Online Application - Nightingale College

APPLICANT INFORMATION

Name of Admissions Advisor you have worked with:*

NOTE: If you have not worked with an Admissions Advisor, please call 801-689-2160 before applying

What start date are you applying for:

What SOFE Area are you applying for:

***Your SOFE area preference doesn’t guarantee that your ELs will be conducted in the location you have selected. Your preference will be taken into consideration, along with other factors in determining the location of your actual SOFE locations.

First Name*

Last Name*

Middle Initial

Maiden Name*

Date of Birth*

Address*

Street Address City State ZIP Code

Primary Phone*

Check the box to receive official College documents via text message

Opt In to Receive Text Messages

E-Mail Address*

Social Security No.*

Race*

Ethnicity*

Marital Status*

Gender

Program Applying for*

Please list any and all states you may wish to test or become registered as a nurse in the future

* This may affect your course schedule as some states have specific course requirements

Paid Application Fee?*

Yes
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

Highest level of Education

Are you an LPN

High School Name

Please mark the diploma received.

High School Diploma
GED
Secondary Leaving Certificate

College Attended #1

College Attended #2

College Attended #3

College Attended #4

Did You Graduate College?

Yes
No

Degree(s) Obtained

Signature*

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*

In order to complete your application, please upload your proof of high school graduation and a picture ID or passport below:

Drop files here or

Accepted file types: jpeg, png, pdf, doc, xlsx, txt, Max. file size: 20 MB, Max. files: 2.

***We only accept the following file formats: Jpeg, png, pdf, doc, xlsx, txt

NOTE: The application fee is $150 and entrance exam fee is $20. You may cancel this application and receive a refund of the $170.00 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.

Enrollment Application - New Form

APPLICANT INFORMATION

PREVIOUS EDUCATION

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