ASSOCIATE DEGREE PROGRAM IN NURSING ... - Quincy College
ASSOCIATE DEGREE PROGRAM IN NURSING ... - Quincy College
ASSOCIATE DEGREE PROGRAM IN NURSING ... - Quincy College
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ev. 01.08.14<br />
<strong>ASSOCIATE</strong> <strong>DEGREE</strong> <strong>PROGRAM</strong> <strong>IN</strong> NURS<strong>IN</strong>G<br />
QU<strong>IN</strong>CY CAMPUS<br />
NURS<strong>IN</strong>G APPLICATION FOR ADMISSION<br />
FULL TIME SEPTEMBER 2014<br />
A non-refundable $50 application fee must accompany this application.<br />
See application deadlines on back.<br />
ID#<br />
Mr. Mrs. Ms.<br />
Last Name First Name Middle Name<br />
Permanent<br />
Mailing<br />
Address:<br />
List other names that may appear on credentials<br />
Number Street/P.O. Box Apt. Number<br />
City State Zip Country<br />
Home Phone:<br />
Area Code<br />
Phone Number<br />
Email:<br />
Cell Phone:<br />
Area Code<br />
Phone Number<br />
Work Phone:<br />
Social Security#:<br />
Demographics:<br />
- -<br />
Date of Birth: / / (Month/Day/Year)<br />
Gender: Male Female<br />
Are you a Veteran? Yes No (If, yes, please provide a copy of DD Form 214)<br />
Are you of Hispanic or Latino descent? Yes No<br />
Ethnicity:<br />
(optional)<br />
Citizenship:<br />
(required)<br />
Please check all that apply.<br />
White<br />
Black or African American<br />
Asian<br />
Are you a U.S. Citizen?<br />
Yes<br />
Native Hawaiian or Other Pacific Islander<br />
American Indian or Alaska Native<br />
Other (please explain)<br />
No, I am an immigrant or permanent resident.<br />
Please specify country of citizenship<br />
No, I am here on a VISA.<br />
Please specify VISA type<br />
country of citizenship<br />
and<br />
Students who answered no must submit a copy of their Visa/Immigration card.<br />
This school is authorized under federal law to enroll non-immigrant alien students.<br />
Is English your native language? Yes No<br />
1250 Hancock St • <strong>Quincy</strong>, MA 02169 • 617-984-1710 or 1-800-698-1700 • www.quincycollege.edu
High School<br />
or GED:<br />
I have a High School diploma ___________ or GED __________<br />
Date graduated or GED completed__________________________________________________<br />
High School Attended_______________________________________________________________<br />
City_____________________________ State__________________________<br />
QC Attendance:<br />
Have you ever attended <strong>Quincy</strong> <strong>College</strong> before? Yes_____ No _____<br />
Post-Secondary<br />
Education:<br />
If yes, when? ______________What was your major? _________________<br />
List other colleges and/or universities attended:<br />
____________________________________________________________________________________<br />
Name of School # 1 Major Credits/Certificate/Degree earned<br />
____________________________________________________________________________________<br />
Name of School # 2 Major Credits/Certificate/Degree earned<br />
Transfer:<br />
Are you applying for transfer from a Nursing Program at another institution?<br />
_____Yes<br />
_____ No<br />
Certification:<br />
If yes, Name of School:<br />
Program:<br />
Official transcripts are required with your application. Submit all official transcripts in a sealed<br />
envelope by the school from which they were issued in your completed application packet.<br />
DO NOT have college and/or high school transcripts sent directly to <strong>Quincy</strong> <strong>College</strong>. If the<br />
school will not issue an official copy directly to you, please have transcripts sent to:<br />
Nursing Admissions<br />
c/o Admissions Office<br />
1250 Hancock Street<br />
<strong>Quincy</strong>, MA 02169<br />
I certify that the information I have submitted here is complete and accurate to the best<br />
of my knowledge, and if accepted, I agree to observe the financial, academic, and social<br />
regulations of <strong>Quincy</strong> <strong>College</strong>. I further certify that no one has completed this application on<br />
my behalf. I also understand that incomplete applications will not be accepted.<br />
_____________________________________________________ ___________________<br />
Signature of Applicant<br />
Date<br />
<strong>Quincy</strong> <strong>College</strong> is an academic community dedicated to openness, tolerance and respect. Our doors and programs are<br />
open to all students without regard to age, race, religion, sex, marital or parental status, national origin, veteran status,<br />
physical or mental disability or sexual orientation. The <strong>College</strong> does not discriminate in its education programs or in admissions<br />
to, access to, treatment in, or employment in its programs and activities. <strong>Quincy</strong> <strong>College</strong> strives to not only meet,<br />
but exceed all Federal, State, and Local statutes governing equal opportunity and inclusion. All questions, concerns, or<br />
complaints regarding the <strong>College</strong>’s Affirmative Action/Title VI or Sexual Harassment/Title IX policies should be forwarded to<br />
Mary Scott, Vice President for Human Resources, 1250 Hancock Street, <strong>Quincy</strong>, MA 02169 or by calling 617-984-1768 or at<br />
mscott@quincycollege.edu. Inquiries regarding services for students with disabilities or the Americans with Disabilities Act<br />
should be forwarded to Susan Bossa, Associate Vice President for Student Development, 1250 Hancock Street, <strong>Quincy</strong>, MA<br />
02169 or by calling 617-984-1656 or at sbossa@quincycollege.edu.
