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Fall 2026 Nursing Program Application
Submit the information below to begin the application process for Centralia College's Registered Nursing program. The application is due April 15. All prerequisites and requirements must be completed by June 30.
Student ID Number
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Name
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First
Last
Phone
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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
Additional Questions
The next two questions will not be used to evaluate your application.
Do you have experience working in the healthcare field?
Yes, I have worked in healthcare.
No, I have not worked in healthcare.
If yes, what was your position and how long (ex. NA-C, 1 year, or EMT, 6 months)?
Certification & Signature
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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Clear
