PRACTICAL NURSE EDUCATION
ISOTHERMAL COMMUNITY COLLEGE (ICC)
WEIGHTED ADMISSION FORM
Fall 2016
Date received: ______/__________/________
Weighted Admission Application Period:
Fall Enrollment Period— February 1, 2016 to April 15, 2016
Weighted Admission Application Packet:
Must be completed and submitted to nursing advisor before or during the above enrollment period.
Name : _________________________________________________________________________________
(Last) (First) (Middle) (Other Name Used)
Address Apt. No .
State Zip Code City
Home Phone
ICC Student ID #
Work Phone
SSN#
Cell Phone
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 student and verified by the nursing advisor during the enrollment period February 1, 2016 to April 15, 2016 .)
Completion
Date
Verification General admission requirement to be completed
Complete the Online Application Process to Isothermal Community College and have an acceptance letter from Admissions. ( www.isothermal.edu/admissions ).

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 Nursing re-application form.
**ANY QUESTIONS—CONTACT TINA PORTER, Nursing Advisor @ 828-395-1621**

PRACTICAL NURSE EDUCATION
ISOTHERMAL COMMUNITY COLLEGE (ICC)
WEIGHTED ADMISSION FORM
Fall 2016
The following program admission requirements for ICC must be met prior to submitting weighted admission form. (To be completed by student and verified by the nursing advisor during the enrollment period of February 1, 2016 to April 15, 2016 .)

Complete all required developmental courses completed with a grade of “C” or better.
DRE/DMA course Date completed Grade Verification
 Reading RED 090 DRE 098 ___________ _________ ________
 English ENG 090 DRE 098 ___________ _________ ________
 Mathematics MAT 060 DMA 10, 20, & 30 ___________ _________ ________
 Mathematics MAT 070 DMA 40 & 50 ___________ _________ ________

Submit three (3) references (only teachers or employers). Reference forms that are more than one (1) year old at the time of the general admission requirements deadline will not be accepted.
Verification ______________________

Verification of NAI registry listing is required by August 16, 2016 . Verification includes:
 completion of a North Carolina state approved NAI Training program; or
 completion of an abbreviated NAI course with proof of full-time uninterrupted employment in an acute care, long term care, or other approved setting as an NAI for six months.
NAI Exp. Date _________________ Verification ______________________

Review and sign the Practical Nurse Education Technical Standards document.
Verification _____________________

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.
 ACA 122-College Transfer Success BIO 168-Anatomy and Physiology I
 ENG 111-Writing & Inquiry BIO 169-Anatomy and Physiology II
 PSY 150-General Psychology
While waiting for admission, students are encouraged to complete other courses such as NAII,
Developmental Psychology, Medical Terminology I, and Medical Terminology II.
Student Initials __________________ Verification ______________________

Students are required to take the TEAS V entrance exam prior to the enrollment deadline. After meeting the above requirements, the student will be notified to register for the TEAS test.
Schedules will be posted at a later date.
Student Initials __________________ Verification ______________________

Apply for financial aid.
Date applied ___________________ Verification _____________________
Return weighted admission form and attachments to:
Notification of acceptance/denial will be mailed approximately 6 weeks following
weighted admission period deadline.
Attn: Tina Porter
P.O. Box 804
Spindale, NC 28160

PRACTICAL NURSE EDUCATION
ISOTHERMAL COMMUNITY COLLEGE (ICC)
WEIGHTED ADMISSION FORM
Fall 2016
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,
Room 302E.)

Letters of acceptance will be mailed to applicants by PNE Director on or before July 18, 2016 .

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 July 18 and August 16, 2016 .

Date completed ________________________
Applicant will need to return the completed health forms returned to PNE Director by August 18,
2016.
Date returned ________________________

Upon acceptance into the PNE Program, the following background items must be completed at the students’ expense:
Date completed
 Criminal Background Check (Statewide Criminal NC; Residency History) ___________________

12 Panel Drug Test ___________________

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.)
Certification for American Heart Association Basic Life Support (BLS) for the Healthcare
Provider will be submitted to PNE Director by August 18, 2016 .
BLS Exp. Date ______________________
Student should plan to attend the New Student Orientation scheduled for August 18, 2016 from
8:00 am to 4:00 pm.
Student attended ________________________

ATI TEAS Entrance Exam
Criteria
PRACTICAL NURSE EDUCATION
ISOTHERMAL COMMUNITY COLLEGE (ICC)
WEIGHTED ADMISSION WORKSHEET
Fall 2016
Student Name: ___________________________ SS#: _______________ ICC ID# ________________
Actual Score/Grade Points Scored
TEAS SCORE : students should score 45 or higher to be considered

93 – 100 = 28 points

84 – 92 = 24 points

78 – 83 = 20 points

71 – 77 = 16 points

63 – 70 = 12 points

55 – 62 = 8 points

45 – 54 = 4 points
General Education Program-Related Calculated GPA (points = credits x letter grade A=4, B=3, and C=2)
Semester/
Courses Taken
*BIO
165 OR
*BIO
168
Credits
4
College/University where course was taken
Year
Course
Taken
Letter Grade
Quality
Points
*BIO
166
*BIO
169
4
ACA 115
ACA 122
ENG 111
PSY 150
PSY 110 or 241
BIO 163
MED 121
1
1
3
3
3
5
3
MED 122
Total Credits
3
Total Quality Points
Total Quality Points ______ ÷ Total Credits _____ =
Program-Related GPA _________
Program-
Related
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

PRACTICAL NURSE EDUCATION
ISOTHERMAL COMMUNITY COLLEGE (ICC)
WEIGHTED ADMISSION FORM
Fall 2016
Previous Education/Training from Accredited or Approved Institution
Education/Training Date Obtained Point Scale Awarding
Institution
Highest Education
Degree Earned
College Diploma – 5
Associate’s Degree – 15
Bachelor’s Degree – 25
Master’s Degree – 35
Certifications Med. Aide, EMT,
Phlebotomy, Message therapy and NA II = 2 points/each
TOTAL POINTS
(include all blue shaded areas)
Points Earned