PRACTICAL NURSE PROGRAM
APPLICATION INFORMATION
Dear Prospective Student,
Thank you for your interest in the Northwest Mississippi Community College Practical Nursing Program located
on the Senatobia Campus, Benton-Marshall Campus, DeSoto Campus, and Oxford Campus. The PN program
accepts applications from January through April 30 each year for the fall semester.
The Oxford Campus also begins a new class each January. PN applications for this class (spring semester) will
be accepted from June through mid-October each year.
The PN program is a twelve-month course, which begins each August and January for Oxford. A campus-wide
schedule is followed with regard to holidays, semester registration, and breaks.
Admission criteria for acceptance into the program:
• You must include a new/updated application to Northwest.
• You must make application to the Practical Nursing Department. (see deadlines above)
• You must have a high-school diploma or GED equivalency.
• You must provide proof* of a composite score of 16 or higher on the enhanced ACT.
*PROOF REQUIRED: OFFICIAL HIGH SCHOOL TRANSCRIPT OR ACT PRINTOUT OF SCORES.
• You must be 18 years of age or older.
• You must be physically sound and have no felonious or criminal record.
• After these requirements are met, you will then be eligible to take the TEAS (a nurse entrance
test).
• There is a $50.00 cash fee for the TEAS test.
• Testing begins in February for the fall semester and mid-SEPTEMBER for the SPRING SEMESTER at
the Oxford Campus.
• Call Rhonda Still, 662-562-3366 (Senatobia or Benton-Marshall), or Brenda Holmes, 662-238-7952
(Oxford) after mid-January to schedule a testing date and time for the fall class and mid-August to
schedule a testing date and time for the Oxford Campus spring class. Dr. Tim Williams,
662-280-6127, at the DeSoto Campus will be mailing notifications of TEAS test dates and times.
• Practical Nursing candidates who score at or above the program average (62) for math and reading
on the TEAS will be considered for admission.
Admission Policy
Practical Nursing (PN) – Students desiring to enter the PN program will
be selected based on the following criteria:
1. Applicants must be at least 18 years of age.
2. Applicants must have a high school diploma or GED equivalency.
3. Applicants must submit a new or updated Northwest application and
a PN application to the campus they are planning to attend.
4. Applicants must have an enhanced ACT composite score of 16 or
greater and must send proof of their ACT score to Northwest’s
Registrar’s Office. PROOF REQUIRED: Official high school transcript or
ACT printout of scores.
5. Once a prospective student has all required documentation on file
with the PN Program, an opportunity to sit for the Test of Essential
Academic Skills (TEAS) can be scheduled by calling Brenda Holmes at
662-238-7952.
* The Practical Nursing Program accepts applications from mid-January
through April 30 of each year. Testing begins each February.
** The LYTC-Oxford Campus also accepts applications from June
through mid-October for students planning to attend Spring semester.
Testing begins for this class in September.
Persons interested in applying for the Practical Nursing program at the
Oxford campus should make application to the following address:
ATTN: PN Program
NWCC/Lafayette-Yalobusha Technical Center
1310 Belk Drive
ESTIMATED COST OF PN PROGRAM
FIRST SEMESTER:
TUITION ……… $1,125.00
BOOKS & KIT……….…….. 1,250.00
CPR (First Aid) ……….. 35.00
UNIFORMS ………. 350.00
INSURANCE ………. 15.00
TOTAL FIRST SEMESTER ……….……….$2,775.00
SECOND SEMESTER:
TUITION ……… $1,125.00
TOTAL SECOND SEMESTER ……….………….……….$1,125.00
SUMMER SEMESTER:
TUITION ……… $1,125.00
TOTAL THIRD SEMESTER ……….………..…. $1,125.00
Northwest Mississippi Community College
PRACTICAL NURSING
Advisors: Kitchens, Williams, Shawn, Hill
The Practical Nursing Program prepares the individual to assist in providing general nursing care
requiring basic knowledge of the biological, physical, behavioral, psychological, and sociological sciences;
and of nursing procedures which do not require the skills, judgment, and knowledge required of a
registered nurse. This care is performed under the direction of a registered nurse, licensed physician, or
dentist.
Students that complete the program requirements, 3 semesters, as identified by the Mississippi
Department of Education, will be eligible to apply for PN licensure. The graduate of the program
functions as a provider of care and a member of a profession.
