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RN to BSN Online Application Form

For Office Use Only

Fee Received By:

Date/Amt.

Coordinator's Initials

OUR LADY OF HOLY CROSS COLLEGE

DEPARTMENT OF NURSING

APPLICATION FOR ADMISSION

RN to BSN PROGRAM

ADMITTING NOW!

DIRECTIONS: Fill in all applicable fields. Answer all
questions. Incorrect or incomplete information will delay processing of this application. Contents of this application are considered confidential and will be available only to authorized persons.

Application Fee of $50.00 (non-refundable) in the form of a check or money order made payable to Nursing: OLHCC and a completed application form should be returned to the Department of Nursing Office immediately for consideration.

Admission is requested for:

Fall

Spring

	Requested year of admission:

Prefix

Mr.

Miss

Mrs.

	Last Name (required)

	First name

	Middle Initial

	Maiden Name

	Permanent Address (Number and Street)

	Apt.

	City

	State

	Zip Code

	Home Phone

	Cell Phone

	Your E-mail

	Date of Birth

	Birthplace

	Current Address (Number and Street. If different from above.)

	Apt.

	City

	State

	Zip Code

For Statistical Purposes:

	Race

Sex

Female

Male

	Age

	Marital Status

	Number of Children

	Ages of Children (separate with a comma)

	Religion

	Previous Education: List every University, College, or Vocational School you have ever attended. Begin with your current school first. Include: Institution Name, Dates of Attendance, Major Area of Study, Degree or Diploma.

	Employment History (most recent first): Include Institution and Address, Dates of Employment, Position and Reason for Leaving.

Do you have a current unencumbered license?

Yes

	RN License State:

	RN License Number:

Have you ever before made application to OLHCC Department of Nursing?

Yes

	If 'Yes' to previous question, give date of previous application to the OLHCC Department of Nursing:

Current Enrollment:

Are you currently enrolled at OLHCC?

Yes

	If you are not a student at OLHCC, are you enrolled at another college? If so, where?


	I am currently not attending school.

	List the pre-requisite courses you are enrolled in or will enroll in for spring/summer/fall 20___. Indicate the semester and year, then list courses.

If you are not a student at OLHCC, have you been accepted to OLHCC? (If not, applicant must apply to OLHCC before Application for Admission to the Department of Nursing can be processed.)

Yes

	List any Honors, Awards, Scholarships/community involvement.

Please request three persons (excluding relatives) to complete letters of reference. One letter should be from a professional reference. The references should be sent to :

Our Lady of Holy Cross College
Department of Nursing
4123 Woodland Drive
New Orleans, LA 70131
Attn: Admissions Committee/RN-BSN program.

Your application is not complete until all references are received.

In order for this application to be accepted and processed, you must attach a copy of all transcripts from each institution attended, including OLHCC.

	DIRECTIONS: In the space below, compose a personal statement explaining why you wish to pursue a BSN degree at OLHCC.

	By entering the date and my name in the box below, I HEREBY CERTIFY THAT THE INFORMATION GIVEN IN THIS APPLICATION IS TRUE AND COMPLETE.

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RN to BSN Online Application Form

Our Lady of Holy Cross College, 4123 Woodland Drive, New Orleans, LA 70131-7399, (504) 394-7744 or 1-800-259-7744Copyright 2013, Our Lady of Holy Cross College Jobs at OLHCC | Site Map | Annual Report | Contact Us

Our Lady of Holy Cross College, 4123 Woodland Drive, New Orleans, LA 70131-7399, (504) 394-7744 or 1-800-259-7744
Copyright 2013, Our Lady of Holy Cross College
Jobs at OLHCC | Site Map | Annual Report | Contact Us