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Nursing Information Sessions - Delaware County Community College

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NURSING ADMISSION<br />

PROCEDURES<br />

FALL 2014<br />

Chester <strong>County</strong><br />

<strong>Information</strong> presented in this packet supersedes<br />

all other information obtained by the applicant.<br />

The Chester <strong>County</strong> <strong>Nursing</strong> Program is offered to residents of Chester <strong>County</strong> only. All candidates are strongly<br />

encouraged to submit their petitions and supporting paperwork by the priority consideration deadline of: Friday, October<br />

25, 2013, at 12 o’clock noon. Petitions should be submitted only after all the requirements outlined in this packet have<br />

been fulfilled. Petitions must be submitted in-person at the Rhoads Education Building, Chester <strong>County</strong> Hospital, 701 E.<br />

Marshall Street, West Chester, PA. The priority petitioning period is as follows:<br />

OPENING DATE: Monday, August 12, 2013 at 9 a.m.<br />

CLOSING DATE: Friday, October 25, 2013 at 12 noon<br />

It is recommended that students petition during the early months of the priority petitioning period. Petitioning early in<br />

the process will be to your benefit as it allows the Admissions Committee to review a student’s petition for errors and<br />

missed items.<br />

All priority petitioning candidates with completed petitioning paperwork submitted by the priority closing date will be<br />

considered for a seat in the program based on the strength of their Test of Essential Academic Skills (TEAS) scores. Seats<br />

for the 2014 <strong>Nursing</strong> Program will be awarded via a highest to lowest ranking system using each priority petitioner’s<br />

highest TEAS scores from a single test.<br />

The Admissions Office will continue to accept qualified, completed petitions for 2014 after the priority deadline for<br />

consideration for a seat, if any remain available, or for placement on a wait list. The wait list is maintained until mid-<br />

July 2014 when it is dissolved. Any candidate who wishes to be considered for a future program must petition again<br />

and meet any new admission criteria for that future entrance year.<br />

Candidates petitioning for <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong>’s Fall 2014 <strong>Nursing</strong> Program are responsible for the<br />

information contained in this packet. Please retain for future reference.<br />

<strong>Nursing</strong> <strong>Information</strong> <strong>Sessions</strong><br />

Attending an <strong>Information</strong> Session is highly recommended in order to learn more about the curriculum<br />

and the special admission requirements. TEAS test preparation is discussed at each session. <strong>Sessions</strong><br />

last approximately 2 hours and begin promptly at the time listed. Please arrive 10 minutes early to sign<br />

in and pick up materials. No reservations are required.<br />

Day Date Time Location<br />

Thursday 1/30/2014 6PM Marple Campus (Media, PA) Academic Building/Room 2246<br />

Tuesday 2/11/2014 6PM Chester <strong>County</strong> Hospital (W. Chester, PA) Rhoads Edu. Building/Auditorium<br />

Thursday 3/6/2014 6PM Southeast Center (Sharon Hill, PA) Café<br />

Thursday 4/17/2014 6PM Marple Campus (Media, PA) Academic Building/Room 2246<br />

For additional information sessions scheduled after the dates above,<br />

please visit the <strong>College</strong>’s Calendar & Events: www.dccc.edu<br />

Updated: 1/6/2014


FACTS ABOUT THE PROGRAM/Chester <strong>County</strong> Program<br />

1. Upon successful completion of the curriculum, students receive an associate in applied science (AAS) degree and<br />

are eligible to sit for the state licensure examination to become a registered nurse (NCLEX-RN).<br />

2. Admission into <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong>’s <strong>Nursing</strong> program is selective. Not everyone who petitions<br />

and meets the qualifications can be accommodated due to limited seating for the program.<br />

3. Students are awarded seats in the program via meeting all the admission criteria outlined in this packet. Please<br />

read the contents of this packet thoroughly and attend a <strong>Nursing</strong> <strong>Information</strong> Session to learn about the<br />

curriculum, requirements for admission, and TEAS preparation. <strong>Information</strong> Session dates are listed on the front<br />

of the packet and posted under Calendar & Events at: http://www.dccc.edu/events<br />

4. All nursing applicants must be a resident of Chester <strong>County</strong> to be eligible for the Chester <strong>County</strong> program.<br />

Proof of residency will be required of all candidates (see page 9). Preference is given to residents from sponsoring<br />

school districts. At present, sponsoring school districts in <strong>Delaware</strong> <strong>County</strong> are: Chester-Upland, Garnet Valley<br />

(Bethel residents only), Haverford, Interboro, Radnor, Ridley, Rose Tree Media, Southeast Delco, Springfield,<br />

Upper Darby, Wallingford-Swarthmore (Rutledge and Swarthmore residents only), and William Penn.<br />

5. <strong>Nursing</strong> applicants must be United States citizens or permanent residents to be offered a seat in the nursing<br />

program.<br />

6. <strong>Nursing</strong> clinical (NUS 110) begins every fall semester. Students are encouraged to take as many of the non-clinical<br />

classes (English, anatomy & physiology, sociology, etc.) as possible prior to entering the Fall 2014 <strong>Nursing</strong><br />

Program.<br />

7. The semester sequence, once accepted into the program, is fall/spring, fall/spring. No summer clinical course<br />

work is scheduled. However, students are free to take elective courses during the summer semesters.<br />

8. Both DAY and EVENING/WEEKEND programs are offered. There is a maximum of 32 seats for the DAY Program<br />

and 32 seats for the EVENING/WEEKEND Program in NUS 110 (Fundamentals of <strong>Nursing</strong>). This number is based<br />

on the number of clinical positions available to <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> students at area hospitals.<br />

9. The <strong>Nursing</strong> Admissions Committee will make final selection after careful evaluation of an applicant’s<br />

demonstrated ability and potential for success. The Committee relies on the scores the applicant achieves on the<br />

Test of Essential Academic Skills (TEAS) as a predictor of success within the program and on the RN licensure<br />

exam. For more information on the TEAS, please attend a <strong>Nursing</strong> Info Session and refer to pages five (5) and six<br />

(6) of the packet.<br />

10. At times, the <strong>College</strong> enters into partnerships with specific hospitals. The guidelines for admission to these<br />

sections may vary and will be made available as agreements are finalized. Partnership announcements will be<br />

posted in the Admissions Office and in the Allied Health, Emergency Services and <strong>Nursing</strong> Department.<br />

