ISOTHERMAL COMMUNITY COLLEGE (ICC)
PRACTICAL NURSE EDUCATION
WEIGHTED ADMISSION FORM
Spring 2015
Date received:
______/__________/________
Weighted Admission Application Period:
Fall Enrollment Period—February 3 through June 2, 2014
Weighted Admission Application Packet:
Must be completed and submitted to pre-nursing advisor before or during the above enrollment period.
Name: _________________________________________________________________________________
(Last)
(First)
(Middle)
(Other Name Used)
Address
Apt. No.
City
State
Zip Code
Home Phone
Work Phone
Cell Phone
ICC Student ID #
SSN#
DOB
ICC Email Address
Personal Email Address
The following general admission requirements for ICC must be met prior to submitting weighted
admission form. Please date each section as completed. (To be completed by pre-nursing applicant and
verified by the pre-nursing advisor during the enrollment period February 3 through June 2, 2014.)
Completion Verification General admission requirement to be completed
Date
Complete the Online Application Process to Isothermal Community College and
have an acceptance letter from Admissions. ( www.isothermal.edu/admissions).
Ø Make sure to code the major as A55280L or A55280B
Submit all official and sealed high school transcript(s) or GED scores from a
regionally accredited high school or a state registered private or home school to
the Admissions Office.
Submit all official and sealed college transcript(s) from the issuing institution to
the ICC Admissions Office for evaluation. * Please note that transfer credit can
only be awarded for courses that reflect a GPA of 2.0 or higher.
Complete college placement test, which includes Reading, Writing, and Math
skills. Schedule of times and dates are available in the Advising Center, Student
Center Building10.
*Copies of all transcripts and other documents must accompany this application. All applicant information must be updated
annually. If you have previously applied, you must see Tina Porter to complete a Pre-Nursing re-application form.
**ANY QUESTIONS—CONTACT TINA PORTER, Pre-Nursing Advisor @ 828-395-1621**
ISOTHERMAL COMMUNITY COLLEGE (ICC)
PRACTICAL NURSE EDUCATION
WEIGHTED ADMISSION FORM
Spring 2015
The following program admission requirements for ICC must be met prior to submitting weighted
admission form. (To be completed by pre-nursing applicant and verified by the pre-nursing advisor
during the enrollment period of February 3 through June 2, 2014.)
All required developmental courses completed with a grade of “C” or better.
Ø
Ø
Ø
Ø
Reading
English
Mathematics
Mathematics
RED 090
ENG 090
MAT 060
MAT 070
DRE/DMA course
DRE 098
DRE 098
DMA 10, 20, & 30
DMA 40 & 50
Date completed
Grade
Verification
___________
_________
________
___________
_________
________
___________
_________
________
___________
_________
________
Three (3) references (only teachers or employers) submitted to Pre-Nursing Advisor (Tina Porter).
Reference forms that are more than one (1) year old at the time of the general admission requirements
deadline will not be accepted.
Verification ______________________
Student listed on North Carolina NAI registry by September 1, 2014.
NAI Exp. Date _________________ Verification ______________________
Certification for American Heart Association Basic Life Support (BLS) for the Healthcare
Provider will be submitted to PNE Director by September 1, 2014.
BLS Exp. Date ______________________
Return signed Technical Standards to pre-nursing advisor with packet before or during the
enrollment period of February 3, 2014 through June 2, 2014.
Verification _____________________
The following additional student information and dates are to be reviewed by the applicant and verified
by the pre-nursing advisor during the enrollment period of February 3 through June 2, 2014.
Students are encouraged to enroll in and complete the following required courses prior to being
admitted to the PNE program. All courses must be completed with a “C” or higher to be accepted
as transfer into the PNE program. See attached point sheet for course grade calculation.
Ø ACA 115-Success & Study Skills
BIO 168-Anatomy and Physiology I
Ø ENG 111-Expository Writing
BIO 169-Anatomy and Physiology II
Ø PSY 110-Life Span Dev. or [PSY 150 General Psych and PSY 241-Dev. Psych]
While waiting for admission, students are encouraged to complete other courses such as NAII, Medical
Terminology I, and Medical Terminology II.
