Gadsden Technical College School of Practical Nursing 2024-2025 Admission Application
201 Martin Luther King Jr. Blvd. *Quincy, FL 32351 *(850) 875-8324 *www.gadsdentech.org
Name
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First Name
Middle Name
Last Name
Date of Birth
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Month
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Day
Year
Date
Current Age
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Gender at Birth
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Social Security Number
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Ethnicity:
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Race:
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Citizenship:
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Mailing Address
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Street Address
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Physical Address
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Primary Phone Number
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Secondary Phone Number
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Email
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EMERGENCY CONTACT INFORMATION
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First Name
Last Name
Emergency contact relationship to you:
Emergency contact phone Number:
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What year did you receive your high school diploma?
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*
What type of high diploma did you receive?
*
Please Select
Standard High School Diploma
GED Testing
Home School
None-Currently a high school senior
Other
Please list the name and address of the high school you graduated from or your current high school if you are a high school senior:
*
You must submit official (sealed/unopened) high school transcript to Gadsden Technical College School of Practical Nursing. Transcript can be emailed from your pervious high school to: draked@gcpsmail.com Transcript can also be mailed or hand delivered to: 201 Martin Luther King Jr. Blvd. ; Quincy, FL 32351
College/Technical Education
You must submit official (sealed/unopened) college transcripts to Gadsden Technical College School of Practical Nursing. Transcripts can be emailed from the college you attended to: draked@gcpsmail.com Transcript can also be mailed or hand delivered to: 201 Martin Luther King Jr. Blvd. ; Quincy, FL 32351
Have you received any college or technical education?
*
Yes, Please complete the college/technical education history below
No
College/Technical Education History
College Name
Dates of Attendance
(MM/YYYY)
Type of Degree Obtained
College #1
College #2
College #3
College #4
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Are you a Veteran?
*
Yes (documentation will be required if accepted into the program)
No
How did you learn about Gadsden Technical College School of Practical Nursing
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Friend/Family
Facebook
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Other
Have you been enrolled in Gadsden Technical College School of Practical Nursing in the past?
*
No
Yes
If yes, what year were you enrolled?
Are you prepared to meet the financial requirements of this Program?
No
Yes
If yes, please explain how.
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Employment/Work Experience:
Name of Employer
Job Title/Position
Employment Start Date: (MM/YYYY)
Employment End Date: (MM/YYYY)
Employer #1
Employer #2
Employer #3
Employer #4
Employer #5
Employer #6
Employer #7
Have you ever been investigated by the Department of Children and Families (DCF) or Department of Professional Regulations?
*
No
Yes
If yes, please explain.
Have you ever been arrested for anything regardless of adjudication?
*
No
Yes
If yes, please explain.
Do you take or use any drugs/medications which may alter logical thinking?
*
No
Yes
If yes, please explain.
Do you have the ability to drive or have reliable transportation to school campus and applicable clinical facilities?
*
No
Yes
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Supporting Document Upload
The application process is not complete until all required (*) supporting documents listed below are uploaded. Hit the "Save and Continue Later" button at the bottom of this page. You will receive a link via email which will allow you to return to your application for submission of documents at a later date. All documents must be uploaded prior to the closure of the open enrollment period (4/1/2024 - 7/7/2024). Seating for this Nursing Program is limited, therefore all applicants are encouraged to complete the application process in an expeditious manner.
Official Identification (Example: Driver’s License, State ID)
*
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All supporting documents must for uploaded to complete the application process.
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A Copy of Your TEAS Test Scores
*
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Romotely proctored TEAS scores will not be accepted. Only scores from an official testing site/facility will be accepted. All supporting documents must for uploaded to complete the application process.
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Medical History and Physical Examination (Including Immunizations)
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Please visit our website at: (https://content.myconnectsuite.com/api/documents/7d2f1eea86814ed18514a11100a197f2.pdf) to print out the required Medical History and Physical Examination form. All supporting documents must for uploaded to complete the application process.
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Three (3) Reference Letters
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All supporting documents must for uploaded to complete the application process.
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OPIONAL: Any Current Medial Certification/Licensure (i.e. CPR, CNA, MA, Phlebotomy, Etc...)
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Submitted a photocopy of a current/valid certification/licensure to receive extra points towards admission.
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***WARNING!!!
If you have not submitted all of your required (*) "Supporting Documents", then hit the "Save and Continue Later" button. This will send you an email link that will allow you to return at a later date to upload your documents.
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MISSION STATEMENT
The mission of Gadsden Technical College is to recognize the worth and potential of each student. We are committed to providing opportunities for basic and advanced instruction in a conducive learning environment. The College encourages academic and technical curiosity, innovation and creativity by integrating applied academic skills in all occupational areas. We strive to instill the attitudes and skills necessary to produce motivated, self-sufficient individuals who are able to function effectively in our ever-changing, complex.
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