11. The <strong>College</strong> does not have a healthcare facility. Specific healthcare providers offer all clinical experiences. These<br />

healthcare providers will not allow a student convicted of a prohibited offense or child abuse (see <strong>Delaware</strong><br />

<strong>County</strong> <strong>Community</strong> <strong>College</strong> Criminal Background Check Procedures) to take part in clinical experiences at their<br />

facility. Such students would not be able to complete their studies and, therefore, will not be accepted into the<br />

program.<br />

12. LPN licensure, recent RN courses, paramedic or equivalent military training may qualify a student for advanced<br />

placement in the program. Students may receive credit for the first year of the <strong>Nursing</strong> program after meeting<br />

certain criteria. Contact the Assessment Center at 610-359-5322 for information on advanced placement.<br />

PAGE 2


REQUIREMENTS FOR ADMISSION<br />

All admission requirements listed on the following pages must be completed before a seat in the program<br />

or a position on the wait list can be awarded. All candidates are strongly encouraged to petition during the<br />

priority consideration period and submit their completed petition no later than the deadline of: Friday,<br />

October 25, 2013, at 12 o’clock noon. Only those petitions with all requirements completed will be<br />

considered for a seat in the program or a position on the wait list.<br />

#1 APPLY FOR GENERAL ADMISSION<br />

Complete a <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> application for admission. Acceptance to the <strong>College</strong> does not<br />

guarantee acceptance into the <strong>Nursing</strong> program. Current students, those enrolled or registered for classes, do not<br />

need to apply to the <strong>College</strong> again.<br />

If you previously enrolled at the <strong>College</strong> and stopped attending for one year or longer, you must submit another<br />

“paper” application and check the box indicating that you are applying for readmission.<br />

#2 TAKE THE PLACEMENT TEST or WAIVE THE TEST<br />

Take the <strong>College</strong>’s placement test if you have not done so previously.<br />

TAKE THE PLACEMENT TEST: <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong>’s full-scale placement test(s) are required for any<br />

student who has not completed a college-level math and/or English Composition with a grade of “C” or better.<br />

Directions on how to schedule the placement test is outlined in the student’s Welcome Packet. Placement testing<br />

should be scheduled as soon as possible after receipt of the Welcome Packet. You may schedule the test by<br />

telephoning the Assessment Office: 610-359-5322 or schedule an appointment yourself through your student portal<br />

on delaGATE. Placement Testing must be completed before the deadline of 12 o’clock noon on October 25, 2013, for<br />

priority consideration. If remedial courses are required of you, those courses must be completed before beginning<br />

NUS 110. Failure to complete the remedial courses will make you ineligible to begin NUS 110.<br />

WAIVE THE PLACEMENT TEST: You may waive all or part of the placement test if you have successfully completed<br />

English Composition and/or a college level mathematics with a grade of "C" or better and have transferred those<br />

courses into the <strong>College</strong>. <strong>College</strong> math and/or English Composition courses must be transferred into the <strong>College</strong><br />

before the priority deadline of October 25 th , 2013, at 12 o’clock noon to be eligible for priority seating or a position on<br />

the wait list. The process to transfer courses may take 4-8 weeks, please plan accordingly. See number #3 below for<br />

directions on how to transfer credits.<br />

#3: TRANSFER COLLEGE CREDITS EARNED<br />

If applicable, submit official transcript(s) from each college and/or university attended. Send all official, final, sealed<br />

envelopes containing the document(s) to: <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong><br />

901 South Media Line Road<br />

Media, PA 19063<br />

Attn: Admissions Office<br />

Next, complete a Petition for Transfer of Credit form available from the Assessment Center, Room 2195, Marple Campus.<br />

Forms are also available from the <strong>College</strong>’s website at: https://www.dccc.edu/sites/default/files/assets/pdf/pot.pdf<br />

The process to transfer courses may take 4-8 weeks, please plan accordingly. You will receive written notification from<br />

the Assessment Center after the evaluation is completed. Evaluations/transfers will not be conducted until this form is<br />

received.<br />

INTERNATIONAL CREDENTIALS: If you attended a college or university outside the United States and want to<br />

transfer those credits earned into the <strong>College</strong>, you must submit a course-by-course evaluation report from an<br />

approved credential evaluation service. An approved evaluation service must be a member of The National<br />

Association of Credential Evaluation Service (NACES). A current list of members can be found at www.naces.org.<br />

Please note: English courses from foreign countries are not eligible for transfer to the <strong>College</strong>. A Petition for<br />

Transfer of Credit form is also required (see link to form and directions above).<br />

PAGE 3


#4: HIGH SCHOOL CREDENTIALS<br />

Submit a sealed, official, final document indicating successful high school graduation or its equivalency. This step must<br />

be completed by all candidates regardless of post-secondary educational experience(s). If you have been a student at<br />

the <strong>College</strong> in the past, please take note that the paper-copy of your high school transcript may no longer be on file if<br />

you have had a gap in your enrollment with the <strong>College</strong> for a year or longer. Follow the directions below to verify that<br />

this required document is on file with the <strong>College</strong> to assure that you have met this requirement. If you are in doubt<br />

about this document being properly on file, we recommend that you have it sent again and follow through with a<br />

verification request to the Admissions Office as noted below.<br />

CHOOSE THE SCENARIO APPROPRIATE FOR YOU and follow the directions accordingly:<br />

1. GRADUATE FROM A HIGH SCHOOL<br />

Contact the Guidance Department of the high school where you graduated. Request an official, sealed,<br />

paper-copy of your transcript to be sent directly to the <strong>College</strong>. (See the <strong>College</strong>’s mailing address below.)<br />

2. GED RECIPIENT<br />

Contact the Department of Education (DOE) in the state where you were granted your GED. Most DOE’s<br />

offer a “Transcript Request Form” that can be accessed by using the “SEARCH BOX” on their website.<br />

IMPORTANT NOTE: An open copy of your GED test scores indicating that you passed the GED test or a<br />

copy of your diploma are not acceptable documents. You must order a separate, official copy of your<br />

GED transcript from the DOE and have that document sent directly from the DOE to the <strong>College</strong> to fulfill<br />

this requirement. (See the <strong>College</strong>’s mailing address below.)<br />

