Registered Nursing Application

Note: Space is limited in this program. In addition to applying to Clark State, students must also apply to this program. Please meet with your advisor to ensure all requirements are met.

First Name: *

Middle Name *

Last Name: *

If you've legally changed your name, please list other names that may be associated with your Clark State account:

Phone Number: *

Clark State E-mail: * @students.clarkstate.edu

Student ID #: *

Street Address: *

City: *

State: *

Zip: *

What program are you applying to? * NOTE: We cannot guarantee your selection due to space limitations. If your selection cannot be accommodated, you may be placed into a cohort based on each cohort's space limitations.

Have you applied to Clark State College? * Application and acceptance into the College is required before we can consider your application.

Have you declared the appropriate RN program (RN, LPN to RN, or Paramedic to RN) as your major? *

Are your official transcripts from other colleges are on file at Clark State? *

Do you have a minimum 2.5 cumulative grade point average (GPA) in the required courses in the curriculum that you have completed and have a minimum 2.0 Clark State College institutional GPA? If no college courses have been completed, you must have a minimum high school GPA of 2.5. *

Please upload a PDF documenting earned academic degree(s) or certificate(s) from Clark State or another regionally accredited post-secondary institution. (File must be a PDF)

Please upload a PDF of your unofficial Clark State transcript. (File must be a PDF) *

Did you receive an overall proficient score for the TEAS test or have completed 30 college credit hours with a minimum of a “C” or better? * This includes the sub scores for reading, math, science and English. Minimum proficiency level for all sub scores is 58.7.

Do you have a current State Tested Nurse Aide (STNA) certification, MST 1181, or equivalent completed within the last 2 years, in progress, or planned for completion prior to starting nursing courses? *

LPN to RN Evening/Weekend Program Applicants Only

Please upload a PDF file documenting current valid licensure as an LPN. (Files must be a PDF)

Please upload a PDF file documenting one year of clinical work experience in Ohio as an LPN (within the last 3 years) OR a PDF file documenting completion an LPN program within the last 18 months. (Files must be a PDF).

Please indicate whether you have completed or plan to take the course BIO 1131.

Please indicate whether you have completed or plan to take the course BIO 2121.

Please indicate whether you have completed or plan to take the course BIO 2122.

Please indicate whether you have completed or plan to take the course ENG 1111.

Please indicate whether you have completed or plan to take the course ENG 1112.

Please indicate whether you have completed or plan to take the course PSY 1111.

Acknowledgment for All Applicants

I attest that all information on this application is complete and correct.

I understand that it is my responsibility to confirm that all application materials are received on or before the deadline date.

I have read and understand the information provided and referenced on the Registered Nursing Program information found on the Clark State website.

By submitting this application, I acknowledge and agree to the terms of the Healthcare Program Registration Agreement that is provided on the Admissions for Healthcare Programs webpage.

Questions? Contact Us!

Garrett Fisher

Assistant Dean, School of Nursing
937-328-5461
Email

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