events*

COVID-19 Information

The COVID-19 pandemic continues to evolve and the Nursing Program wishes to make you aware of some important information:

The program will adhere to all college policies and clinical agency policies regarding COVID-19.
Please note that the method of delivery of courses (i.e. face-to-face, hybrid online) and clinical experiences may have to be adjusted, up to and including, the possibility of cancellation.
Course calendars/due dates may have to be adjusted based upon changing situations and availability of classrooms, lab space, and/or clinical rotations.
In order to meet the program's outcome, you will be required to participate in clinical activities at healthcare facilities. Participation in these activities may result in a possible exposure.
On-campus time may be required in order to complete certain testing, lab objectives, and/or clinical objectives.
Face masks/face coverings may be required while conducting on-campus activities or clinical activities.
It is highly recommended that you purchase a webcam/microphone or computer device with a built-in webcam/microphone in the event that coursework and/or method of delivery must change due to circumstances related, but not limited to, COVID-19.

The Nursing Department will reach out regarding student requirements and if/when any changes are implemented. Please frequently monitor your GC Viking email and Canvas course announcements.

Grayson College

Associate Degree Nursing Program (LVN-RN)

Applicant Check List

Application to Grayson College*

Conditionally or Fully Admitted to Grayson College*

All Transcripts of each College Attended Submitted to Grayson College and/or with Application to the Nursing Program*

Application to Grayson Nursing Program*

Completion of Pre-Requisite Courses (AP I, AP II, & Math Requirement)*

Completion & Submission of HESI A2 Admission Exam Scores*

Submission of VN License, if applicable*

Started Immunization in time to complete them by the first day of class*

Will submit a copy of my Blue Card or BON eligibility documents to nursing once they are received*

Please Upload Files Here:*

**ONLY upload HESI/NLN-NEX Test Results and VN License**

Please include your NEX Science Results for:

NEX/Science/Anatomy

NEX/Science/Chemistry

NEX/Science/Health

NEX/Science/Physiology

Your application will be considered incomplete if you don't include all required scores.

Drag and drop files here or

Any files you are unable to upload today should be emailed to nursing@grayson.edu

By submitting this document, I confirm that I have read and understood all of the information provided. I agree to abide by the terms outlined above, and I affirm that all of the information I have provided is accurate, complete, and true to the best of my knowledge.

Send me a copy of my responses

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