FIRST SEMESTER SEMESTER HOURS SECOND SEMESTER SEMESTER HOURS
PNV 1213, Body Structure & Function 3
PNV 1614, Medical/Surgical Nursing 4
PNV 1426, Fundamentals of Nursing 6 PNV 1622, Medical/Surgical Nursing
PNV 1437, Fundamentals of Nursing Clinical 2
Lab/Clinical 7 PNV 1634, Alterations in Adult Health 4
PNV1642, Alterations in Adult Health
Clinical 2
PNV 1524, IV Therapy & Pharmacology 4
Total 16 Total 16
THIRD SEMESTER SEMESTER HOURS
PNV 1715, Maternal-Child Nursing 5
PNV 1813, Mental Health Concepts 3
PNV 1914, Nursing Transition 4
Total 12
Phone (662) 238-7952
PRACTICAL NURSE PROGRAM APPLICATION
ALL PRIOR FILES ARE INACTIVE. THE REQUIREMENTS FOR APPLICATION
MUST BE COMPLETED IF YOU ARE RE-APPLYING.
Applications for the fall semester will be accepted from January through April 30 each year.
Applications for the spring semester will be accepted from
June through mid-October each
year.
NAME_____________________________________________________________________
Last
First
Middle
Maiden
MAILING
ADDRESS__________________________________________________________________
Street
City
State Zip
EMAIL ADDRESS _________________________________ DOB ___________________
TELEPHONE______________________________ ________________________________
Home Number
Business or Cell Number
Have you taken the ACT? (Circle) Yes No If yes, composite score___________________
(Minimum 16 ACT required
- YOU MUST PROVIDE PROOF OF SCORE - H.S. Transcript
or ACT printout)
High School_______________________________________ Year Graduated____________
If you hold a GED Certificate, date received _____________________________________
Please circle yes or no for the following questions. These are questions that will be on the
NCLEX PN (State Board Exam).
1. Yes No Have you been convicted of any criminal offense in any state or federal court (other than minor traffic violations)?
2. Yes No Have you been convicted of a felony?
4. Yes No
Have you had or do you now have any disease or condition that interferes with
your ability to perform the essential functions of your profession, including
any disease or condition generally regarded as chronic by the medical
community, i.e., (1) mental or emotional disease or condition; (2) alcohol or
other substance abuse; (3) physical disease or condition, that presently
interferes with your ability to practice your profession?
5. Yes No Have you been denied a professional license or permit, or privilege of taking a
an examination, or had a professional license or permit disciplined in any way
by any licensing authority in Mississippi or elsewhere?
6. Yes No
Have you ever been discharged other than honorably from the armed service or
from a city, county, state or federal position?
Note: Providing false information on this application may cause the applicant to be
excluded from acceptance into the PN Program.
______________________________________________ ________________________
Applicant’s Signature (Legal Name)
Date
Return completed application to:
ATTN: PRACTICAL NURSING
Lafayette-Yalobusha Technical Center
1310 Belk Drive
Application for admission
Registrar’s office 4975 Hwy 51 north P.O. Box 7047 Senatobia, ms 38668
Last First Middle Maiden
Street City State Zip County
Name:____________________________________________________________________________________________________ Physical Address:__________________________________________________________________________________________ Mailing Address: __________________________________________________________________________________________
Street or P.O. Box City State Zip County if different from physical
City/State/Country of Birth: _______________________ MS Resident? Race/Ethnicity: Are you Hispanic/Latino?
What is your race? (You may choose more than one) ___White ___ Black or African American
___ Asian ___ American Indian or Alaska Native ___ Native Hawaiian or Other Pacific Islander Date of Birth: ___/___/____
Family Information
Last
Choose One: ___ Parent ___ Guardian** ___Spouse Name: ______________________________________________
First
Mailing Address: ___________________________________________________________________________________
Street or P.O. Box City State Zip
Location: ___________________________________ (Month/year)
Do you have a GED diploma? If yes, graduation date: _________ State where GED was completed: _______
(Month/Year) City State
College Information
Have you ever attended NWCC?
Last First
List all colleges previously attended:
Failure to list complete and accurate information could result in the cancellation of your enrollment.
What semester do you plan to attend NWCC? ___ Fall ___Spring ___ Summer What year? _____________________ High School: _________________________________________________________ Graduation Date: ___________________
High School information
GED Information
I certify the information I have provided on this application is accurate and that I have not intentionally withheld information requested. I further understand that falsification of information is a basis for denying admission or for immediate termination of enrollment. My signature above also authorizes the release of my transcripts from all schools previously attended to Northwest’s Registrar’s office.
