WESTERN OKLAHOMA STATE COLLEGE



WESTERN OKLAHOMA STATE COLLEGE

DEPARTMENT OF NURSING EDUCATION

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2011 APPLICATION PACKET

NURSING APPLICATION PACKET

The Nursing Department at Western Oklahoma State College is looking forward to selecting another successful nursing class to begin fall 2011. We are excited about the entrance of this class. We currently have campuses at Altus, Elk City, and Lawton. Classes are taught via ITV with instructors in the classrooms at each campus.

Applicants will need to indicate on the application which campus they prefer to attend. Students willing to travel to campus sites other than the one located in their area will need to indicate their choice by priority such as first, second, etc.

Applications for the program must be turned in to the Nursing office at any of our three (3) campuses or be mailed to the Altus Campus (see address below) by May 15, 2011. Please review the following curriculum pre-requisites. Other general education courses required before graduation are listed on the enclosed Curriculum Plan. Students are selected on a point system basis. This includes points given for pre-nursing test scores, cumulative GPA, completion of required general education courses and for the grades received in those courses. Please note that more point value is given for completion of science courses and the grades received in those courses. Pre-requisites may be taken during the summer 2011 semester as long as courses are completed and grades are turned in to the nursing department office before fall 2011 classes begin. Classes taken after May 15 will not be counted for points in the application process.

CONTACT INFORMATION AND MAILING ADDRESS:

Western Oklahoma State College

Department of Nursing Education

2801 North Main Street

Altus, Oklahoma 73521

Melissa Hurst 580-477-7830

GENERAL STUDENTS

You MUST have the following pre-requisites completed, with appropriate transcripted grades, to enter the program:

• Human Anatomy with a lab - (must have a grade of “C” or better)

• College Algebra

• General Chemistry with a lab - (must have a grade of “C” or better)

TRANSFER STUDENTS

Procedures for Transfer Student entry to the program varies related to transferability of nursing course credits, program accreditation, and correspondence with WOSC’s nursing program area of study per semester. Please be certain to contact the nursing department prior to applying (580-477-7830).

LPN STUDENTS

Procedures for LPN entry to the program differ because of program accreditations, Cooperative Agreements, etc. Each LPN applicant MUST contact the department at 580-477-7830 to have LPN credits assessed for entry purposes, as additional mobility testing may be required. To receive advance standing credit, LPN applicants must hold a valid LPN license and be in good standing and currently practicing as an LPN. LPN students must have completed the following courses with appropriate grades to be considered for selection:

• Human Anatomy with lab – (must have a grade of “C” or better)

• College Algebra

• General Chemistry with lab - (must have a grade of “C” or better)

• Human Physiology with lab - (must have a grade of “C” or better)

• Microcomputer Applications

• General Psychology

• LPN to RN Transition Course-This course is offered the summer before entry into NURS 2219 (This is mandatory and will be offered during the 2nd 4 week session of the summer semester)

HESI EXAM REQUIREMENT FOR PROGRAM COMPLETION

All students are required to take the HESI exam during their last semester in NURS 2229. All students will take the test a total of three scheduled times as indicated in the syllabus and the initial cost is included in the course fees. Western requires a score of 850 on the HESI exam. If a score of less than 850 is obtained, a remediation plan must be developed. This must be a written plan that is discussed with the classroom instructor. Once remediation is complete, a student must re-take the HESI exam until his/her score is equal to or greater than 850. The HESI exam can be taken up to one additional time. The cost for the fourth additional test is the student’s responsibility and is NOT included in semester tuition.

If a score of 850 is not achieved, a student will receive an Incomplete in the course until it is achieved. If a score of 850 cannot be achieved by the fourth exam, then the student will not successfully pass the course or complete the nursing program. At this point, NURS 2229 must be retaken and successfully completed.

HIGH SCHOOL & COLLEGE TRANSCRIPTS

An official copy of high school transcript/GED AND college transcripts for each college attended (including WOSC transcripts) must be submitted with the nursing application. Combined college transcripts will not be accepted. A cumulative GPA of 2.0 out of a possible 4.0 is required. Applicants with a cumulative GPA less than 2.0 are considered ineligible for acceptance into the nursing program. Applications submitted without all transcripts will be incomplete and will not be considered for selection.

LPN students must also submit a copy of their LPN Program Transcript of Certificate of Completion along with a copy of their current LPN license.