Reviewed by student __________________
Verification ______________________
Notification to take TEAS Entrance Exam will be sent to the applicant either by form letter or ICC
email by Pre-Nursing Advisor, Advising Center administered during the week of September 8-12,
2014.
Reviewed by student __________________
Verification ______________________
Return weighted admission form and
attachments to:
Isothermal Community College
Attn: Tina Porter
P.O. Box 804
Spindale, NC 28160
Notification of acceptance/denial will be
mailed approximately 6 weeks following
weighted admission period deadline.
ISOTHERMAL COMMUNITY COLLEGE (ICC)
PRACTICAL NURSE EDUCATION
WEIGHTED ADMISSION FORM
Spring 2015
The following program admission requirements are only for applicants who are accepted into the PNE
program (D45660). (To be completed by PNE Director, office located in the Rutherford Learning
Center.)
Letters of acceptance will be mailed to applicants by PNE Director on or before September 29,
2014.
Ø Applicants need to return the acceptance response form included with the letter by the date indicated
on the form.
Date acceptance response form returned ____________________
Applicants will need to schedule the physical exam between October 13 and December 8, 2014.
Date completed ________________________
Applicant will need to return the completed health forms returned to PNE Director by December
15, 2014.
Date returned ________________________
Upon acceptance into the PNE Program, the following background items must be completed at the
students’ expense:
Date completed
Ø Criminal Background Check (Statewide Criminal NC; Residency History) ___________________
Ø 12 Panel Drug Test
___________________
Ø Nationwide Database with Sex Offender Index
___________________
An acceptable background check is required for clinical experiences. The background checks will
be completed during the first semester, NUR 101. Students must be able to attend clinical
experiences in all agencies used by the college. Information for obtaining the background checks
will be provided to all students by the Director of PNE.
While the above background information is not required by Isothermal Community College
for either general college admission or entrance into the nursing program, students should be
aware that this information will be required by the personnel department at your future
clinical location. Failure to provide this information to a clinical site in a timely fashion could
result in a cancellation of your clinical site arrangements.
(Isothermal does not have access to or awareness of the background results. Clinical agencies will notify
the student directly regarding any issues with the background results.)
Apply for financial aid.
Date applied ________________________
Student attended the New Student Orientation Day on October 24, 2014.
Student attended ________________________
ISOTHERMAL COMMUNITY COLLEGE (ICC)
PRACTICAL NURSE EDUCATION
WEIGHTED ADMISSION WORKSHEET
Spring 2015
Student Name: _____________________________
ATI TEAS Entrance Exam
Criteria
SS#: ___________________
Actual Score/Grade
ICC ID# __________________
Points Scored
TEAS SCORE: students should score 55
or higher to be considered
• 93 – 100 = 24 points
• 84 – 92
= 20 points
• 78 – 83
= 16 points
• 71 – 77
= 12 points
• 63 – 70
= 8 points
• 55 – 62
= 4 points
General Education Program-Related Calculated GPA (points = credits x letter grade A=4, B=3, and C=2)
Courses Taken
Credits
College/University where
Semester/
Letter Grade
Quality Points
course was taken
Year Course
Taken
*BIO
*BIO
4
165
OR
168
*BIO
*BIO
4
166
169
ACA 115
1
ENG 111
3
PSY 110 or 241
3
PSY 150
3
BIO 163
5
MED 121
3
MED 122
3
Total Credits
Total Quality Points
Total Quality Points __________ ÷ Total Credits ___________
= Program-Related GPA _______________________
ProgramRelated GPA
2.0 – 2.49 = 2 points
2.5 – 2.99 = 4 points
3.0 – 3.49 = 6 points
3.5 – 4.00 = 8 points
Previous Education/Training from Accredited or Approved Institution
Education/Training Awarding Institution
Date Obtained
Point Scale
Highest Education
College Diploma – 5
Degree Earned
Associate’s Degree – 15
Bachelor’s Degree – 25
Master’s Degree – 35
Certifications
Med. Aide, EMT,
Phlebotomy and NA II =
2 points/each
Points Earned
TOTAL POINTS (include all blue shaded areas)