{"id":5676,"date":"2025-09-30T09:28:53","date_gmt":"2025-09-30T16:28:53","guid":{"rendered":"https:\/\/www.palomar.edu\/nursing\/?page_id=5676"},"modified":"2026-06-29T08:24:04","modified_gmt":"2026-06-29T15:24:04","slug":"5676-2","status":"publish","type":"page","link":"https:\/\/www.palomar.edu\/nursing\/5676-2\/","title":{"rendered":""},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_28' style='display:none'><div id='gf_28' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Generic RN Application for Spring 2027<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_28'  action='\/nursing\/wp-json\/wp\/v2\/pages\/5676#gf_28' data-formid='28' novalidate>\n        <div id='gf_progressbar_wrapper_28' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>7<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_14' style='width:14%;'><span>14%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_28_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_28' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_28_120\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_120'>LinkedIn<\/label><div class='ginput_container'><input name='input_120' id='input_28_120' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_28_120'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_28_10\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Applicant Information<\/h3><div class='gsection_description' id='gfield_description_28_10'>This is a 7-page application. Use the Application Checklist on the website to verify you are ready to submit your application. \nWhile 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. <\/div><\/div><div id=\"field_28_59\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_59'>Have you previously applied to this program in a prior application cycle?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_59' id='input_28_59' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='No' >No<\/option><option value='Yes' >Yes<\/option><\/select><\/div><\/div><fieldset id=\"field_28_4\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_28_4'>\n                            \n                            <span id='input_28_4_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.3' id='input_28_4_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_4_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                <\/span>\n                            <span id='input_28_4_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.4' id='input_28_4_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_28_4_4' class='gform-field-label gform-field-label--type-sub '>Middle Name<\/label>\n                                                <\/span>\n                            <span id='input_28_4_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.6' id='input_28_4_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_4_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_28_52\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Any Previous Name(s)<\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_28_52'>\n                            \n                            <span id='input_28_52_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_52.3' id='input_28_52_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_28_52_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                <\/span>\n                            <span id='input_28_52_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_52.4' id='input_28_52_4' value=''   aria-required='false'     \/>\n                                                    <label for='input_28_52_4' class='gform-field-label gform-field-label--type-sub '>Middle Name<\/label>\n                                                <\/span>\n                            <span id='input_28_52_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_52.6' id='input_28_52_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_28_52_6' class='gform-field-label gform-field-label--type-sub '>Last Name(s)<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_28_90\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_90'>Preferred Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_90'>State the name you wish to be called.<\/div><div class='ginput_container ginput_container_text'><input name='input_90' id='input_28_90' type='text' value='' class='large'  aria-describedby=\"gfield_description_28_90\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_28_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_51'>Palomar Student ID Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_28_51' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_28_8\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_8'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_8' id='input_28_8' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_28_8_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_28_8_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_28_8' class='gform_hidden' value='https:\/\/www.palomar.edu\/nursing\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_28_6\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_6'>Best Contact Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_28_6' type='tel' value='' class='large'  placeholder='(###) ###-####' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_28_7\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Best Contact Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_28_7'>Write the email address you will check most frequently; this does not need to be your Palomar email address. <\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_28_7_container'>\n                                <span id='input_28_7_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_7' id='input_28_7' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_28_7\" \/>\n                                    <label for='input_28_7' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_28_7_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_7_2' id='input_28_7_2' value=''    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_28_7\" \/>\n                                    <label for='input_28_7_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_28_5\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Home Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_28_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_28_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_28_5_1' value=''    aria-required='true'    \/>\n                                        <label for='input_28_5_1' id='input_28_5_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_28_5_2_container' >\n                                        <input type='text' name='input_5.2' id='input_28_5_2' value=''     aria-required='false'   \/>\n                                        <label for='input_28_5_2' id='input_28_5_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_28_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_28_5_3' value=''    aria-required='true'    \/>\n                                    <label for='input_28_5_3' id='input_28_5_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_28_5_4_container' >\n                                        <input type='text' name='input_5.4' id='input_28_5_4' value=''      aria-required='true'    \/>\n                                        <label for='input_28_5_4' id='input_28_5_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_28_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_28_5_5' value=''    aria-required='true'    \/>\n                                    <label for='input_28_5_5' id='input_28_5_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_28_5_6_container' >\n                                        <select name='input_5.6' id='input_28_5_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' selected='selected'>United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_28_5_6' id='input_28_5_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_28_42\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Demographic Data Questions<\/h3><div class='gsection_description' id='gfield_description_28_42'>This 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. \nIf you prefer not to answer any question(s), please choose the &#8220;Other&#8221; option for that question. <\/div><\/div><div id=\"field_28_41\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_41'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_41'>Choose &#8220;Other&#8221; if you do not identify as either male or female.