Generic RN Application for Spring 2027 Step 1 of 7 14% FacebookThis field is for validation purposes and should be left unchanged.Applicant InformationThis is a 7-page application. Use the Application Checklist on the website to verify you are ready to submit your application. While you can save your progress, it is recommended that you have all your application materials ready for uploading. Please note that we only accept PDF documents so make sure they are converted to this file format before starting the application to save you time. Have you previously applied to this program in a prior application cycle?(Required)NoYesYour Name(Required) First Name Middle Name Last Name Any Previous Name(s) First Name Middle Name Last Name(s) Preferred Name(Required)State the name you wish to be called.Palomar Student ID Number(Required)Date of Birth(Required) MM slash DD slash YYYY Best Contact Phone Number(Required)Best Contact Email Address(Required)Write the email address you will check most frequently; this does not need to be your Palomar email address. Enter Email Confirm Email Home Address(Required) Street Address Address Line 2 City State ZIP Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Demographic Data QuestionsThis demographic data information is reported to state and federal agencies for statistical purposes only. The manner in which the options are written are directly from the reporting agency and do not represent how Palomar College views our students. If you prefer not to answer any question(s), please choose the “Other” option for that question. Gender(Required)Choose “Other” if you do not identify as either male or female.GenderMaleFemaleOtherPronouns(Required)Please state the pronouns you would like us to use.PronounsShe/HerHe/HimThey/ThemNot ListedRace/Ethnicity(Required)This question applies to US citizens, resident aliens, and other eligible non-citizens only.Race/EthnicityBlack or African AmericanAmerican Indian or Alaska NativeSouth Asian (e.g., Indian, Pakistani, etc)FilipinoNative HawaiianOther AsianOther Pacific IslanderWhite/CaucasianHispanic/LatinoMixed raceOther raceIs English your 1st language?(Required)YesNoLanguage(s) Spoken at Home(Required)List all. Applicant Educational ExperienceList of Colleges & Universities Attended(Required)List ALL colleges/universities attended, including Palomar College (if you have already attended here). Note that you will only receive points for the degree if it is posted on your transcript. Name of College/UniversityLocation of School (City, State)Term System (Quarter/Semester)Start Date (MM/YYYY)End Date (MM/YYYY)Degree Obtained (AA/AS/BS/MA, etc; place N/A if none) Add RemoveUnofficial Transcript Copies(Required)Upload an unofficial transcript for EACH school listed, including Palomar College. Please state the school as the file name for each transcript uploaded. If using AP scores to clear a GE requirement, please upload the AP score report. Note that we do not have access to ANY transcripts you may have sent to our records office. What you upload here is what we will use for the Science & Fixed Set GPA criteria. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Acknowledgement(Required)ALL boxes must be checked. I uploaded all the unofficial transcripts of each college/university I attended including applicable proof of the degree/s obtained. (degree awarded can be indicated on the transcript or certificate uploaded.) I understand that failure to submit proof of applicable degree/s obtained will not earn me additional points. I understand that failure to provide the unofficial transcripts as proof of my Prerequisite coursework will make me an ineligible applicant. Select All Nursing Prerequisite CourseworkStudents must receive a grade of “C” or better in each course AND have a combined 2.5 minimum GPA. Anatomy must be taken within the last 10 years while Physiology and Microbiology within the last 7 years. For Spring 2027 application, the last term Anatomy will be accepted is Fall 2016 and the last term for Physiology and Microbiology is Fall 2019. For AP courses, you may place N/A for required information that are not applicable (e.g. Number of Units, Letter Grade Received)Anatomy or A&P I(Required)If lab is separate, state lab information on 2nd row. Name of CollegeTerm (ex. Fall 2022)Course Name (ex. BIO 210)Number of UnitsLetter Grade ReceivedSeparate Lab Course? (Y/N)Repeated the Course? (Y/N)Repeat Reason Add RemovePhysiology or A&P II(Required)If lab is separate, state lab information on 2nd row. Name of CollegeTerm (ex. Fall 2022)Course Name (ex. BIO 220)Number of UnitsLetter Grade ReceivedSeparate Lab Course? (Y/N)Repeated the Course? (Y/N)Repeat Reason Add RemoveMicrobiology(Required)If lab is separate, state lab information on 2nd row. Name of CollegeTerm (ex. Fall 2022)Course Name (ex. MICRO 100)Number of UnitsLetter Grade ReceivedSeparate Lab Course? (Y/N)Repeated the Course? (Y/N)Repeat Reason Add RemoveEnglish Composition / Written Communication(Required)Name of CollegeTerm (ex. Fall 2022)Course Name (ex. ENGL 100)Number of UnitsLetter Grade ReceivedSpeech / Oral Communication(Required)Name of CollegeTerm (ex. Fall 2022)Course Name (ex. SPCH 100)Number of UnitsLetter Grade ReceivedIntermediate Algebra or Higher Mathematics(Required)Name of CollegeTerm (ex. Fall 2022)Course Name (ex. MATH 100)Number of UnitsLetter Grade ReceivedPsychology(Required)Name of CollegeTerm (ex. Fall 2022)Course Name (ex. PSYC 100)Number of UnitsLetter Grade ReceivedSociology(Required)Name of CollegeTerm (ex. Fall 2022)Course Name (ex. SOC 100)Number of UnitsLetter Grade ReceivedHumanities(Required)Required for degree purposes. This course will not be calculated into your GPA.Name of CollegeTerm (ex. Fall 2022)Course Name (ex. HUMA 100)Number of UnitsLetter Grade ReceivedAcknowledgement(Required) All the Science and General Ed prerequisite coursework are reflected on the transcripts I uploaded. Proficiency in language other than EnglishThis section is NOT required and only if you choose to provide proof of proficiency in a language other than English. 