New PN Application

PN Application

Initial Application Date

First Name

Last Name

Birth Date

Cell Phone

Street

City

State/Province

Zip/Postcode

Full Local Address

If Different from Home address

Program

How did you hear about us?

High School Alma Mater

Year Graduated

Awards/Recognition

Prerequisites (Enter a Letter Grade)

English Credits

English Grade

Math Credits

Math Grade

Biology I Credits

Biology I Grade

Biology II Credits

Biology II Grade

Social Science Credits

Social Science Grade

Optional Math Credit

Pharmacology or Clinical Calculations

Optional Math Grade

Pharmacology or Clinical Calculations

AHLS Medical Terminology Credits

AHLS Medical Terminology Grade

ATI TEAS Score

This is a Numeric Score. Enter 0 if not taken.

Emergency Contact Information

Emergency Contact Person

Relationship

Emergency Contact Number

Emergency Contact Email

PN ADMISSION DOCUMENTS

Upload all required exhibits on checklist below. Ensure attachments are completed prior to hitting the submit button. DNS-HC will not view multiple submissions. Applicants will have to submit the application containing all exhibits at the time of initial application for program consideration.

Exhibit 1 - Government Issued Identification

Government Issued Identification

Exhibit 2 - Social Security Card

Social Security Card

Exhibit 3 - School Transcript(s)- it does not have to be official. Must Include: Math I and II or Calculus, English, and Anatomy with a minimum grade of C

High School Transcripts

***All applicants will receive an email confirming submission and instructions that will detail the next step in the admission process.

NOTE: The code below is case sensitive

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