<\/div><div class='ginput_container ginput_container_select'><select name='input_41' id='input_28_41' class='medium gfield_select'  aria-describedby=\"gfield_description_28_41\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Gender<\/option><option value='Male' >Male<\/option><option value='Female' >Female<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_28_89\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_89'>Pronouns<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_89'>Please state the pronouns you would like us to use.<\/div><div class='ginput_container ginput_container_select'><select name='input_89' id='input_28_89' class='medium gfield_select'  aria-describedby=\"gfield_description_28_89\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Pronouns<\/option><option value='She\/Her' >She\/Her<\/option><option value='He\/Him' >He\/Him<\/option><option value='They\/Them' >They\/Them<\/option><option value='Not Listed' >Not Listed<\/option><\/select><\/div><\/div><div id=\"field_28_44\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_44'>Race\/Ethnicity<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_44'>This question applies to US citizens, resident aliens, and other eligible non-citizens only.<\/div><div class='ginput_container ginput_container_select'><select name='input_44' id='input_28_44' class='large gfield_select'  aria-describedby=\"gfield_description_28_44\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Race\/Ethnicity<\/option><option value='Black or African American' >Black or African American<\/option><option value='American Indian or Alaska Native' >American Indian or Alaska Native<\/option><option value='South Asian (e.g., Indian, Pakistani, etc)' >South Asian (e.g., Indian, Pakistani, etc)<\/option><option value='Filipino' >Filipino<\/option><option value='Native Hawaiian' >Native Hawaiian<\/option><option value='Other Asian' >Other Asian<\/option><option value='Other Pacific Islander' >Other Pacific Islander<\/option><option value='White\/Caucasian' >White\/Caucasian<\/option><option value='Hispanic\/Latino' >Hispanic\/Latino<\/option><option value='Mixed race' >Mixed race<\/option><option value='Other race' >Other race<\/option><\/select><\/div><\/div><div id=\"field_28_53\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_53'>Is English your 1st language?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_53' id='input_28_53' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_28_54\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-two-thirds gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_54'>Language(s) Spoken at Home<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_54'>List all.<\/div><div class='ginput_container ginput_container_text'><input name='input_54' id='input_28_54' type='text' value='' class='large'  aria-describedby=\"gfield_description_28_54\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_28_40' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_28_2_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Continue Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_28_2' class='gform_page' data-js='page-field-id-40' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_28_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_28_17\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Applicant Educational Experience<\/h3><\/div><fieldset id=\"field_28_24\" class=\"gfield gfield--type-list gfield--input-type-list gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >List of Colleges &amp; Universities Attended<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_28_24'>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. <\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College\/University<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Location of School (City, State)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term System (Quarter\/Semester)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Start Date (MM\/YYYY)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">End Date (MM\/YYYY)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Degree Obtained (AA\/AS\/BS\/MA, etc; place N\/A if none)<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_24_cell1 gform-grid-col' data-label='Name of College\/University'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_24\" aria-label='Name of College\/University, Row 1' data-aria-label-template='Name of College\/University, Row {0}' type='text' name='input_24[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_24_cell2 gform-grid-col' data-label='Location of School (City, State)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_24\" aria-label='Location of School (City, State), Row 1' data-aria-label-template='Location of School (City, State), Row {0}' type='text' name='input_24[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_24_cell3 gform-grid-col' data-label='Term System (Quarter\/Semester)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_24\" aria-label='Term System (Quarter\/Semester), Row 1' data-aria-label-template='Term System (Quarter\/Semester), Row {0}' type='text' name='input_24[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_24_cell4 gform-grid-col' data-label='Start Date (MM\/YYYY)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_24\" aria-label='Start Date (MM\/YYYY), Row 1' data-aria-label-template='Start Date (MM\/YYYY), Row {0}' type='text' name='input_24[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_24_cell5 gform-grid-col' data-label='End Date (MM\/YYYY)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_24\" aria-label='End Date (MM\/YYYY), Row 1' data-aria-label-template='End Date (MM\/YYYY), Row {0}' type='text' name='input_24[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_24_cell6 gform-grid-col' data-label='Degree Obtained (AA\/AS\/BS\/MA, etc; place N\/A if none)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_24\" aria-label='Degree Obtained (AA\/AS\/BS\/MA, etc; place N\/A if none), Row 1' data-aria-label-template='Degree Obtained (AA\/AS\/BS\/MA, etc; place N\/A if none), Row {0}' type='text' name='input_24[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_28_25\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_25'>Unofficial Transcript Copies<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_25'>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 &amp; Fixed Set GPA criteria. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_25' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_25&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_25&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_25&quot;,&quot;filelist&quot;:&quot;gform_preview_28_25&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:25},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_25&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_25' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_25' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_25 gfield_description_28_25\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_25'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_25'><\/ul> <div id='gform_preview_28_25' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_28_99\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Acknowledgement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_28_99'>ALL boxes must be checked.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox gfield_choice--select_all_enabled' id='input_28_99'><div class='gchoice gchoice_28_99_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_99.1' type='checkbox'  value='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.)'  