3. INTERNATIONAL DOCUMENTATION<br />

If you attended high school outside the United States, you must submit an evaluation report that<br />

indicates you earned credentials equivalent to a U.S. high school diploma. This document must come<br />

from an approved credentialing evaluation service. An approved evaluation service must be a member of<br />

The National Association of Credential Evaluation Service (NACES). A current list of members can be<br />

found at www.naces.org.<br />

Send all official, final, sealed envelopes containing the paper-copy of the transcripts/international evaluations to:<br />

<strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong><br />

901 South Media Line Road<br />

Media, PA 19063<br />

Attn: Admissions Office<br />

Verify that an official, final, paper-copy of your high school transcript is properly on file with the <strong>College</strong>.<br />

To do so, simply contact the Admissions Office, not the Records Office at 610-359-5050 (Select Option #3) or<br />

admiss@dccc.edu and offer the following information so your file can be properly located:<br />

Your full name as indicated by your permanent records at the <strong>College</strong><br />

Maiden name, if applicable<br />

Date of Birth<br />

DCCC Student ID Number (P#)<br />

Name of school or agency<br />

#5: APPLY FOR FINANCIAL AID (FAFSA)<br />

This step is highly recommended. One of the keys to success in college is having a plan to pay for your education.<br />

Applying for financial aid is easy when you follow the step-by-step guide offered on the <strong>College</strong>’s website at:<br />

http://www.dccc.edu/admissions-and-financial-aid/financial-aid/application-process<br />

Deadlines apply, so file your application without delay. If you have questions or need help regarding financial aid call<br />

the <strong>College</strong> at 610-359-5050.<br />

PAGE 4


#6: REGISTER FOR GENERAL EDUCATION COURSES (Non-<strong>Nursing</strong>)<br />

Register with the help of an advisor to begin completing your non-clinical (those listed without NUS as a prefix) courses.<br />

Students find it helpful to complete as many non-clinical courses as possible before beginning the first <strong>Nursing</strong> clinical<br />

course (NUS 110). A list of required courses for the <strong>Nursing</strong> program is included in this packet (see page 11).<br />

For admission into <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong>’s 2014 <strong>Nursing</strong> program, there are NO pre-requisite courses<br />

required. Students must complete all necessary remediation course work before beginning Fundamentals of <strong>Nursing</strong><br />

(NUS 110), but completion of those courses is not required at the time of petitioning.<br />

New students to <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> will receive information about attending a <strong>College</strong> Planning Session<br />

where they will meet with an advisor to choose a schedule of appropriate course work. This appointment will be<br />

scheduled immediately following the Placement Test.<br />

Students continuing at the <strong>College</strong> may see an advisor for assistance in scheduling classes.<br />

#7: TAKE THE TEST OF ESSENTIAL ACADEMIC SKILLS (TEAS) - Version V<br />

Studies have shown that scores on this test are a predictor of success in the <strong>Nursing</strong> program and for passing the National<br />

Council Licensure Examination for Registered Nurses (NCLEX-RN). Consequently, the <strong>College</strong> relies on the TEAS scores<br />

when determining an applicant’s potential for success both in the program and on the NCLEX-RN exam. The <strong>Nursing</strong><br />

Admissions Committee also recommends, though does not require, that students complete all necessary remediation<br />

course work before attempting the TEAS.<br />

1. Applicants must achieve all of the following minimum Adjusted Individual Scores (AIS) from a single testing<br />

session:<br />

1. Reading: 70%;<br />

2. Science: 45%;<br />

3. Mathematics: 60%;<br />

4. English Language and Usage: 46%<br />

Applicants who do not meet all four minimum scores from a single testing session will not be considered for the<br />

program, even if all the other requirements are completed.<br />

2. You may take this test a total of 3 times only (NOT 3x’s a year). Only your first three chronological test scores,<br />

regardless of where the TEAS was taken will be considered. There must be six weeks between test dates to<br />

allow for sufficient re-test preparation. The testing fee is $50.00 per test attempt. If you have not achieved the<br />

minimum scores required by the third test, you will not be able to schedule the test through this <strong>College</strong> again.<br />

3. Your highest scores from a single test will be used. Scores from more than one test will not be split or mixed.<br />

4. The test lasts approximately 3.5 hours. It is administered both at the Marple and Downingtown Campuses<br />

throughout the year.<br />

5. Calculator usage is not permitted during the test.<br />

6. You will receive your TEAS results immediately upon completion of the test. A separate score report will not be<br />

mailed to you. The <strong>College</strong> will receive and record your TEAS results electronically.<br />

7. <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> will only offer a computerized version of the TEAS to students interested in<br />

applying to our <strong>Nursing</strong> program. If you have a documented learning disability, please contact the Office of<br />

Disability Services (610-325-2748) for further instruction.<br />

PAGE 5


DIRECTIONS: HOW TO PREPARE FOR THE TEAS<br />

It is recommended, though not required, that students complete all necessary remediation course work before<br />

attempting the TEAS test. In addition, taking as many of the non-clinical general education courses (those not listed with<br />

NUS as a prefix) will better prepare a testing candidate for the rigors of the TEAS test.<br />

1. A test preparation book, the TEAS Study Manual Version V, is available for purchase in the <strong>Delaware</strong> <strong>County</strong><br />

<strong>Community</strong> <strong>College</strong> Bookstore on the Marple Campus and online at www.atitesting.com. Limited copies are also<br />

available for review in the Library for students with a valid <strong>College</strong> student ID card and proof of registration for<br />

the test.<br />

2. Online practice exams (Version V) are also available at www.atitesting.com for a fee. Practice exam scores are<br />

not considered valid scores for admission into the <strong>Nursing</strong> program.<br />

3. TEAS test Preparation Courses are offered through the <strong>College</strong>’s <strong>Community</strong> Education & Training Department at<br />

various times throughout the year. For information and registration please call: 610-359-7344.<br />

DIRECTIONS: HOW TO SCHEDULE THE TEAS TEST<br />

In order to schedule the TEAS, you must first have a current <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> application (including<br />

the one-time application fee of $25.00 on file with the Records Office and all balances due to the <strong>College</strong> must be paid<br />

prior to paying for and registering for the test. TEAS tests are offered all year long and are generally offered on Tuesdays,<br />

