ADN Mentor Appointment Request for spring 2026

ADN Mentor Appointment Request for spring 2026
Student ID#*
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
This 6 minute VIDEO will help you to understand the requirements of the program.
Which program are you applying to (both are face-to-face)?*

Traditional ADN (2-year) programTransition ADN (1-year) program (you must have a current LVN license)
What school did you attend for Vocational Nursing?
What year did you graduate:
What year did you earn your LVN/LPN? Type a label
HESI A2 date: must be less than 5 years*
Reading*
minimum score = 80
Grammar*
minimum score = 75
Math*
minimum score = 80
Hepatitis B:*

I have documentation of a positive titer (this requires a blood draw)I am in process with the 3-shot series, and it is not time for the next shot or titer yet
Which courses have you completed? For the 1-year transition program, all 7 must be complete. For the 2-year traditional program, if the first 4 are not complete (2 MUST be complete), you must provide documentation that the remaining courses are in progress, and you do not have to have the last 3.*

BIOL 2401 with labBIOL 2402 with labBIOL 2420 with labMATH 1342ENGL 1301PSYC 2314Fine Arts elective
If you have attended any colleges other than Panola College, you must have already requested your official transcript (from that college) to be sent to Panola College Admissions, and allow up to two weeks for your courses to be evaluated. You will need to contact Panola College Admissions at 903-693-2038 to get a copy of your Transfer Transcript Evaluation before submitting this form. You will want to double check to be sure that all colleges and courses are listed, and that all grades are correct.
I have attended:*

Panola College only, and have printed out my unofficial transcript from Campus ConnectColleges other than Panola College, and I have a copy of my Transfer Transcript EvaluationBoth Panola College and other colleges, and have both documents listed above
I have attended an ADN or BSN program before, and the Panola College Verification of Good Standing form (filled out by your previous nursing program chair) has been received by Katie Davis (you may call 903-694-4019 to verify this or to get the form).*

No, I have not attended a professional nursing programYes, I have attended a professional nursing program, and the form has been received by Katie Davis
Here are the earliest appointments available at this time. If you would like to request one, please mark it below. If these do not fit your schedule, please scroll down and "submit" (green button) without choosing. This form will be updated frequently.
Please choose one

9/8/25 @ 1:309/8/25 @ 2:009/8/25 @ 2:309/9/25 @ 9:009/9/25 @ 9:309/9/25 @ 10:009/9/25 @ 10:309/9/25 @ 1:009/9/25 @ 1:309/10/25 @ 9:309/11/25 @ 8:009/11/25 @ 8:30
This is only a REQUEST for an appointment. Once you have submitted the form, you will get a phone call within 24 hours (business hours only) with some followup questions if needed, and then a confirmation email. If you are not able to submit, or have a question, please contact Katie Davis at 903-694-4019 or katie.davis@panola.edu.
Please verify that you are human*
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