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Date: __________________ o Application o Paid Receipt o Transcripts Initials: ________________


Last name, First name, M.I.: Email address: Day telephone: Previous Last Names: Application Dates: April 1, 2014 to June 30, 2014 Student ID#: Social Security #: Date of Birth:

Before submitting this form, students are required to:

C o m p l e t e t h e o n l i n e South Puget Sound Community College A pplication. ebClient/Applicant/ApplW elcom e.aspx Attend the online Nursing Session. Date: ______________________

Pay the $25 application fee (code AD) and submit the receipt with application. If mailing the form, submit the fee for processing. This fee is non-refundable.

Complete the Following

Submit Official Transcripts from the College or University where the required prerequisites were completed. Applications will be accepted prior to completion if finished by Spring Quarter 2014. If this is the case, submit class schedule with application. Send another official transcript when grades are posted but no later than June 30, 2014. Prerequisites Minimum Grade B+ or Better B+ or Better B or Better B or Better B or Better GPA Grade Rcvd Name of College or University Date Completed Faculty/Dean Signature *For Narrative Transcripts Only*

BIOL& 241 3.33 BIOL& 242 3.33 BIOL& 260 3.00 CHEM& 121 3.00 ENGL& 101 or 3.00 102 MATH& 146 B or Better 3.00 PSYC& 200 B or Better 3.00 * Microbiology and Anatomy & Physiology Courses must have been completed within 7 years of the application deadline. * * Decimal grades are converted into letter grades based on the numerical values printed in the current SPSCC catalog. *

Lottery Process
When all of the applications are received and processed, those students who have met the pre-requisite requirements will be placed in the lottery pool. A random drawing will be done and students contacted with the results. If re-applying for the Fall of 2015-2016, a new application must be submitted. Submit application to the Student Services One Stop in building 22 or mail to: South Puget Sound Community College - Attention: Jean Walls - 2011 Mottman Road SW - Olympia, WA 98512 Please contact Jean Walls at with any questions about the admissions process. It is the students responsibility to make sure all required documents are received. Your signature certifies and confirms you have read, understood, and agree to comply with the requirements for the Nursing Program.

Applicant signature_________________________________________________________________Date_______________________
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Acceptance to the Nursing Program is based on the completion of admission and pre-requisite guidelines in the Nursing Program Planning Guide Nursing Program prerequisite reviews will determine eligibility for the Nursing Lottery. If transferring credits from another college, have official transcripts submitted in the sealed envelopes with the application. Official transcripts may also be received electronically, as long as it is sent from the Registrars office. If taking courses at another college contact Sheryl Kermoade at with concerns regarding credit transferability. Students applying for Financial Aid are required to submit a FAFSA, the SPSCC data sheet, and any other documents. For deadlines refer to the web page or email The Program Planning Guide is the primary resource for information regarding the Nursing program. It is the students responsibility to maintain contact with Nursing Department advisors and to remain informed about any changes that may occur. This information is not intended to replace the Program Planning Guide for the 20142015 Nursing Program, but rather to clarify information regarding the admission process. Submission of a complete application does not guarantee acceptance into the program. Once accepted into the nursing program, further correspondence will be sent from the Nursing Department. South Puget Sound Community Colleges equal opportunity policy prohibits discrimination in our services and in employment against any person on the basis of race or ethnicity, creed, color, national origin, sex, marital status, sexual orientation, sexual identity, age, religion, Vietnam-era or disabled veteran status, or the presence of any sensory, physical or mental disability except in the case of a bona fide occupation qualification. South Puget Sound Community College is an equal opportunity/affirmative action employer and complies with the Americans with Disabilities Act (ADA). The colleges ADA coordinator is the chief human resources officer, 2011 Mottman Rd SW, Olympia WA 98512, (596-5360). Students who need disability accommodation should contact Disability Support Services in Building 22, second floor, email or call (360)596-5306.

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