Wednesdays, and Thursdays at three different times each of these days (morning, afternoon, & early evening).<br />

1. Registration for the test must be done in-person at the Admissions Office/Marple Campus, Founder’s Hall, Room 3545.<br />

2. Testing times & test scheduling are not offered over the telephone or via email.<br />

3. Obtain a “payment form” from the Admissions Office Receptionist at the Marple Campus.<br />

4. Complete the “payment form” and take the form to the Cashier’s Window to make payment.<br />

5. The cost is $50.00 per test. Payment methods include: cash, personal check, money orders, and most major credit cards.<br />

6. The cashier will generate a receipt-of-payment and give you a copy.<br />

7. Present the receipt-of-payment to the front desk receptionist at the Admissions Office/Marple Campus.<br />

8. The Admissions Receptionist will assist you with choosing a testing location, date and time, based on availability.<br />

9. Testing is offered at both the Marple and Downingtown Campuses ALL year round.<br />

NOTE: TEAS testing dates/times are offered only in-person and after the student presents a receipt of payment from the Cashier.<br />

DIRECTIONS: TRANSFERRING TEAS SCORES FROM ANOTHER TESTING SITE<br />

TEAS scores taken elsewhere may be used to petition for the program if you have not yet completed three attempts.<br />

TEAS scores taken elsewhere must be sent officially from ATI (creator of the TEAS) to the <strong>College</strong>’s Assessment Office.<br />

Student copies will NOT be accepted. Scores must be received by the Assessment Office prior to the deadline of October<br />

25 th , 2013, at 12 o’clock noon to be considered for the priority petitioning period. Please note, a student’s petition will<br />

not be considered until the official test results have been received and recorded by the Assessment Office.<br />

PAGE 6


#8: OBTAIN BACKGROUND CLEARANCES<br />

Concorde, Inc. has been contracted by the <strong>College</strong> to assist students in obtaining and storing their required background<br />

clearances. Petitioning students are required to open a Concorde account to properly obtain and/or store these<br />

clearances. The fee for this service is $111.00 per petitioning student.<br />

All clearances must be dated August 1, 2012, or after, to be eligible for the fall 2014 program. In addition, all clearances<br />

must be completed, sent, and stored by Concorde, Inc., no later than 12 noon on Friday, October 25 th , 2013, to be eligible<br />

for the fall 2014 priority consideration period.<br />

A total of three (3) clearances are required to properly petition to the program:<br />

1. Federal Criminal History (FBI) Report - (See directions on page 8.)<br />

2. PA Criminal History Report – (See directions on page 8.)<br />

3. PA Child Abuse History Clearance – (See directions on page 8.)<br />

DIRECTIONS: HOW TO OPEN AN ACCOUNT WITH CONCORDE, INC.<br />

1. Log onto: https://www.concorde2000.com/admissions/<br />

2. Click the drop-down box arrow and select: DELAWARE COUNTY COMMUNITY COLLEGE<br />

3. Click: CONTINUE<br />

4. Review the welcome page and click: NEXT<br />

5. Enter: APPLICANT INFORMATION<br />

6. ADD TO CART: PETITIONING NURSING STUDENT<br />

7. Enter: CREDIT CARD INFORMATION<br />

8. Click: CONTINUE<br />

Once you have purchased the Concorde Inc. services associated with your DCCC program, you will receive an email from<br />

Concorde Inc. with additional instructions on how to proceed and begin the process for obtaining and storing your<br />

background clearance documents. The email will include instructions on how to log-in to your personal account and track<br />

the receipt and storage of your required background clearance documents.<br />

Criminal Convictions<br />

Please note that under Pennsylvania law, the State Board of <strong>Nursing</strong> may not issue a license to an applicant who has been<br />

convicted of a felonious act prohibited by the Controlled Substance, Drug, Device and Cosmetic Act, or convicted of a<br />

felony relating to a controlled substance in a court of law of the United States or any other state, territory or country<br />

unless 10 years have elapsed since the date of conviction and the applicant can demonstrate that he/she has made<br />

significant progress in personal rehabilitation.<br />

Felony convictions, which do not fall into the provision listed above, and certain misdemeanor offenses, may be a finding<br />

of impaired moral character. The determination of whether such conduct constitutes poor moral character is a<br />

discretionary matter for the Board of <strong>Nursing</strong> (717-783-7142).<br />

Students who have been arrested resulting in any summary, misdemeanor, or felony offense and specifically a<br />

prohibitive offense contained in Act 13 and/or Act 169* may not be able to complete their studies because clinical<br />

experiences needed for course/program success may be prohibited. If students cannot complete their clinical studies,<br />

they will not be accepted into the <strong>Nursing</strong> program.<br />

*A detailed list is available for review in either the Admissions or Allied Health, Emergency Services, and <strong>Nursing</strong> offices.<br />

NOTE: Once awarded a seat in the program, due to hospital policies, the <strong>College</strong> requires a drug screening for all newly accepted<br />

students prior to beginning their clinical experiences. If you are awarded a seat in the program, you will receive more detailed<br />

information on this requirement at a special <strong>College</strong> Planning Session held in March 2014.<br />

PAGE 7


DIRECTIONS: FEDERAL CRIMINAL HISTORY (FBI) REPORT & SEND TO CONCORDE, Inc.<br />

1. Follow the directions to open a Concorde, Inc., account. (See page 7: DIRECTIONS: HOW TO OPEN AN ACCOUNT<br />

WITH CONCORDE, INC.)<br />

2. Review and respond to the subsequent emails sent to you from Concorde, Inc. regarding the process to secure your FBI<br />

Criminal History (FBI) Report. It is your responsibility to follow the directions thoroughly and respond to the requested<br />

required information and forms timely.<br />

3. When selecting the agency to process your fingerprints, choose: The Department of Welfare, not the Department of<br />

Education.<br />

4. After receiving the FBI results in the mail, either scan & email, FAX, or send via U.S. mail to Concorde for review and<br />

storage. (See below: DIRECTIONS: EMAIL, FAX or send via U.S. Mail TO CONCORDE, INC.)<br />