id='choice_28_99_1'   aria-describedby=\"gfield_description_28_99\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_28_99_1' id='label_28_99_1' class='gform-field-label gform-field-label--type-inline'>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.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_99_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_99.2' type='checkbox'  value='I understand that failure to submit proof of applicable degree\/s obtained will not earn me additional points.'  id='choice_28_99_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_99_2' id='label_28_99_2' class='gform-field-label gform-field-label--type-inline'>I understand that failure to submit proof of applicable degree\/s obtained will not earn me additional points.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_99_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_99.3' type='checkbox'  value='I understand that failure to provide the unofficial transcripts as proof of my Prerequisite coursework will make me an ineligible applicant.'  id='choice_28_99_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_99_3' id='label_28_99_3' class='gform-field-label gform-field-label--type-inline'>I understand that failure to provide the unofficial transcripts as proof of my Prerequisite coursework will make me an ineligible applicant.<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gfield-choice-toggle-all\"><button type=\"button\" id=\"button_99_select_all\" class=\"gfield_choice_all_toggle gform-theme-button--size-sm\" onclick=\"gformToggleCheckboxes( this )\" data-checked=\"0\" data-label-select=\"Select All\" data-label-deselect=\"Deselect All\">Select All<\/button><\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_28_111' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_28_111' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_28_3_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Continue Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_28_3' class='gform_page' data-js='page-field-id-111' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_28_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_28_55\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Nursing Prerequisite Coursework<\/h3><div class='gsection_description' id='gfield_description_28_55'>Students must receive a grade of \u201cC\u201d 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)<\/div><\/div><fieldset id=\"field_28_35\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Anatomy or A&amp;P I<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_28_35'>If lab is separate, state lab information on 2nd row. <\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term (ex. Fall 2022)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Name (ex. BIO 210)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of Units<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Letter Grade Received<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Separate Lab Course? (Y\/N)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Repeated the Course? (Y\/N)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Repeat Reason<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_35_cell1 gform-grid-col' data-label='Name of College'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_35\" aria-label='Name of College, Row 1' data-aria-label-template='Name of College, Row {0}' type='text' name='input_35[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_35_cell2 gform-grid-col' data-label='Term (ex. Fall 2022)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_35\" aria-label='Term (ex. Fall 2022), Row 1' data-aria-label-template='Term (ex. Fall 2022), Row {0}' type='text' name='input_35[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_35_cell3 gform-grid-col' data-label='Course Name (ex. BIO 210)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_35\" aria-label='Course Name (ex. BIO 210), Row 1' data-aria-label-template='Course Name (ex. BIO 210), Row {0}' type='text' name='input_35[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_35_cell4 gform-grid-col' data-label='Number of Units'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_35\" aria-label='Number of Units, Row 1' data-aria-label-template='Number of Units, Row {0}' type='text' name='input_35[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_35_cell5 gform-grid-col' data-label='Letter Grade Received'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_35\" aria-label='Letter Grade Received, Row 1' data-aria-label-template='Letter Grade Received, Row {0}' type='text' name='input_35[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_35_cell6 gform-grid-col' data-label='Separate Lab Course? (Y\/N)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_35\" aria-label='Separate Lab Course? (Y\/N), Row 1' data-aria-label-template='Separate Lab Course? (Y\/N), Row {0}' type='text' name='input_35[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_35_cell7 gform-grid-col' data-label='Repeated the Course? (Y\/N)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_35\" aria-label='Repeated the Course? (Y\/N), Row 1' data-aria-label-template='Repeated the Course? (Y\/N), Row {0}' type='text' name='input_35[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_35_cell8 gform-grid-col' data-label='Repeat Reason'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_35\" aria-label='Repeat Reason, Row 1' data-aria-label-template='Repeat Reason, Row {0}' type='text' name='input_35[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 2)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 2)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_63\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Physiology or A&amp;P II<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_28_63'>If lab is separate, state lab information on 2nd row. <\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term (ex. Fall 2022)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Name (ex. BIO 220)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of Units<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Letter Grade Received<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Separate Lab Course? (Y\/N)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Repeated the Course? (Y\/N)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Repeat Reason<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_63_cell1 gform-grid-col' data-label='Name of College'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_63\" aria-label='Name of College, Row 1' data-aria-label-template='Name of College, Row {0}' type='text' name='input_63[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_63_cell2 gform-grid-col' data-label='Term (ex. Fall 2022)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_63\" aria-label='Term (ex. Fall 2022), Row 1' data-aria-label-template='Term (ex. Fall 2022), Row {0}' type='text' name='input_63[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_63_cell3 gform-grid-col' data-label='Course Name (ex. BIO 220)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_63\" aria-label='Course Name (ex. BIO 220), Row 1' data-aria-label-template='Course Name (ex. BIO 220), Row {0}' type='text' name='input_63[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_63_cell4 gform-grid-col' data-label='Number of Units'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_63\" aria-label='Number of Units, Row 1' data-aria-label-template='Number of Units, Row {0}' type='text' name='input_63[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_63_cell5 gform-grid-col' data-label='Letter Grade Received'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_63\" aria-label='Letter Grade Received, Row 1' data-aria-label-template='Letter Grade Received, Row {0}' type='text' name='input_63[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_63_cell6 gform-grid-col' data-label='Separate Lab Course? (Y\/N)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_63\" aria-label='Separate Lab Course? (Y\/N), Row 1' data-aria-label-template='Separate Lab Course? (Y\/N), Row {0}' type='text' name='input_63[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_63_cell7 gform-grid-col' data-label='Repeated the