Applicant’s Signature: ________________________________________________________________________________ Date: _______________________ **If you choose guardian, you must mail in official guardianship documents.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Social Security Number: _______ - _____ - _________
Intended Major: __________________________ Major Code: _____________
(See reverse for codes)
*Non-degree seeking students are not eligible for financial aid.
All official college transcripts are required for admission to be complete.
E-mail: _____________________________________________________@________________________________________ Phone Number: ( ) - _________ - _____________
Gender: U.S.Citizen?
Official high school transcript or GED and ACT scores (see NWCC catalog for exceptions) are required for admission to be complete. Male Female Yes No (mark one) Yes No Yes No Yes No Yes No
X
Campus you plan to attend:
Senatobia DeSoto Oxford Online
If any of your transcripts are from out of state, you must provide proof of residency.
Degree Seeking Non-degree Seeking*
Dates attended: _____________________________________________ Name at time attended: ______________________________________
CODES FOR MAJORS
205 Accountancy 120 Animal Science 405 Art
704 Biology
220 Business & Computer Teacher Education 218 Business Administration 708 Chemistry 416 Communications/Public Relations 410 Communications/Broadcasting 415 Communications/Journalism 213 Computer/Management Information Systems 712 Computer Science 515 Criminal Justice 305 Elementary Education 345 Exercise Science 130 Forestry
510 General College Curriculum 105 General Agriculture
724 General Science
340 Health & Physical Education 505 Liberal Arts
417 Marketing Communications/PR Mgmt
784 Mathematics
420 Music, Music Education, Music Performance
423 Music Business/Industry 605 Nursing (Associate Degree) 240 Office Administration 131 Outdoor Recreation & Mgmt 788 Physics
720 Pre-Architecture
744 Pre-Clinical Laboratory Sciences 347 Pre-Communicative Disorders 730 Pre-Cytotechnology 732 Pre-Dental 734 Pre-Dental Hygiene 716 Pre-Engineering 710 Pre-Forensic Chemistry 127 Pre-Health Information Management 742 Pre-Health Sciences 726 Pre-Horticulture 718 Pre-Landscape Architecture 722 Pre-Landscape Contracting 736 Pre-Medical 748 Pre-Nursing (BSN) 752 Pre-Occupational Therapy 738 Pre-Optometry 756 Pre-Pharmacy 760 Pre-Physical Therapy 764 Pre-Radiological Sciences 768 Pre-Veterinary Medicine
770 Pre-Veterinary Medical Technology 520 Psychology
342 Recreation
307 Secondary Education 535 Social Work
425 Theatre
ASSOCIATE OF ARTS DEGREE
ASSOCIATE OF APPLIED SCIENCE
CAREER CERTIFICATE
6005 Accounting Technology
6022 Agricultural Business & Mgmt Tech/Animal Husbandry 6010 Agricultural Tech/John Deere Tech
8014 Automotive Technology 8014 Automotive Tech/Chrysler College Auto Program 6012 Aviation Maintenance Tech 6045 Business & Marketing Management Tech
6098 Cardiovascular Technology 6030 Civil Engineering Technology 6032 Civil Engineering Surveying/Geomatics MSU
6052 Drafting & Design Engineering Tech/Arch Eng
6025 Early Childhood Education Technology
6070 EMT-Paramedic
6085 Funeral Service Technology 6035 Graphic Design Technology 6079 Health-Care Data Technology 8015 Heating, Air Conditioning & Refrigeration Tech
6065 Hotel & Restaurant Mgmt Tech 6056 Industrial Electronics
Engineering Tech
6038 Information Systems Tech/ Computer Networking
6041 Information Systems Tech/ Computer Programming 6009 Microcomputer Technology 6014 Office Systems Technology 6090 Paralegal Technology
6099 Paralegal Tech/Pre-Paralegal Studies UM 2+2 Option 6093 Respiratory Therapy 6092 Surgical Technology
7005 Precision Manufacturing and Machining Technology
6031 Civil Engineering Technology (One-Yr Certificate)
8005 Collision Repair Technology 8075 Commercial Truck Driving 8035 Cosmetology
8036 Cosmetology/Nail Technician Option
6071 EMT-Basic
8062 Health Care Assistant
6013 Office Systems Technology Yr Certificate)
8060 Practical Nursing 8070 Welding And Cutting