5. You will receive an email confirmation from Concorde, Inc., verifying that your document has been received. Submit a<br />

copy of this email with your petition.<br />

DIRECTIONS: PA CRIMINAL HISTORY REPORT<br />

1. Follow the directions to open a Concorde, Inc., account. (See page 7: DIRECTIONS: HOW TO OPEN AN ACCOUNT<br />

WITH CONCORDE, INC.<br />

2. Review and respond to the subsequent emails sent to you from Concorde, Inc. regarding the process to secure your PA<br />

Criminal History Report. It is your responsibility to follow the directions thoroughly and respond to the requested,<br />

required information and forms timely.<br />

3. Concorde will facilitate the PA Criminal History Report and post it to your account for review. The report will not<br />

come to your home address, as Concorde will facilitate the entire process for this clearance and post it to your account<br />

automatically for you to access and view.<br />

DIRECTIONS: PA CHILD ABUSE HISTORY CLEARANCE & SEND TO CONCORDE, Inc.<br />

1. As the student, you are responsible for obtaining the PA Child Abuse History Clearance and sending it to your<br />

Concorde, Inc., account for storage & review, prior to the October 25 th , 2013 priority deadline.<br />

2. Download the order form:<br />

http://www.dpw.state.pa.us/ucmprd/groups/webcontent/documents/form/s_001762.pdf You can also request an<br />

order form from the Admissions Office/Marple Campus or pick one up at an Info Session.<br />

3. Fill out the PA Child Abuse History Clearance order form thoroughly and indicate yourself as the requester.<br />

Include the money order for the required fee. (See directions on order form). The results can take 2 to 8 weeks<br />

to be returned to you. Plan accordingly if you intend to meet the Friday, October 25 th , 2013, 12 o’clock noon<br />

deadline for priority petitioning.<br />

4. After receiving the PA Child Abuse History Clearance results in the mail, submit the document to your Concorde<br />

account. (See below: DIRECTIONS: EMAIL, FAX or send via U.S. Mail TO CONCORDE, INC.)<br />

5. You will receive an email confirmation from Concorde, Inc., verifying that your document has been received. Submit a<br />

copy of this email with your petition.<br />

DIRECTIONS: EMAIL, FAX or send via U.S. MAIL TO CONCORDE, Inc.<br />

Once the original document(s) are mailed back to you (Federal Criminal History (FBI) Report and PA Child Abuse History<br />

Clearance), you are required to send a copy to Concorde, Inc., with the coversheet(s) provided by Concorde when you first<br />

opened your account. Concorde will then check to make sure the document you submitted is the appropriate document<br />

required. Concorde will store your submitted documents for the <strong>College</strong> to review. You may submit these documents to<br />

Concorde, Inc., via one (1) of the methods listed below, but they must be received by Concorde no later than 12 o’clock noon<br />

on Friday, October 25 th , 2013, to be eligible for priority consideration.<br />

1. Upload the document to your computer and email it as an attachment to: DCCC@Concorde2000.com<br />

OR<br />

2. FAX the document(s) to Concorde, Inc: 215-405-3767<br />

OR<br />

3. Mail the document(s) via U.S. Mail to: Concorde, Inc., 1835 Market Street - 12 th Floor, Philadelphia, PA 19103<br />

Attn: Candice Brady, DQF Manager


#9: MAINTAIN A MINIMUM OVERALL GPA = 2.5<br />

At the time of petitioning and through the start of NUS 110 students must meet and maintain an overall minimum grade point<br />

average (GPA) of a 2.5 or higher for all college course work completed at DCCC to be considered for a seat in the program or to<br />

be offered a position on the wait list. If your overall GPA falls below the minimum 2.5 requirement at any time, the offer of<br />

admission to the <strong>Nursing</strong> program or the position on the wait list will be revoked and you will not be permitted to register for,<br />

or begin, NUS 110.<br />

#10: CODE OF CONDUCT<br />

Be in compliance and in good standing with the <strong>College</strong>’s Code of Conduct as defined in the Student Handbook. Students<br />

must be in good disciplinary standing with the <strong>College</strong>. Students who have outstanding sanctions or violations filed with the<br />

Office of Student Affairs will not be admitted to the program. If your standing at the <strong>College</strong> falls below Good Standing at any<br />

time after you are admitted to the program, your offer of admission will be revoked and you will not be permitted to register<br />

for or begin NUS 110.<br />

#11: PROOF OF RESIDENCY<br />

Provide proof of residency via a valid, current, legible photocopy of one (1) of the following items:<br />

1. Permanent driver's license (temporary updates and duplicate licenses are not accepted)<br />

2. Utility bill (gas, electric, water or sewer only; cell phone bills are not acceptable)<br />

3. A current paycheck stub with your current address listed<br />

4. A current property tax bill in your name<br />

5. Most recent IRS Tax Return Transcript: A free official IRS document listing you as a dependent from:<br />

http://www.irs.gov/Individuals/Order-a-Transcript?portlet=105<br />

The above-named items are the ONLY acceptable forms of proof of residency. The address listed on the proof of residency<br />

submitted must match the 1) address listed on the fall 2014 <strong>Nursing</strong> program petition, 2) the address listed in the <strong>College</strong>’s<br />

database, and 3) the addresses submitted on all background clearances. The Admissions Office reserves the right to request<br />

additional proof of residency documents as necessary.<br />

#12: SUBMIT YOUR PETITION<br />

Once all the requirements have been fulfilled, submit the items below, together and in-person, to the Admissions Office at the<br />

Rhoads Education Building of the Chester <strong>County</strong> Hospital, 701 E. Marshall Street, West Chester, PA, no later than 12<br />

Noon on Friday, October 25 th , 2013.<br />

1. The Petition Form – last page of this packet<br />

2. A photocopy of an approved Proof of Residency – (See item #11 above)<br />

3. Photocopies of your confirmation emails from Concorde, Inc. indicating the submission of appropriate clearances -<br />

(See pages 7 & 8)<br />

NOTIFICATION OF THE STATUS OF YOUR PETITION<br />

If you submit a petition and all supporting documentation by the priority deadline, you will receive a letter regarding the status of your petition NO<br />

later than the end of January 2014. Any completed petitions and/or missing documentation received after the priority deadline will be considered on<br />

a space-available basis or for placement on a wait list.<br />

All petitions received during the priority petitioning period will be ranked via the student’s highest single TEAS scores. Seats will be<br />

awarded to those students with the highest TEAS scores.<br />

<br />

<br />

If offered a seat in the program, you must submit a $150.00 deposit to reserve your space by May 1, 2014. The $150.00 will hold your seat<br />

for fall 2014 only. If you are still registered for NUS 110 after the third week of class, your deposit will be refunded. If you drop out of the<br />

program at any time before then, your deposit will not be refunded.<br />

Students are required to petition again for admission into a future entrance year and meet any new admissions requirements if they:<br />