Course? (Y\/N)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_63\" aria-label='Repeated the Course? (Y\/N), Row 1' data-aria-label-template='Repeated the Course? (Y\/N), Row {0}' type='text' name='input_63[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_63_cell8 gform-grid-col' data-label='Repeat Reason'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_63\" aria-label='Repeat Reason, Row 1' data-aria-label-template='Repeat Reason, Row {0}' type='text' name='input_63[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 2)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 2)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_62\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Microbiology<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_28_62'>If lab is separate, state lab information on 2nd row. <\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term (ex. Fall 2022)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Name (ex. MICRO 100)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of Units<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Letter Grade Received<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Separate Lab Course? (Y\/N)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Repeated the Course? (Y\/N)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Repeat Reason<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_62_cell1 gform-grid-col' data-label='Name of College'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_62\" aria-label='Name of College, Row 1' data-aria-label-template='Name of College, Row {0}' type='text' name='input_62[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_62_cell2 gform-grid-col' data-label='Term (ex. Fall 2022)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_62\" aria-label='Term (ex. Fall 2022), Row 1' data-aria-label-template='Term (ex. Fall 2022), Row {0}' type='text' name='input_62[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_62_cell3 gform-grid-col' data-label='Course Name (ex. MICRO 100)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_62\" aria-label='Course Name (ex. MICRO 100), Row 1' data-aria-label-template='Course Name (ex. MICRO 100), Row {0}' type='text' name='input_62[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_62_cell4 gform-grid-col' data-label='Number of Units'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_62\" aria-label='Number of Units, Row 1' data-aria-label-template='Number of Units, Row {0}' type='text' name='input_62[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_62_cell5 gform-grid-col' data-label='Letter Grade Received'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_62\" aria-label='Letter Grade Received, Row 1' data-aria-label-template='Letter Grade Received, Row {0}' type='text' name='input_62[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_62_cell6 gform-grid-col' data-label='Separate Lab Course? (Y\/N)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_62\" aria-label='Separate Lab Course? (Y\/N), Row 1' data-aria-label-template='Separate Lab Course? (Y\/N), Row {0}' type='text' name='input_62[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_62_cell7 gform-grid-col' data-label='Repeated the Course? (Y\/N)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_62\" aria-label='Repeated the Course? (Y\/N), Row 1' data-aria-label-template='Repeated the Course? (Y\/N), Row {0}' type='text' name='input_62[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_62_cell8 gform-grid-col' data-label='Repeat Reason'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_62\" aria-label='Repeat Reason, Row 1' data-aria-label-template='Repeat Reason, Row {0}' type='text' name='input_62[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 2)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 2)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_66\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >English Composition \/ Written Communication<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term (ex. Fall 2022)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Name (ex. ENGL 100)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of Units<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Letter Grade Received<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_66_cell1 gform-grid-col' data-label='Name of College'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of College, Row 1' data-aria-label-template='Name of College, Row {0}' type='text' name='input_66[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_66_cell2 gform-grid-col' data-label='Term (ex. Fall 2022)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Term (ex. Fall 2022), Row 1' data-aria-label-template='Term (ex. Fall 2022), Row {0}' type='text' name='input_66[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_66_cell3 gform-grid-col' data-label='Course Name (ex. ENGL 100)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Course Name (ex. ENGL 100), Row 1' data-aria-label-template='Course Name (ex. ENGL 100), Row {0}' type='text' name='input_66[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_66_cell4 gform-grid-col' data-label='Number of Units'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of Units, Row 1' data-aria-label-template='Number of Units, Row {0}' type='text' name='input_66[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_66_cell5 gform-grid-col' data-label='Letter Grade Received'><input aria-invalid='false' aria-required=\"true\"  aria-label='Letter Grade Received, Row 1' data-aria-label-template='Letter Grade Received, Row {0}' type='text' name='input_66[]' value=''   \/><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_69\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Speech \/ Oral Communication<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term (ex. Fall 2022)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Name (ex. SPCH 100)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of Units<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Letter Grade Received<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_69_cell1 gform-grid-col' data-label='Name of College'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of College, Row 1' data-aria-label-template='Name of College, Row {0}' type='text' name='input_69[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_69_cell2 gform-grid-col' data-label='Term (ex. Fall 2022)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Term (ex. Fall 2022), Row 1' data-aria-label-template='Term (ex. Fall 2022), Row {0}' type='text' name='input_69[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_69_cell3 gform-grid-col' data-label='Course Name (ex. SPCH 100)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Course Name (ex. SPCH 100), Row 1' data-aria-label-template='Course Name (ex. SPCH 100), Row {0}' type='text' name='input_69[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_69_cell4 gform-grid-col' data-label='Number of Units'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of Units, Row 1' data-aria-label-template='Number of Units, Row {0}' type='text' name='input_69[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_69_cell5 gform-grid-col' data-label='Letter Grade Received'><input aria-invalid='false' aria-required=\"true\"  aria-label='Letter Grade Received, Row 1' data-aria-label-template='Letter Grade Received, Row {0}' type='text' name='input_69[]' value=''   \/><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_67\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Intermediate Algebra or Higher Mathematics<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term (ex. Fall 2022)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Name (ex. MATH 100)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of Units<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Letter Grade Received<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_67_cell1 gform-grid-col' data-label='Name of College'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of College, Row 1' data-aria-label-template='Name of College, Row {0}' type='text' name='input_67[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_67_cell2 