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Nursing Program Application
Submit the information below to begin the application process for Centralia College's Registered Nursing program. Initial applications are due by April 15, 2021.
Personal Information
Choose one:
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I am a new student applying for the first-year nursing program.
I am applying to be admitted as an Advanced Placement Student starting the second year of the program as space is available.
Student ID Number
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Name
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First
Last
Email
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Mailing Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Colleges/Universities Attended (please include any nursing schools)
College Name
Dates Attended
Most Recent College
Previous College
Previous College
Required and Recommend Courses
Pre-approved course alternates are listed on the nursing program webpage.
Nursing Prerequisites
How many total times have you taken or plan to take this course?
College/University and the Quarter/Year or Semester/Year
College/University and the Quarter/Year or Semester/Year
College/University and the Quarter/Year or Semester/Year
BIOL& 241—Human A&P I
BIOL& 242—Human A&P II
CHEM& 121—Intro to Chemistry
ENGL& 101—English Composition I
MATH& 146—Intro to Statistics
PSYC& 200—Lifespan Psychology
Core Degree Requirements (Recommended)
How many total times have you taken or plan to take this course?
College/University and the Quarter/Year or Semester/Year
College/University and the Quarter/Year or Semester/Year
College/University and the Quarter/Year or Semester/Year
BIOL& 260—Microbiology
CMST& 220—Public Speaking
CMST 250—Intercultural Comm.
SOC& 101—Intro to Sociology
ANTH& 206—Cultural Anthropology
Certification
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I certify that I am the person named above and that to the best of my knowledge, all statements on this form are true.
Signature
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