1. Do not meet the admissions requirements for 2014, as outlined in the fall 2014 <strong>Nursing</strong> Admission Procedures Packet.<br />

2. Are wait listed and not offered a seat by mid-July 2014 when the wait list is dissolved.<br />

3. Are unable to accept an offered seat for 2014. Students may not defer their nursing admission in any case.<br />

4. Inform the Admissions Office they are no longer interested in enrolling for fall 2014 and give up their seat or wait list position.<br />

5. Drop out of the program after being assigned a seat in the class, but before the first day of class.<br />

6. Fall below the minimum GPA requirement (2.5) or not being in compliance/ good standing with the <strong>College</strong>’s Code of Conduct<br />

and the seat was revoked.<br />

PAGE 9


OTHER IMPORTANT INFORMATION<br />

1. The Admissions Office will notify students by U.S. mail regarding the status of their petitions. If a petition is<br />

incomplete, the candidate will be notified by U.S. mail regarding the missing items/requirements. Any missing<br />

items must be submitted before the priority consideration deadline date of Friday, October 25 th , 2013, to be<br />

considered for seat in the program, or a position on the wait list. Any required items received after the priority<br />

deadline, will be considered “post priority” and will be considered for a seat only if any remain, or offered a seat<br />

on the wait list.<br />

2. Changes in curriculum, clinical schedules and admission requirements for the <strong>Nursing</strong> program may occur<br />

between the time of application and the time of enrollment. Students are expected to meet any new<br />

requirements for the class in which they enroll.<br />

3. Credits received for BIO 150 and BIO 151 (Human Anatomy and Physiology I & II) prior to enrollment must be<br />

current within five (5) years of the date you begin your first clinical course (therefore, dated fall 2009 or later).<br />

4. <strong>Nursing</strong> students must achieve a grade of “C” or better in BIO 150 and BIO 151. Students enrolled in NUS 110 and<br />

BIO 150 concurrently who fail to achieve a “C” or better in BIO 150 are prevented from registering for NUS 111.<br />

Students enrolled in NUS 111 and BIO 151 concurrently who have not achieved at least a “C” grade in BIO 151 are<br />

not permitted to progress to the next <strong>Nursing</strong> class.<br />

5. The course NUS 102-<strong>Nursing</strong> Mathematics, is a one-credit course that is a pre-requisite or co-requisite for NUS<br />

110. It is not listed in the curricular sequence as a required course because students may meet this requirement<br />

either by passing an Equivalency Test given during the <strong>Nursing</strong> Orientation Session in May 2014 or by passing NUS<br />

102, <strong>Nursing</strong> Mathematics. It is recommended that students complete this requirement prior to beginning the<br />

first <strong>Nursing</strong> course, NUS 110. Students who do not successfully complete <strong>Nursing</strong> Mathematics by the end of<br />

NUS 110 will not be permitted to enroll in NUS 111.<br />

6. Students are not permitted to defer their enrollment into the <strong>Nursing</strong> Program for a future enrollment date.<br />

Students must petition again and meet all admission requirements in accordance with the policies and procedures<br />

required for the new petitioning year.<br />

7. If offered admission into the program, a $150.00 deposit to reserve your seat will be due by May 1, 2014. The<br />

$150.00 deposit will hold the seat for the Fall 2014 program only. All previous balances due to the <strong>College</strong> must<br />

be paid in-full prior to submitting the $150.00 deposit.<br />

8. Deposit refunds will be issued only if the student: 1) remains enrolled in NUS 110 for the first three full weeks of<br />

the semester, and 2) does not have any outstanding balances due to the <strong>College</strong> at that time. If the student drops<br />

out of the program, at any time before the end of the third week, the deposit will not be refunded.<br />

9. Once accepted to the program, a required special <strong>College</strong> Planning Session and separate Orientation for admitted<br />

students will be held in the Spring months. During these sessions, students will participate in an advisement<br />

session, register for program course work, and learn about the program guidelines and requirements. Admitted<br />

students will be notified by U.S. mail regarding the dates for these two required sessions.<br />

10. Admitted students must pass a drug test to be eligible for the clinical experience. Instructions on how and where<br />

to take the drug test will be explained to admitted students during the required special college planning session.<br />

11. In addition to normal tuition, fees, and books, students are required to purchase uniforms, insurance and<br />

miscellaneous supplies.<br />

12. Additional testing fees for achievement tests will be added to your tuition bill each semester. <strong>Information</strong><br />

regarding these fees will be discussed at the <strong>Nursing</strong> <strong>College</strong> Planning Session in February/March 2014.<br />

13. It is your responsibility to notify the Admissions Office and the Records Office of residency and phone number<br />

(day and evening) changes. We must have current contact information.<br />

14. If you fail or withdraw from Fundamentals of <strong>Nursing</strong> (NUS 110) once the Fall 2014 term begins, you must petition<br />

for readmission through the Allied Health, Emergency Services, and <strong>Nursing</strong> Division. See the current <strong>Delaware</strong><br />

<strong>County</strong> <strong>Community</strong> <strong>College</strong> catalog for more information or contact the Allied Health, Emergency Services &<br />

<strong>Nursing</strong> Division at 610-359-5353.<br />

PAGE 10


DELAWARE COUNTY COMMUNITY COLLEGE<br />

NURSING PROGRAM<br />

Curricular Sequence: Day Program<br />

Curricular Sequence: Evening/Weekend Program<br />

First Semester (Fall) Credits First Semester Credits<br />

BIO 150 Anatomy & Physiology I 4 ENG English Composition I 3<br />

ENG 100 English Composition I 3 SOC 110 Introduction to Sociology 3<br />

PSY 140 General Psychology 3 _________ Humanities or Social Science Elective 3<br />

NUS 110 Fundamentals of <strong>Nursing</strong> 8 PSY 140 General Psychology 3<br />