gform-grid-col' data-label='Term (ex. Fall 2022)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Term (ex. Fall 2022), Row 1' data-aria-label-template='Term (ex. Fall 2022), Row {0}' type='text' name='input_67[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_67_cell3 gform-grid-col' data-label='Course Name (ex. MATH 100)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Course Name (ex. MATH 100), Row 1' data-aria-label-template='Course Name (ex. MATH 100), Row {0}' type='text' name='input_67[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_67_cell4 gform-grid-col' data-label='Number of Units'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of Units, Row 1' data-aria-label-template='Number of Units, Row {0}' type='text' name='input_67[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_67_cell5 gform-grid-col' data-label='Letter Grade Received'><input aria-invalid='false' aria-required=\"true\"  aria-label='Letter Grade Received, Row 1' data-aria-label-template='Letter Grade Received, Row {0}' type='text' name='input_67[]' value=''   \/><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_68\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Psychology<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term (ex. Fall 2022)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Name (ex. PSYC 100)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of Units<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Letter Grade Received<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_68_cell1 gform-grid-col' data-label='Name of College'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of College, Row 1' data-aria-label-template='Name of College, Row {0}' type='text' name='input_68[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_68_cell2 gform-grid-col' data-label='Term (ex. Fall 2022)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Term (ex. Fall 2022), Row 1' data-aria-label-template='Term (ex. Fall 2022), Row {0}' type='text' name='input_68[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_68_cell3 gform-grid-col' data-label='Course Name (ex. PSYC 100)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Course Name (ex. PSYC 100), Row 1' data-aria-label-template='Course Name (ex. PSYC 100), Row {0}' type='text' name='input_68[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_68_cell4 gform-grid-col' data-label='Number of Units'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of Units, Row 1' data-aria-label-template='Number of Units, Row {0}' type='text' name='input_68[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_68_cell5 gform-grid-col' data-label='Letter Grade Received'><input aria-invalid='false' aria-required=\"true\"  aria-label='Letter Grade Received, Row 1' data-aria-label-template='Letter Grade Received, Row {0}' type='text' name='input_68[]' value=''   \/><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_70\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Sociology<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term (ex. Fall 2022)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Name (ex. SOC 100)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of Units<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Letter Grade Received<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_70_cell1 gform-grid-col' data-label='Name of College'><input aria-invalid='false' aria-required=\"true\"  aria-label='Name of College, Row 1' data-aria-label-template='Name of College, Row {0}' type='text' name='input_70[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_70_cell2 gform-grid-col' data-label='Term (ex. Fall 2022)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Term (ex. Fall 2022), Row 1' data-aria-label-template='Term (ex. Fall 2022), Row {0}' type='text' name='input_70[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_70_cell3 gform-grid-col' data-label='Course Name (ex. SOC 100)'><input aria-invalid='false' aria-required=\"true\"  aria-label='Course Name (ex. SOC 100), Row 1' data-aria-label-template='Course Name (ex. SOC 100), Row {0}' type='text' name='input_70[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_70_cell4 gform-grid-col' data-label='Number of Units'><input aria-invalid='false' aria-required=\"true\"  aria-label='Number of Units, Row 1' data-aria-label-template='Number of Units, Row {0}' type='text' name='input_70[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_70_cell5 gform-grid-col' data-label='Letter Grade Received'><input aria-invalid='false' aria-required=\"true\"  aria-label='Letter Grade Received, Row 1' data-aria-label-template='Letter Grade Received, Row {0}' type='text' name='input_70[]' value=''   \/><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_71\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Humanities<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_28_71'>Required for degree purposes. This course will not be calculated into your GPA.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name of College<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Term (ex. Fall 2022)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Course Name (ex. HUMA 100)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Number of Units<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Letter Grade Received<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_71_cell1 gform-grid-col' data-label='Name of College'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_71\" aria-label='Name of College, Row 1' data-aria-label-template='Name of College, Row {0}' type='text' name='input_71[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_71_cell2 gform-grid-col' data-label='Term (ex. Fall 2022)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_71\" aria-label='Term (ex. Fall 2022), Row 1' data-aria-label-template='Term (ex. Fall 2022), Row {0}' type='text' name='input_71[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_71_cell3 gform-grid-col' data-label='Course Name (ex. HUMA 100)'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_71\" aria-label='Course Name (ex. HUMA 100), Row 1' data-aria-label-template='Course Name (ex. HUMA 100), Row {0}' type='text' name='input_71[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_71_cell4 gform-grid-col' data-label='Number of Units'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_71\" aria-label='Number of Units, Row 1' data-aria-label-template='Number of Units, Row {0}' type='text' name='input_71[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_71_cell5 gform-grid-col' data-label='Letter Grade Received'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_71\" aria-label='Letter Grade Received, Row 1' data-aria-label-template='Letter Grade Received, Row {0}' type='text' name='input_71[]' value=''   \/><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_118\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Acknowledgement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_28_118'><div class='gchoice gchoice_28_118_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_118.1' type='checkbox'  value='All the Science and General Ed prerequisite coursework are reflected on the transcripts I uploaded.'  id='choice_28_118_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_118_1' id='label_28_118_1' class='gform-field-label gform-field-label--type-inline'>All the Science and General Ed prerequisite coursework are reflected on the transcripts I uploaded.