Skagit Valley College, Whidbey Island Campus

Practical Nursing Program Prerequisite Waitlist Application

 

Name ____________________________ SID# ________________________

 

All prerequisites and the NAC requirement must be completed in order to place your name on the Practical Nursing Program waitlist.

Please indicate the prerequisite classes you have completed with a grade C or better.  Attach a copy of your active Washington State CNA certificate.

 

Prerequisite Courses and requirements met:	Quarter Completed	School of Completion+++
ENGL 101*
HMATH 100*, or NURS 132* Applied Math for Nurses
NURS 136   A/P for LPN OR
BIOL& 241* A/P for RN
BIOL& 242 * A/P For RN OR
AHE 106 A/P for Medical Assistant
Current CNA**state certification

 *May require prerequisites before taking.

**Must be current for entry to the program.

^{+++Transfer students: an official SVC, Transcript Evaluation must accompany this form.}

Please check appropriate line as to your intentions.

 

_____  Fall Full-time Practical Nursing Program

 

_____  Part-time Practical Nursing Program

 

 

I have completed all my prerequisites and NAC requirement for entering the Practical Nursing Program. 

 

Signature: _______________________________  Date: _______________

 

E-mail ______________________________  Phone: __________________

 

 

RETURN THIS FORM TO:

Genie Abbott

Nursing Program Assistant

Nursing Department

SVC, Whidbey Island Campus

1900 SE Pioneer Way

Oak Harbor, WA  98277

 

For additional information please contact Genie Abbott at 360-679-5323.