ESL – English as Second Language

Students for whom English is a second language shall be required to present evidence of proficiency in the English language prior to admission.

Per the 2010-2011 WOSC College Catalog page 18:

“Students seeking enrollment in a state system college or university must meet the admission standards in the admission policy, the retention policy, and the policy on admission of transfer students. This policy is adopted to ensure that students will have a reasonable chance to succeed at a higher education institution based on their ability to comprehend, read, and write the English language.”

DRUG SCREEN

Applicants accepted into the nursing program will undergo a random drug screen prior to entry into the enrolled course. Licensed practical/vocational nurses with positive drug screens are reported to their state of licensure per state board nursing rules.

AFFIRMATIVE ACTION COMPLIANCE STATEMENT

Western Oklahoma State College, in compliance with Title VI and Title VII of the Civil Rights Acts of 1964, Title IX of the Education Amendments of 1972, Section 503 of the Rehabilitation Act of 1973Section 402 of the Readjustment Assistance Act of 1974, and other federal laws and regulations, does not discriminate on the basis of race, color, national origin, sex, age, religion, handicap, or status as veteran in any of its policies, practices or procedures. This includes, but is not limited to admissions employment, financial aid, and educational services.

International Students

Applicants classified as an international student using an F-1 Student Visa may attend at one of Western’s campuses. However, all initial processing & paperwork must be completed with the Office of Registrar at the Altus campus. Oklahoma law only allows a license to be issued to U.S. citizens, U.S. nationals, and legal permanent resident aliens. Other qualified aliens may be issued a temporary license that is valid until the expiration of their visa status, or if there is no expiration date, for one year. For more information regarding this matter, applicants can contact the Oklahoma Board of Nursing.

STATEMENT CONCERNING THE AMERICAN WITH DISABILITY ACT

According to the ADA (Americans with Disabilities Act), each student with a disability is responsible for notifying the College of his/her disability and requesting accommodations. If you think you have a qualified disability and need classroom accommodations, contact the Counseling Office (C-1E). To receive services, you must submit appropriate documentation and complete an intake process during which the existence of a qualified disability is verified and reasonable accommodations are identified. Please call (580) 477-7710, or email april.dill@wosc.edu for more information.

Please advise the instructor of your disability as soon as possible to ensure timely implementation of appropriate accommodations. Faculty have an obligation to respond when they receive official notice of a disability from the Counseling Office but are under no obligation to provide retroactive accommodations.

CRIMINAL BACKGROUND INFORMATION

All Students (GENERAL, LPN, and TRANSFER STUDENTS) must obtain the following:

1. Criminal History Background Check from Oklahoma State Bureau of Investigation (OSBI). The original copy must accompany the application packet. Faxed copies will not be accepted.

The college does not deny an applicant entry into the nursing program due to a positive criminal history. However, various clinical agencies have restrictions regarding individuals with a criminal record. Criminal background information is reviewed and decisions are made based on the clinical agency’s policies and guidelines. If an applicant does not meet the standards set by the Oklahoma Board of Nursing or the clinical agencies, the applicant will not be able to complete the requirements of the program. According to the Oklahoma Board of Nursing:

“An individual with a felony conviction or who had sentencing terms imposed by the court related to a deferred sentence for a felony offense cannot apply for licensure for at least five years after completion of all sentencing terms, including probation and suspended sentences, unless a presidential or gubernatorial pardon is reviewed [59 O.S. § 567.5 & 567.6].”

OSBI Criminal History Checks:

Background checks can be requested/received by mail or in person. Do not request background history check by fax. Faxed reports will not be accepted.

Steps to Obtaining an OSBI Criminal History Checks

1. Request by mail

Complete the “Criminal History Information Request Form” off the OSBI website –

When completing the form, for “Type of Search Requested” the following must be chosen/selected:

• Name Based - $15.00

• Sex Offender - $2.00

• Mary Rippy Violent Offender - $2.00

Mail completed form, acceptable method of payment and pre-paid self-addressed envelope to:

Criminal History Record Information Request

6600 North Harvey Place

Oklahoma City, OK 73116

Acceptable methods of payment by mail include money orders, Visa, MasterCard, Discover, cashier’s check or certified check. No personal checks are accepted.

Requests are processed and returned in 1 to 3 weeks from the date they are received.