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_28_39' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_28_39' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_28_4_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Continue Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_28_4' class='gform_page' data-js='page-field-id-39' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_28_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_28_31\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Proficiency in language other than English<\/h3><div class='gsection_description' id='gfield_description_28_31'>This 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. <\/div><\/div><fieldset id=\"field_28_79\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Non-English language skills or coursework<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_28_79'><div class='gchoice gchoice_28_79_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_79.1' type='checkbox'  value='College coursework (advance language coursework or 3 semesters of the same language)'  id='choice_28_79_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_79_1' id='label_28_79_1' class='gform-field-label gform-field-label--type-inline'>College coursework (advance language coursework or 3 semesters of the same language)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_79_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_79.2' type='checkbox'  value='Letter from employer, volunteer supervisor, professor, or fluency teaching centers \/ Language Certification Form'  id='choice_28_79_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_79_2' id='label_28_79_2' class='gform-field-label gform-field-label--type-inline'>Letter from employer, volunteer supervisor, professor, or fluency teaching centers \/ Language Certification Form<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_103\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Documented Non-English Language Proficiency &#8211; College Coursework<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_28_103'><div class='gchoice gchoice_28_103_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_103.1' type='checkbox'  value='The language courses are included in the unofficial transcripts I already uploaded.'  id='choice_28_103_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_103_1' id='label_28_103_1' class='gform-field-label gform-field-label--type-inline'>The language courses are included in the unofficial transcripts I already uploaded.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_101\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_101'>Documented Non-English Language Proficiency &#8211; Certification Letter or Language Certification Form<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_101'>Upload your certification here. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_101' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_101&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_101&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_101&quot;,&quot;filelist&quot;:&quot;gform_preview_28_101&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:101},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_101&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_101' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_101' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_101 gfield_description_28_101\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_101'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_101'><\/ul> <div id='gform_preview_28_101' class='ginput_preview_list'><\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_28_72' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_28_72' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_28_5_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Continue Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_28_5' class='gform_page' data-js='page-field-id-72' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_28_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_28_83\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">TEAS Exam Information<\/h3><div class='gsection_description' id='gfield_description_28_83'>We 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).<\/div><\/div><fieldset id=\"field_28_56\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >TEAS Exam Scores<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_28_56'>List ALL TEAS Version 7 exam scores, regardless of whether they were passing or not; and regardless of whether they have expired.<\/div><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Date of TEAS Exam<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Score<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_56_cell1 gform-grid-col' data-label='Date of TEAS Exam'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_56\" aria-label='Date of TEAS Exam, Row 1' data-aria-label-template='Date of TEAS Exam, Row {0}' type='text' name='input_56[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_56_cell2 gform-grid-col' data-label='Score'><input aria-invalid='false' aria-required=\"true\" aria-describedby=\"gfield_description_28_56\" aria-label='Score, Row 1' data-aria-label-template='Score, Row {0}' type='text' name='input_56[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_28_60\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_60'>Unofficial TEAS Exam Copies<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_60'>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 &#8220;TEAS and (DATE) as the file name for each TEAS score report uploaded. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_60' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_60&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_60&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_60&quot;,&quot;filelist&quot;:&quot;gform_preview_28_60&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:60},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_60&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_60' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_60' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_60 gfield_description_28_60\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_60'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_60'><\/ul> <div id='gform_preview_28_60' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_28_112\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Acknowledgement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_112.1' id='input_28_112_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_28_112_1' >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.<\/label><input type='hidden' name='input_112.2' value='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.' class='gform_hidden' \/><input type='hidden' name='input_112.3' value='27' class='gform_hidden' \/><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_28_73' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_28_73' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_28_6_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Continue Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_28_6' class='gform_page' data-js='page-field-id-73' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_28_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_28_78\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Multi-Criteria Information<\/h3><div class='gsection_description' id='gfield_description_28_78'>This section is not required and only if you choose to submit your supporting documentation of proof to be awarded additional points. <\/div><\/div><fieldset id=\"field_28_85\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Relevant health certifications<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_28_85'><div class='gchoice gchoice_28_85_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.1' type='checkbox'  value='LVN License'  id='choice_28_85_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_85_1' id='label_28_85_1' class='gform-field-label gform-field-label--type-inline'>LVN License<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_85_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.2' type='checkbox'  value='Military Healthcare Occupation'  id='choice_28_85_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_85_2' id='label_28_85_2' class='gform-field-label gform-field-label--type-inline'>Military Healthcare Occupation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_85_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_85.3' type='checkbox'  value='Allied Health Certification (ex. CNA, EMT, Home Aide, etc.)'  id='choice_28_85_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_85_3' id='label_28_85_3' class='gform-field-label gform-field-label--type-inline'>Allied Health Certification (ex. CNA, EMT, Home Aide, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_74\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_74'>Health certification documentation &#8211; LVN License<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_74'>Please upload a copy of your license or provide a screenshot of your license from the website.