<strong>ASSOCIATE</strong> <strong>DEGREE</strong> <strong>PROGRAM</strong> <strong>IN</strong> NURS<strong>IN</strong>G -<strong>ASSOCIATE</strong> <strong>IN</strong> SCIENCE<br />
The Associate Degree Program in Nursing is offered as a two-year full-time day program at the <strong>Quincy</strong> and<br />
Plymouth Campuses beginning each year in September. All degree requirements must be completed within four<br />
years of initial admission to the program.<br />
In all nursing courses, students are scheduled for clinical nursing practice in a variety of settings under the<br />
supervision of qualified nursing faculty. Required clinical time may be days, evenings, or weekends. Acceptance<br />
to the program does not guarantee a clinical placement. Applicants are advised that clinical agencies require<br />
that a Criminal Offender Record Information (CORI) check is completed on students before they are allowed<br />
in the clinical setting. A positive CORI check may result in dismissal from the program. Additionally, some clinical<br />
partners require drug screening of students placed in their facility. These providers reserve the right to refuse and/<br />
or reject a student whose drug test does not meet facility guidelines. Students who test positive for the presence<br />
of illegal drugs will result in dismissal from the program.<br />
Students who successfully complete the program are eligible to take the NCLEX examination for licensure as a<br />
Registered Nurse (RN). Applicants are advised that they must be of good moral character in order to be granted<br />
licensure by the Commonwealth of Massachusetts. A student who has been convicted in a court of law will be<br />
reviewed by the Massachusetts Board of Registration in Nursing and may be denied entrance to the licensure<br />
examination.<br />
The Associate Degree Program in Nursing is fully approved by the Commonwealth of Massachusetts Board of<br />
Registration in Nursing and accredited by the National League for Nursing Accrediting Commision (NLNAC), 3343<br />
Peachtree Rd. NE, Suite 500, Atlanta, GA,30326, 1-404-975-5000.<br />
<strong>ASSOCIATE</strong> <strong>DEGREE</strong> <strong>PROGRAM</strong> <strong>IN</strong> NURS<strong>IN</strong>G<br />
YEAR ONE<br />
YEAR TWO<br />
Fall Semester Credits Fall Semester Credits<br />
RNU 108 Fundamentals of Client Care 7 RNU 206 Advanced Concepts of Client Care II 10<br />
BIO 131 1 Anatomy and Physiology I 3 BIO 151 3 Microbiology<br />
3<br />
BIO 141 1 Anatomy and Physiology I lab 1 BIO 152 3 Microbiology lab<br />
1<br />
ENG 101 1 English Composition I 3 CSI or CSA Computer Elective<br />
3<br />
MAT 103 <strong>College</strong> Algebra or higher<br />
3<br />
Spring Semester<br />
Spring Semester<br />
RNU 109 Advanced Concepts of Client Care I 10 RNU 208 Advanced Concepts of Client Care III<br />
BIO 132 2 Anatomy and Physiology II 3 ENG 102 English Composition II<br />
BIO 142 2 Anatomy and Physiology II lab 1 HIS/GOV Either HIS 101, HIS 102<br />
PSY 101 2 General Psychology 3<br />
GOV 201 or GOV 211<br />
or HIS 111 or HIS 112<br />
10<br />
3<br />
3<br />
Total Credits Required for Graduation 67<br />
1<br />
Must be completed before RNU 109<br />
2<br />
Must be completed before RNU 206<br />
3<br />
Must be completed prior to or concurrent with RNU 208<br />
Additional Program Information<br />
• Students must have a satisfactory health and immunization record<br />
• Students must be certified in CPR for the Health Care Provider<br />
• The passing grade for all courses is “C” (73%). Students are not eligible to continue in the program if they receive less than a “C” (73%) in any<br />
program specific course (i.e. MLT, EXS, PHB, PNU, RNU, SUR). Students are not eligible for graduation until they have earned a “C” (73%) in all<br />
program courses.<br />
• Students may transfer courses from any regionally accredited college and/or university within the United States. Official transcripts must be<br />
submitted showing completion of the courses with a final grade of “C” or better. **Please speak with an advisor about transfer credit.<br />
• All international transcripts must be evaluated by a <strong>Quincy</strong> <strong>College</strong> designated evaluation center. **Please speak with an advisor about<br />
transferring international college credits.<br />
• Natural science courses must have been taken in Fall 2009 or after in order to be considered valid for the program.<br />
• <strong>Quincy</strong> <strong>College</strong> reserves the right to make changes to school policies. Students will be notified when this occurs.<br />
• Computer Science courses must have been taken in Fall 2007 or after in order to be considered valid for the program.