2. OSBI Request In person –

You may obtain a Criminal History Record Check in person by going to the OSBI office located at following address:

Broadway Executive Office Park

6600 North Harvey, Building 6, Suite 140,

Oklahoma City, OK 73116.

Same form must be completed and same fees apply.

Admission Assessment Exam

In January 2010, the WOSC Department of Nursing decided to use a new entrance exam: Evolve Reach Admission Assessment Exam. As a result of this change no TEAS exam scores will be accepted for admission. The Evolve Reach Admission Assessment Exam covers five (5) academic areas: Mathematics, Reading, Biology, Anatomy and Physiology.

All applicants will be required to take a pre-entrance nursing exam. This exam will be given on several dates and various times in April and May at all campuses. It may be possible to make arrangements to test at additional testing sites. Exam dates, times and campuses where the exam will be given are included in this packet. The cost of the exam is $30.00 if paid by April 21, 2011. Exam fees will increase to $35.00 on April 25, 2011. All exam fees must be paid at the WOSC Business Office. Students may pay for the exam in person, by credit card or by mailing payments. The “Admission Exam form” must be presented to the cashier at the time of payment.

A copy of the paid receipt must be given to Melissa Hurst in the Nursing Department office before the exam will be scheduled, NO exam will be scheduled without a receipt. Computers are limited therefore exams will be scheduled on an availability basis.

Exam General Rules:

• Applicants may retest ONE (1) time per application period.

• Applicants must present a current photo ID prior to start of exam

• BASIC calculators only will be allowed during exam, no programmable calculators will be allowed. No calculators will be provided.

• No food, drinks, or cell phones are allowed while taking the exam.

PAYMENT

In Person

• Payments can be made in person at the WOSC Business Office at Altus. Provide cashier with completed “Admission Exam form”. Bring paid receipt to Melissa Hurst in the Department of Nursing Office. Exam appointment can be scheduled at this time.

By Credit Card

• When making credit card payment – contact the WOSC Business office at 580-477-7730. You will need to provide them with: exam account number (90112), your social security number and your telephone number. Please ask that they put a copy of the payment receipt in the Nursing Department mailbox. Contact Melissa Hurst at 580-477-7830 to schedule date for exam. You will need to wait a couple of days after making payment before scheduling an exam date. Do not call the same day to make your appointment.

By Mail

• Applicants can mail payment for exam. Make checks payable to Western Oklahoma State College and mail to:

Western Oklahoma State College

Department of Nursing Education

2801 N. Main Street

Altus, OK 73521

• Mail completed Admission Exam Form along with check. Please contact Melissa Hurst at 580-477-7830 to confirm payment received and schedule exam appointment.

2011 Nursing Application

Admission Exam Form

Account # 90112

Provide WOSC Business Office with complete form when making payment.

Today’s Date: __________________________

Name: __________________________________

(Please Print)

SSN: __________ - __________ - ____________

Mailing Address: ____________________________________________

____________________________________________

City State Zip Code

Phone Number: _______________________________

THE COST OF THE EXAM:

• $30.00 IF PAID BY APRIL 15, 2011

• $35.00 IF PAID AFTER APRIL 18, 2011 through APRIL 21, 2011

• NO PAYMENTS WILL BE ACCEPTED AFTER APRIL 25, 2011

ADMISSION EXAM SCHEDULE

SPRING 2011

|DATE |DAY |TIME |SITES |

|April 4, 2011 |Monday |9:00am-2:00pm |Altus and Lawton |

|April 6, 2011 |Wednesday |9:00am-2:00pm |Altus, Lawton and Elk City |

|April 8, 2011 |Friday |12:00pm-5:00pm |Altus and Elk City |

|April 12, 2011 |Tuesday |9:00am-2:00pm |Altus, Lawton and Elk City |

|April 14, 2011 |Thursday |9:00am-2:00pm |Altus and Lawton |

|April 19, 2011 |Tuesday |9:00am-2:00pm |Altus, Lawton and Elk City |

|April 20, 2011 |Wednesday |9:00am-2:00pm |Altus, Lawton and Elk City |

|April 26, 2011 |Tuesday |9:00am-2:00pm |Altus, Lawton and Elk City |

|April 28, 2011 |Thursday |9:00am-2:00pm |Altus and Lawton |

|May 2, 2011 |Monday |2:00pm-7:00pm |Altus and Lawton |

|May 4, 2011 |Wednesday |9:00am-2:00pm |Altus, Lawton and Elk City |

|May 6, 2011 |Friday |9:00am-2:00pm |Altus and Elk City |

**Applicants:

• Please allow 5 hours to complete exam.