18 12<br />

Second Semester<br />

Second Semester (Fall)<br />

BIO 151 Anatomy & Physiology II 4 NUS 110 Fundamentals of <strong>Nursing</strong> 8<br />

ENG 112 English Composition II 3 BIO 150 Anatomy & Physiology I 4<br />

PSY 210 Lifespan of Human Development 3 12<br />

NUS 111 <strong>Nursing</strong> Concepts and Practice I 10<br />

20<br />

Third Semester<br />

Third Semester<br />

PSY 220 Abnormal Psychology 3 NUS 111 <strong>Nursing</strong> Concepts and Practice I 10<br />

SOC 110 Introduction to Sociology 3 BIO 151 Anatomy & Physiology II 4<br />

NUS 210 <strong>Nursing</strong> Concepts and Practice II 10 PSY 210 Lifespan of Human Development 3<br />

16 17<br />

Fourth Semester<br />

Fourth Semester<br />

_________ Humanities or Social Science Elective 3 NUS 210 <strong>Nursing</strong> Concepts and Practice II 10<br />

_________ <strong>Nursing</strong> Elective 3 ENG 112 English Composition II 3<br />

(select one course from below) PSY 220 Abnormal Psychology 3<br />

NUS 220 Clinical Enhancement Skills 16<br />

OR<br />

NUS 221 Pharmacology for Health Care<br />

OR<br />

NUS 222 Holistic Advanced Physical<br />

Assessment and Pathophysiology<br />

Fifth Semester<br />

________ <strong>Nursing</strong> Elective 3<br />

(select one course from below)<br />

NUS 211 <strong>Nursing</strong> Concepts and Practice III 10 NUS 220 Clinical Enhancement Skills<br />

16 OR<br />

NUS 221 Pharmacology for Health Care<br />

OR<br />

NUS 222 Holistic Advanced Physical<br />

Assessment and Pathophysiology<br />

NUS 211 <strong>Nursing</strong> Concepts and Practice III 10<br />

13<br />

Total Hours Required: 70 Total Hours Required: 70<br />

PAGE 11


<strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> <strong>Nursing</strong> Program/Chester <strong>County</strong> Hospital Program – Day Students**<br />

<strong>Nursing</strong><br />

Courses<br />

<strong>Nursing</strong> 110<br />

(Fall)<br />

Monday Tuesday Wednesday Thursday Friday<br />

Clinical<br />

Sec 97 and 98<br />

6:45 AM – 1:00 PM<br />

OPEN SIM LAB<br />

12:30 PM-2:30 PM<br />

CLASS<br />

Sec 97 and 08<br />

9:30 AM – 11:30 AM<br />

12:30 pm – 2:30 PM<br />

SIM LAB<br />

Sec 97: 9 AM – 11:30 AM<br />

Sec 98: 12:30 PM – 3:00PM<br />

<strong>Nursing</strong> 111<br />

(Spring)<br />

<strong>Nursing</strong> 210<br />

(Fall)<br />

Clinical<br />

Sec 97 and 98<br />

6:45 AM – 1:00 PM<br />

Class<br />

Sec 97 and 98<br />

9:30 AM – 11:30 AM<br />

Clinical<br />

Sec 97 and 98<br />

6:45 AM – 1 PM<br />

SIM LAB<br />

Scheduled by appointment only<br />

Class<br />

Sec 97 and 98<br />

9:30 AM – 11:30 AM<br />

Class<br />

Sec 97 and 98<br />

9:30 AM – 11:30 AM<br />

Class<br />

Sec 97 and 98<br />

9:30 AM – 11:30 AM<br />

Open Sim Lab<br />

12:30 PM – 2:30 PM<br />

Clinical<br />

Sec 97 and 98<br />

6:45 AM – 1 PM<br />

Clinical<br />

Sec 97 and 98<br />

6:45 AM – 1 PM<br />

<strong>Nursing</strong> 211<br />

(Spring)<br />

Class<br />

Sec 97 and 98<br />

9:30 AM – 11:30 AM<br />

SIM LAB<br />

Scheduled by appointment only<br />

Class<br />

Sec 97 and 98<br />

9:30 AM – 11:30 AM<br />

(EVERY OTHER WED)<br />

Clinical<br />

Sec 97 and 98<br />

6:45 AM – 2 PM<br />

Clinical<br />

Sec 97 and 98<br />

6:45 AM – 2 PM<br />

<strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> <strong>Nursing</strong> Program/Chester <strong>County</strong> Hospital Program – Evening/Weekend Students**<br />

<strong>Nursing</strong><br />

Courses<br />

<strong>Nursing</strong> 110<br />

(Fall)<br />

<strong>Nursing</strong> 111<br />

(Spring)<br />

<strong>Nursing</strong> 210<br />

(Fall)<br />

<strong>Nursing</strong> 211<br />

(Spring)<br />

Monday Tuesday Wednesday Thursday Friday Saturday Sunday<br />

Class<br />

6 PM – 8PM<br />

(Sec 95 and 96)<br />

Sim Lab<br />

(Sec 95) 8PM –<br />

10:30 PM<br />

Open<br />

Sim Lab<br />

5 PM – 7 PM<br />

Open<br />

Sim Lab<br />

5 PM – 7 PM<br />

Every other<br />

Tuesday<br />

Class<br />

6 PM – 8 PM<br />

(Sec 95 and<br />

96)<br />

Class<br />

6 PM – 9 PM<br />

(Sec 95 and<br />

96)<br />

Class<br />

6 PM – 8PM<br />

(Sec 95 and 96)<br />

Sim Lab<br />

(Sec 96) 8PM –<br />

10:30 PM<br />

Class<br />

6 PM – 9 PM<br />

(Sec 95 and 96)<br />

Class<br />

6 PM – 8 PM<br />

(Sec 95 and 96)<br />

Class or Sim Lab<br />

6 PM – 8 PM<br />

(Sec 95 and 96)<br />

Alternating Weeks<br />

Clinical<br />

EVERY OTHER WEEKEND**<br />

6:45 AM – 1 PM<br />

Clinical<br />

EVERY WEEKEND<br />

6:45 AM – 1 PM<br />

Clinical<br />

EVERY WEEKEND<br />

2PM – 8PM<br />

Clinical<br />

EVERY WEEKEND<br />

2 PM – 9 PM<br />

*Please be aware that these times are provided only as a guide to help you plan ahead. The schedule is subject to change, at any time, based upon clinical/class availability and scheduling.<br />