3 points is given in this category. You may submit at least 1 proof from the options below. Non-English language skills or coursework College coursework (advance language coursework or 3 semesters of the same language) Letter from employer, volunteer supervisor, professor, or fluency teaching centers / Language Certification Form Documented Non-English Language Proficiency – College Coursework(Required) The language courses are included in the unofficial transcripts I already uploaded. Documented Non-English Language Proficiency – Certification Letter or Language Certification Form(Required)Upload your certification here. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. TEAS Exam InformationWe require all attempts and scores of the TEAS Version 7 to be submitted. We will use the best score from the first two successful attempts (62% or higher).TEAS Exam Scores(Required)List ALL TEAS Version 7 exam scores, regardless of whether they were passing or not; and regardless of whether they have expired.Date of TEAS ExamScore Add RemoveUnofficial TEAS Exam Copies(Required)Upload either: the full transcript showing ALL your TEAS exam scores OR a copy of each TEAS exam listed above. If uploading each score individually, state “TEAS and (DATE) as the file name for each TEAS score report uploaded. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Acknowledgement(Required) I uploaded my TEAS transcripts or proof of exam scores. I understand that a lacking proof of any TEAS attempt will make me an ineligible applicant. Multi-Criteria InformationThis section is not required and only if you choose to submit your supporting documentation of proof to be awarded additional points. Relevant health certifications LVN License Military Healthcare Occupation Allied Health Certification (ex. CNA, EMT, Home Aide, etc.) Health certification documentation – LVN License(Required)Please upload a copy of your license or provide a screenshot of your license from the website. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Health certification documentation – Military Healthcare Occupation(Required)Upload proof and state the certification as the file name. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Health certification documentation – Allied Health Certification(Required)Upload proof and state the certification as the file name for each certification uploaded. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Relevant work or volunteer experience I have a minimum of 100 hours health related work or volunteer experience within the past 3 years. State the name of the health facility/company where hours were completed.(Required)Work/Volunteer documentation(Required)Hours must be stated to receive points for this section. Average per week is acceptable if start and end dates are included. The Work/Volunteer Certification Form – Section A can also be used for this category. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Life Experiences & Special CircumstancesChoose all that you wish to provide documentation for. Veteran/Active duty military (and spouse) Disabilities Low family income First generation to attend college (no degree yet) Need to work during prerequisite courses Social or Educational disadvantages Difficult personal or family circumstances Refugee Veteran/Active duty military (and spouse)(Required)Provide a copy of DD214 or military ID. If you are the spouse, make sure your proof will show relation to the military. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Disabilities(Required)Provide a copy of a DSPS evaluation, letter from a Physician, or letter from Veterans’ Affairs. You can also upload our Disability Certification Form. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Low Family Income(Required)Provide a letter of eligibility/award of Financial Aid, CCPG, Federal Pell Grant, EOPS, Cal Works, EDD, Cal Fresh, Medi-Cal, etc. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Need to work during prerequisite courses(Required)Provide a letter signed by employer on company letterhead verifying dates of employment. The Work/Volunteer Certification Form can also be used for this category. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Social or Educational Disadvantages Text Box(Required)Difficult Personal or Family Circumstances Text Box(Required)Refugee(Required)Provide a copy of the card indicating refugee status. Drop files here or Select files Accepted file types: pdf, Max. file size: 49 MB. Consent(Required) Your certification of this statement serves the same purpose as a legal signature, and is binding.I certify under penalty of perjury under the laws of the State of California that I have provided complete and accurate responses to all the items on this application. I further certify that all official and unofficial documents submitted in support of this application are authentic and unaltered records that pertain to me. My certification verifies the accuracy and completeness of the information provided. I understand that any misrepresentation or omission may be cause for denial or cancellation of admission, transfer credit, or enrollment.Electronic Signature Agreement(Required)By typing my name, I agree and understand that I am electronically signing this application and that this is the legal equivalent of my manual/handwritten signature. Δ