• Arrive 10 minutes prior to start of exam to complete necessary paperwork.

• If NOT present at start of exam, applicants will have to reschedule exam.

Study Guide

A study guide can be purchased at the WOSC Bookstore Altus Campus or on-line at various websites (, ) or at the following website:

us.

Enter ISBN#: 9781416056355 in search field

Estimated cost of the study guide is $36.95 plus shipping and handling.

APPLICANT CHECKLIST

This is for the Applicants information only

Do not turn in with application

________ OFFICIAL HIGH SCHOOL TRANSCRIPT/GED ATTACHED

________ OFFICIAL COLLEGE TRANSCRIPT(S) ATTACHED FROM ALL COLLEGES ATTENDED

________ OSBI BACKGROUND CHECK ATTACHED

________ CERTIFIED COURT DOCUMENT(S) RELATED TO CONVICTIONS/CHARGES

(If applicable)

________ LPN TRANSCRIPT ATTACHED (Please make sure you have contacted the Nursing Department regarding your LPN program’s accreditation status prior to submitting application)

________ COPY OF LPN LICENSE ATTACHED

CURRICULUM COMPLETED

**General Students must have completed pre-requisite courses and transcripts turned into the nursing office by August 1, 2011.

LPN’s must have all shaded courses completed before August 1, 2011, and copy of transcript (s) turned into the nursing office by August, 1, 2011.

|COURSE |COURSE NAME | |

|**BIOL 2104 |Human Anatomy with lab | |

|BIOL 2304 |Human Physiology with lab | |

|**CHEM 1115 |General Chemistry with lab | |

|**MATH 1513 |College Algebra | |

|COSC 1153 |Microcomputer Applications | |

|PSY 1113 |General Psychology | |

|NURS 1123 |LPN to RN Transition Course* | |

|ENGL 1113 |English Comp I | |

|POLS 1113 |Federal Government | |

|HIST 1483/93 |American History | |

________ APPLICATION TURNED IN

________ TEST DATE SCHEDULED

________ ADMISSION TEST TIME & DATE: _______________________________________

________ TEST PAID FOR

________ RECEIPT TURNED IN TO WOSC DEPT. OF NURSING OFFICE AT ALTUS.

2011 APPLICATION FOR

ADMISSION TO THE ASSOCIATE DEGREE NURSING PROGRAM

TODAY’S DATE _____________________ SOCIAL SECURITY NUMBER ______________

(Month, Day, Year)

NAME: ______________________________________________________________________

(Last) (First) (Middle) (Maiden)

PHONE: _____________________________________________________________________

(Home) (Cell) (Work)

EMAIL ADDRESS: ____________________________________________________________

MAILING ADDRESS: __________________________________________________________

(Street)

____________________________________________________________________________

(City) (State) (Zip) (County)

PERMANENT ADDRESS: ______________________________________________________

(Street)

____________________________________________________________________________

(City) (State) (Zip) (County)

EMERGENCY CONTACT: ______________________________________________________

(Name) (Phone)

____________________________________________________________________________

(City) (State) (Zip)

ARE YOU A U.S. CITIZEN? _____ YES_____ NO

IF NON-CITIZEN (Please mark the appropriate status)

_____ F-1 Student Visa _____ Permanent Resident _____ Other immigrant status

ARE YOU AN LPN / LVN _____ YES _____ NO

(If yes, attach PN school transcript or certificate of completion)

LPN SCHOOL ATTENDED CITY, STATE YEAR GRADUATED

If you attended one of the following Technology Centers did you sign a cooperative agreement with Western Oklahoma State College before graduating? ___YES___ NO

_____ Great Plains Technology Center _____ Southwest Technology Center

_____ Red River Technology Center _____ Western Technology Center

HAVE YOU PREVIOUSLY ATTENDED AN RN NURSING PROGRAM___YES ___ NO

IF YES, LIST SCHOOL ATTENDED:

____________________________________________________________________________

School City, State Year last semester was successfully completed

REASON FOR LEAVING: ______________________________________________________

________________________________________________________________________________________________________________________________________________________

*HAVE YOU EVER BEEN CONVICTED, ENTERED A PLEA OF GUILTY, NO CONTEST, OR A SIMILAR PLEA, OR HAD PROSECUTION OR A SENTENCE DEFERRED OR SUSPENDED AS AN ADULT OR JUVENILE IN ANY STATE OR JURISDICTION?