** Please note that these schedules only reflect <strong>Nursing</strong> class dates and times; they do not include class dates and times for additional classes for which you may register.<br />

PAGE 12<br />

Clinical<br />

EVERY OTHER WEEKEND**<br />

6:45 AM – 1 PM<br />

Clinical<br />

EVERY WEEKEND<br />

6:45 AM – 1 PM<br />

Clinical<br />

EVERY WEEKEND<br />

2 PM – 8 PM<br />

Clinical<br />

EVERY WEEKEND<br />

2 PM – 9 PM


Helpful Checklist<br />

______<br />

1. Submit an application for admission to <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong>,<br />

if not enrolled within the past year. (See page 3.)<br />

______ 2. Take the <strong>College</strong>’s placement test (See page 3.)<br />

OR<br />

Waive the placement test if English Composition I and/or a college level math have<br />

been successfully transferred into <strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> before<br />

Friday, October 25 th , 2013, 12 o’clock noon priority deadline. (See page 3.)<br />

______ 3. If applicable, transfer previously earned college credits into the <strong>College</strong>. (See page 3.)<br />

______ 4. High School credentialing on file with the <strong>College</strong>. (See page 4.)<br />

______ 5. Apply for Financial Aid. (See page 4.)<br />

______ 6. Register for non-nursing courses with the help of an advisor. (See page 5)<br />

______ 7. Successfully pass the TEAS (See page 5.)<br />

______ 8. Secure & store background clearances with Concorde, Inc. (See pages 7 & 8.)<br />

______ 9. Maintain a minimum (2.5 GPA) at the <strong>College</strong> at all times. (See page 9.)<br />

______<br />

10. Be in compliance & in good standing with the <strong>College</strong>’s Code of Conduct at all times.<br />

(See page 9.)<br />

______ 11. Photocopy an approved Proof of Residency for petitioning file. (See page 9.)<br />

______<br />

12. Make photocopies of all pertinent documents for your personal records.<br />

______<br />

13. Submit together and in person at the Chester <strong>County</strong> Hospital Campus:<br />

1. <strong>Nursing</strong> Program petition with an original signature (See page 14.)<br />

2. Valid, current, legible photocopy of proof of residence (See page 9.)<br />

3. A photocopy of the confirmation email from Concorde, verifying receipt of your<br />

FBI- Federal Criminal History Report (See page 8.)<br />

4. A photocopy of the confirmation email from Concorde, verifying receipt of your<br />

PA Child Abuse History Clearance (See page 8.)<br />

The nursing program is accredited by the Accreditation Commission for Education in <strong>Nursing</strong>, 3343 Peachtree Road, NE,<br />

Suite 500, Atlanta, GA 30326, 404-975-5000, www.acenursing.org. It is also approved by the Pennsylvania State Board of<br />

Nurse Examiners, P.O. Box 2649, Harrisburg, PA 17105-2649, 717-783-7142, www.dos.state.pa.us. Program outcomes<br />

are defined and measurable.<br />

<strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> is an equal employment and educational opportunity institution conforming to all<br />

applicable legislation that prohibits discrimination. The <strong>College</strong> does not discriminate on the basis of race, color, religion,<br />

sex, age, national origin, disability, veteran status, sexual orientation, or any other characteristic protected by state or<br />

federal laws in its educational programs, activities, admission or employment policies, as required by Title IX of the<br />

Educational Amendments of 1972, Section 504 of the Rehabilitation Act of 1973 and other applicable statutes. Inquiries<br />

concerning Title IX and/or 504 compliance should be referred to: Betty Brown, associate dean for student success, room<br />

2195, 610-359-5320; and/or Connie McCalla, vice president of human resources, room 3572, 610-359-5094. TTY for the<br />

hearing impaired: 610-359-5020.<br />

<strong>Delaware</strong> <strong>County</strong> <strong>Community</strong> <strong>College</strong> is accredited by the Middle States Association of <strong>College</strong>s and Schools,<br />

Commission on Higher Education, 3624 Market St., Philadelphia, PA 19104.<br />

PAGE 13


NURSING PETITION<br />

FALL 2014<br />

Chester <strong>County</strong> Program<br />

Rhoads Education Building<br />

701 E. Marshall Street<br />

West Chester, PA 19380<br />

610-732-6863<br />

Applicants will only be offered an available seat in the program, or a position on the wait list, once all admission<br />

requirements have been completed and submitted. Please submit the materials listed below together and in-person to<br />

the address listed above before 12 o’clock noon on Friday, October 25 th , 2013, for priority consideration. Please<br />

telephone first to ensure that the office is open to receive your paperwork.<br />

1. <strong>Nursing</strong> Program petition with an original signature (See page 14.)<br />

2. Valid, current, legible photocopy of proof of residence (See page 9.)<br />

3. A photocopy of the confirmation email from Concorde, verifying receipt of your FBI- Federal Criminal<br />

History Report (See page 8.)<br />

4. A photocopy of the confirmation email from Concorde, verifying receipt of your PA Child Abuse<br />

History Clearance (See page 8.)<br />

Student ID # (or Social Security Number)<br />

___P00________________________<br />

Legal Name: ____________________________________________________________________________<br />

Last First Middle<br />

Maiden Name: ___________________________________________________________________________<br />

Last<br />

Legal Address: __________________________________________________________________________<br />

Street Address<br />

__________________________________________________________________________<br />

City State ZIP<br />

Home Phone: __________________________________ Alternative Phone: ________________________<br />

Email: __________________________________________________________________________________<br />

Please answer the following questions:<br />

1. I submitted a petition to the <strong>Nursing</strong> Program previously.<br />

No<br />

Yes - indicate year: ________<br />

(This information will not be used in evaluating your petition; it is merely used to locate any previously submitted paperwork still available.)<br />

2. Please indicate:<br />

High school graduate GED certification International Evaluation<br />

(The “paper copy” of your official, final High School transcripts or GED results MUST be on file with DCCC’s Records Office.)<br />

3. I prefer – check ONE box only:<br />

Day<br />

Evening / weekend<br />

Prefer evening / weekend, but will take day<br />

______________________________________________________<br />

Signature of Petitioner<br />

PAGE 14<br />

_______________________<br />

Date

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