APPLICATION CHECKLIST<br />
The following items must be submitted in one complete package. Failure to submit all documents will result in a delay<br />
in processing.<br />
1. _____ Completed <strong>Quincy</strong> <strong>College</strong> Nursing Application.<br />
Applications will be accepted beginning January 6, 2014. Early decision deadline March 28, 2014.<br />
Regular Decision June 6, 2014. Applications submitted after June 6, 2014 is based on space available basis.<br />
2. _____ $50 nonrefundable application fee.<br />
3. _____ Nursing Admissions Exam. Each <strong>Quincy</strong> <strong>College</strong> applicant is required to take the computerized Nursing<br />
TEAS V and meet the following minimum score (68.7%) prior to submitting this application.<br />
4. _____ Official high school transcript or G.E.D. exam scores showing successful completion. (Students currently in high<br />
school must have completed at least the first quarter of their senior year.)<br />
5. _____ Official college transcripts showing completion of the following prerequisite courses: All transcripts must be<br />
submitted in a sealed envelope by the school by which they are issued.<br />
A. General Biology lab or Anatomy & Physiology I with lab and a grade of “C” or higher, completed<br />
between the Fall of 2009 and the application deadline.<br />
B. Chemistry with Lab and with a grade of “C” or higher, completed between Fall 2009 and<br />
the application deadline (CHE 121or 141 with assigned lab will fulfill this requirement).<br />
For high school seniors, one year of high school Biology or anatomy & Physiology AND a one year Chemistry course<br />
with a grade of “C” or higher will satisfy the prerequisite requirements.<br />
6. _____ Proctored personal statement. (After submitting the application, students must stay on campus to<br />
write a personal statement.)<br />
7. _____ Proof of attendance at a Nursing Information Session. (Please print the email confirmation as proof<br />
of attendance and submit it along with your application.)<br />
8. _____ Prior work validation. (if applicable)<br />
Submit all official transcripts in a sealed envelope by the school from which they were issued in your<br />
completed application packet. DO NOT have college and/or high school transcripts sent directly to<br />
<strong>Quincy</strong> <strong>College</strong>. If the school will not issue an official copy directly to you, please have transcripts sent to:<br />
Nursing Admissions<br />
c/o <strong>Quincy</strong> <strong>College</strong> Admissions Office<br />
1250 Hancock St<br />
<strong>Quincy</strong>, MA 02169<br />
I have read and understand the requirements for admission to <strong>Quincy</strong> <strong>College</strong>. I have enclosed all required<br />
information.<br />
Signature<br />
Date<br />
PLEASE NOTE: Upon acceptance into the Associate Degree in Nursing Program, you will need to reserve your seat with a $250 deposit and also<br />
pay a $100 matriculation fee. Your seat deposit will be applied toward your tuition at the time of registration. If you reserve a seat and do not<br />
attend, the $250 deposit is non-refundable.<br />
*Please be advised that Massachusetts law permits long term care facilities, home health care facilities and other institutions providing care,<br />
treatment, education, training, transportation, delivery of meals, instruction, counseling, supervision, recreation or other services in a home or<br />
community based setting for an elderly person or a disabled person to require Criminal Offender Record Information (“CORI”) for all employees<br />
and/or volunteers who will have direct or indirect contact with such elderly or disabled person(s). All of the providers with which <strong>Quincy</strong> <strong>College</strong><br />
places students as part of their clinical coursework in the Nursing Program now require that all such students participate in a CORI check. These<br />
providers reserve the right to refuse and/or reject any student whose CORI does not meet the applicable guidelines. Some clinical partners<br />
require drug screening of students placed in their facility. These providers reserve the right to refuse and/or reject students whose drug test does<br />
not meet facility guidelines. Students who test positive for the presence of illegal drugs will result in dismissal from the program. Students who do<br />
not complete the applicable clinical coursework are ineligible for graduation from the <strong>Quincy</strong> <strong>College</strong> Nursing Program. Therefore, please be<br />
advised that your admission to the <strong>Quincy</strong> <strong>College</strong> Nursing Program is specifically conditioned upon a satisfactory CORI check, drug screening,<br />
and acceptance by a clinical provider. By accepting you into the <strong>Quincy</strong> <strong>College</strong> Nursing Program, <strong>Quincy</strong> <strong>College</strong> does not represent or<br />
warrant that you will be eligible for placement in a clinical program.