*ANSWER TO QUESTION IS VOLUNTARY

______YES ______NO

*HAVE YOU EVER BEEN CONVICTED OF OR HAVE PENDING INVESTIGATION REGARDING THE COMMISION OF A FELONY? ______YES ______NO

*ANSWER TO QUESTION IS VOLUNTARY

If you answered yes to either question above, you must send certified copies of all court documents related to your criminal history with your application.

According to the Oklahoma Board of Nursing “An individual with a felony conviction or who had sentencing terms imposed by the court related to a deferred sentence for a felony offense cannot apply for licensure for at least five years after completion of all sentencing terms, including probation and suspended sentences, unless a presidential or gubernatorial pardon is reviewed [59 O.S. § 567.5 & 567.6].”

HIGH SCHOOL ATTENDED

____________________________________________________________________________

Name

YEAR GRADUATED

(CITY) (STATE)

COLLEGES/UNIVERSITIES ATTENDED

|COLLEGES / UNIVERSITIES |CITY / STATE |ATTENDED |DEGREE |MAJOR |

|ATTENDED | |FROM / TO | | |

|(List in chronological order) | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

(ATTACH A PAGE FOR ADDITIONAL COLLEGE INFORMATION)

EMPLOYMENT HISTORY (PAST 5 YRS)

|PLACE OF EMPLOYMENT |CITY / STATE |POSITION |DATE STARTED |DATE ENDED |

| | | | | |

| | | | | |

| | | | | |

The Western Oklahoma Department of Nursing Education is approved by the Oklahoma Board of Nursing. Graduates of this state-approved program are eligible to apply to write the National Council Licensure Examination (NCLEX) for registered nurses. Applicants for Oklahoma license to practice nursing. In addition to completing a state-approved nursing education program that meets educational requirements and successfully passing the licensure examination, requirements include submission of an application for licensure, a criminal history records search, and evidence of citizenship or qualified alien status. To be granted a license, an applicant must have the legal right to be in the United States (United States code chapter 8, section 1621). In addition, Oklahoma law only allows a license to be issued to U.S. citizens, U.S. nationals, and legal permanent resident aliens. Other qualified aliens may be issued a temporary license that is valid until the expiration of their visa status, or if there is no expiration date, for one year. Applicants who are qualified aliens must present, in person, valid documentary evidence of:

1. A valid, unexpired immigrant or nonimmigrant visa status for admission into the United States;

2. A pending or approved application for asylum in the United States;

3. Admission into the United States in refugee status;

4. A pending or approved application for temporary protected status in the United States;

5. Approved deferred action status; or

6. A pending application for adjustment of status to legal permanent resident status or conditional resident status.

The Board has the right to deny a license to an individual with a history of criminal background, disciplinary action on another health-related license or certification, or judicial declaration of mental incompetence [59 O.S. §567.5 & 567.6].

I, herein, make application for admission into the nursing program at Western Oklahoma State College. I DECLARE my intention to enroll in the nursing program for the following semester:

______ nursing 1119 ______nursing 1129 _____nursing 2219

general students/Fall Semester lpn students/ spring semester lpn / Transfer Students

Fall semester

i understand that THE NURSING program of western oklahoma state college admits a limited number of students due to available resources and/or faculty, and although i may meet or exceed the minimum requirements for admission, circumstances may prevent the nursing program from admitting all students who have met the admission criteria.

i certify that the information in this application is complete to the best of my knowledge.

all information in this APPLICATION is confidential and will be used by the nursing admission committee and the director of nursing only.

i understand that submission of false INFORMATION is grounds for denial of admission to or dismissal from the western oklahoma state college nursing program. i also understand, if my application packet is not complete, including copies of transcripts from each college i have attended, that i will not be considered for admission in to the program.

Please be aware that due to current economic crisis & budget shortfalls, there is the possibility of an off-site campus closing. if a campus closing does occur, applicants will be notified and may be relocated to another campus.

Campus Site Preferred: (Please rank choice: 1st, 2nd & 3rd)

Altus__________ Elk City________Lawton________

applicant’s signature

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