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APPLICANT INFORMATION
First Name
*
First
Middle Initial
Middle
Last Name
*
Last
Date of Birth
*
Address
*
Street Address
City
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Armed Forces Americas
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State
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Primary Phone
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Check the box to receive official College documents via text message
Opt In to Receive Text Messages
E-Mail Address
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Social Security No.
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Race
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Please Select
American Indian or Alaska Native
Asian
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White
Other
Ehtnicity
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Hispanic or Latino
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Marital Status
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Please Select
Single (Never Married)
Married or in a Domestic Partnership
Divorced or Separated
Widowed
Program Applying for
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Please Select
General Education (GE) Courses
ASN/RN
LPN-RN
BDN/RN
RN-to-BSN
BMTC-to-RN
Non-Matriculating
Paid Application Fee?
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No
Are you a citizen of the United States?
*
Yes
No
Have you ever served in the military?
*
Yes
No
If yes, select your military status.
Veteran
Spouse of Veteran
Active Duty Servicemember
Spouse of Active Duty Servicemember
Have you applied to Nightingale previously?
Yes
No
If so, when?
Have you ever been convicted of a felony?
*
Yes
No
If yes, explain
PREVIOUS EDUCATION
High School Name
High School Years
Please mark the diploma received.
High School Diploma
GED
College
College Years
Did You Graduate College?
Yes
No
Other Education
Other Eduaction Years
Did You Graduate?
Yes
No
GENERAL EDUCATION COMPLETED
Anatomy
Yes
No
If yes, course title
If yes, college name
If yes, how many credits
Physiology
Yes
No
If yes, course title
If yes, college name
If yes, how many credits
Pathophysiology
Yes
No
If yes, course title
If yes, college name
If yes, how many credits
Microbiology
Yes
No
If yes, course title
If yes, college name
If yes, how many credits
General Psychology or Human Growth and Development
Yes
No
If yes, course title
If yes, college name
If yes, how many credits
Chemistry
Yes
No
If yes, course title
If yes, college name
If yes, how many credits
English
Yes
No
If yes, course title
If yes, college name
If yes, how many credits
Math
Yes
No
If yes, course title
If yes, college name
If yes, how many credits
Signature
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By placing your name in this box you agree to submit this information to Nightingale College and are permitting the College to contact you via your primary contact information (If you are providing a cell phone, you are consenting to being contacted through text messages).
Date
*
NOTE: The application fee is $100.00. You may cancel this application and receive a refund of the $100.00 application fee within Three (3) business days of submitting the application, unless you have undergone admissions testing within the three (3) business days. After three (3) business days, the application fee becomes non-refundable.
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