You must have JavaScript enabled to use this form. Required fields are marked with an asterisk '*'. Today's Date Student ID # * Contact Information * Name * Full legal name including first name, middle initial, and last name CravenCC Student Email Address * Phone * Address * street address City/Town * State * ZIP/Postal Code * Additional Last Names Alternate Email Address Alternate Phone Number What City/State are you currently living in? * Nurse Aide I Listing Number If you do not have your CNA at this time, you must be listed on the NC registry by the close of the application period. Do you understand? * Yes No Have you applied to any other health programs at Craven Community College? * Yes No When and which program? Have you met the developmental requirements to take the following classes? ENG-111 * Yes No BIO-163 * Yes No MAT-110 * Yes No Have you taken a high school or college level chemistry and made a C or better? * Yes No What year did you graduate high school or obtain your GED? * Have you sent Craven CC all of your official high school and/or GED transcripts? * Yes No If not, please do so as soon as possible. This is an application requirement. Have you sent Craven CC all of your official college transcripts? * Yes No If not, please do so as soon as possible. This is an application requirement. List all post-secondary institutions attended Do you have a bachelor's degree? * Yes No What institute did you graduate from? Are you CPR certified (American Heart Association Basic Life Support Provider)? * Yes No If not currently certified, you must obtain it prior to beginning the ADN program. Are you an EMT? * Yes No Are you a Certified Medical Assistant? * Yes No Have you taken the TEAS test before? * Yes No I understand that I may submit TEAS scores from the past 12 months (View dates on the ADN Dates and Deadline on the web page). * Yes No I understand that if I have not taken the TEAS within the past 12 months or wish to retake it, I will need to test during the application period and can only test once during this time. * Yes No Have you completed, with a C or above, or currently taking the following classes? Anatomy & Physiology I (BIO 168) (must be within last 10 years) Yes No In Progress What year did you complete BIO 168? Anatomy & Physiology II (BIO 169) (must be within last 10 years) Yes No In Progress What year did you complete BIO 169? Writing and Inquiry (ENG 111) Yes No In Progress Writing/Research in the Discipline (ENG 112) Yes No In Progress Professional Research and Reporting (ENG 114) Yes No In Progress General Psychology (PSY 150) Yes No In Progress Developmental Psychology (PSY 241) Yes No In Progress Higher collegiate level math (ex. 143, 152, 171) with an A or a B Yes No In Progress Higher collegiate level chemistry that includes a lab, with an A or B Yes No In Progress I understand that it is my responsibility to send all official transcripts to the Registrar at Craven Community so that my application can be processed. * Yes No Special Comments Leave this field blank