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_74' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_74&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_74&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_74&quot;,&quot;filelist&quot;:&quot;gform_preview_28_74&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:74},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_74&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_74' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_74' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_74 gfield_description_28_74\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_74'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_74'><\/ul> <div id='gform_preview_28_74' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_28_114\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_114'>Health certification documentation &#8211; Military Healthcare Occupation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_114'>Upload proof and state the certification as the file name. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_114' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_114&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_114&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_114&quot;,&quot;filelist&quot;:&quot;gform_preview_28_114&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:114},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_114&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_114' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_114' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_114 gfield_description_28_114\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_114'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_114'><\/ul> <div id='gform_preview_28_114' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_28_113\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_113'>Health certification documentation &#8211; Allied Health Certification<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_113'>Upload proof and state the certification as the file name for each certification uploaded. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_113' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_113&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_113&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_113&quot;,&quot;filelist&quot;:&quot;gform_preview_28_113&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:113},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_113&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_113' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_113' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_113 gfield_description_28_113\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_113'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_113'><\/ul> <div id='gform_preview_28_113' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_28_119\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Relevant work or volunteer experience<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_28_119'><div class='gchoice gchoice_28_119_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_119.1' type='checkbox'  value='I have a minimum of 100 hours health related work or volunteer experience within the past 3 years.'  id='choice_28_119_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_119_1' id='label_28_119_1' class='gform-field-label gform-field-label--type-inline'>I have a minimum of 100 hours health related work or volunteer experience within the past 3 years.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_81\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_81'>State the name of the health facility\/company where hours were completed.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_81' id='input_28_81' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_28_80\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_80'>Work\/Volunteer documentation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_80'>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 &#8211; Section A can also be used for this category.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_80' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_80&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_80&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_80&quot;,&quot;filelist&quot;:&quot;gform_preview_28_80&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:80},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_80&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_80' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_80' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_80 gfield_description_28_80\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_80'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_80'><\/ul> <div id='gform_preview_28_80' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_28_82\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Life Experiences &amp; Special Circumstances<\/legend><div class='gfield_description' id='gfield_description_28_82'>Choose all that you wish to provide documentation for.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_28_82'><div class='gchoice gchoice_28_82_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.1' type='checkbox'  value='Veteran\/Active duty military (and spouse)'  id='choice_28_82_1'   aria-describedby=\"gfield_description_28_82\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_28_82_1' id='label_28_82_1' class='gform-field-label gform-field-label--type-inline'>Veteran\/Active duty military (and spouse)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_82_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.2' type='checkbox'  value='Disabilities'  id='choice_28_82_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_82_2' id='label_28_82_2' class='gform-field-label gform-field-label--type-inline'>Disabilities<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_82_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.3' type='checkbox'  value='Low family income'  id='choice_28_82_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_82_3' id='label_28_82_3' class='gform-field-label gform-field-label--type-inline'>Low family income<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_82_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.4' type='checkbox'  value='First generation to attend college (no degree yet)'  id='choice_28_82_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_82_4' id='label_28_82_4' class='gform-field-label gform-field-label--type-inline'>First generation to attend college (no degree yet)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_82_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.5' type='checkbox'  value='Need to work during prerequisite courses'  id='choice_28_82_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_82_5' id='label_28_82_5' class='gform-field-label gform-field-label--type-inline'>Need to work during prerequisite courses<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_82_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.6' type='checkbox'  value='Social or Educational disadvantages'  id='choice_28_82_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_82_6' id='label_28_82_6' class='gform-field-label gform-field-label--type-inline'>Social or Educational disadvantages<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_82_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.7' type='checkbox'  value='Difficult personal or family circumstances'  id='choice_28_82_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_82_7' id='label_28_82_7' class='gform-field-label gform-field-label--type-inline'>Difficult personal or family circumstances<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_82_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.8' type='checkbox'  value='Refugee'  id='choice_28_82_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_82_8' id='label_28_82_8' class='gform-field-label gform-field-label--type-inline'>Refugee<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_88\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_88'>Veteran\/Active duty military (and spouse)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_88'>Provide a copy of DD214 or military ID. If you are the spouse, make sure your proof will show relation to the military.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_88' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_88&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_88&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_88&quot;,&quot;filelist&quot;:&quot;gform_preview_28_88&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:88},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_88&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_88' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_88' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_88 gfield_description_28_88\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_88'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_88'><\/ul> <div id='gform_preview_28_88' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_28_109\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_109'>Disabilities<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_109'>Provide a copy of a DSPS evaluation, letter from a Physician, or letter from Veterans\u2019 Affairs. You can also upload our Disability Certification Form.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_109' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_109&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_109&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_109&quot;,&quot;filelist&quot;:&quot;gform_preview_28_109&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:109},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_109&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_109' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_109' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_109 gfield_description_28_109\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_109'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_109'><\/ul> <div id='gform_preview_28_109' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_28_115\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_115'>Low Family Income<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_115'>Provide a letter of eligibility\/award of Financial Aid, CCPG, Federal Pell Grant, EOPS, Cal Works, EDD, Cal Fresh, Medi-Cal, etc.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_115' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_115&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_115&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_115&quot;,&quot;filelist&quot;:&quot;gform_preview_28_115&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:115},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_115&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_115' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_115' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_115 gfield_description_28_115\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_115'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_115'><\/ul> <div id='gform_preview_28_115' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_28_116\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_116'>Need to work during prerequisite courses<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_116'>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.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_116' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_116&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_116&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_116&quot;,&quot;filelist&quot;:&quot;gform_preview_28_116&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:116},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_116&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_116' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_116' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_116 gfield_description_28_116\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_116'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_116'><\/ul> <div id='gform_preview_28_116' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_28_93\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_93'>Social or Educational Disadvantages Text Box<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_93' id='input_28_93' class='textarea large'    placeholder='Provide a written statement.' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_94\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_94'>Difficult Personal or Family Circumstances Text Box<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_94' id='input_28_94' class='textarea large'    placeholder='Provide a written statement.' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_117\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_117'>Refugee<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_28_117'>Provide a copy of the card indicating refugee status.\n<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_117' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_117&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_117&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_117&quot;,&quot;filelist&quot;:&quot;gform_preview_28_117&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/?gf_page=733815e21aba5f5&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.palomar.edu\\\/nursing\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;pdf&quot;}],&quot;max_file_size&quot;:&quot;51200000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:117},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_28_117&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_117' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_117' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_117 gfield_description_28_117\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_117'>Accepted file types: pdf, Max. file size: 49 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_117'><\/ul> <div id='gform_preview_28_117' class='ginput_preview_list'><\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_28_87' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_28_87' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_28_7_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Continue Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_28_7' class='gform_page' data-js='page-field-id-87' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_28_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_28_49\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_49.1' id='input_28_49_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_28_49\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_28_49_1' >Your certification of this statement serves the same purpose as a legal signature, and is binding.<\/label><input type='hidden' name='input_49.2' value='Your certification of this statement serves the same purpose as a legal signature, and is binding.' class='gform_hidden' \/><input type='hidden' name='input_49.3' value='27' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_28_49' tabindex='0'>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. 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aria-describedby=\"gfield_description_28_50\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_28' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='submit' id='gform_submit_button_28' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> <button type='button'  id='gform_save_28_footer_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" 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