Central School of Practical Nursing Application - 2026

Central School of Practical Nursing Application - 2026

Welcome
Thank you for your interest in joining our program. We’re excited that you’re taking the next step toward a rewarding career in nursing. Our team is here to support you throughout the application process, and we look forward to learning more about you.

Central School of Practical Nursing Application - 2026
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com

Education History
Important Document Submission Information

Please ensure that you submit an official transcript or GED® record.

An official transcript must meet the following criteria:

It should be received in a sealed envelope from the institution that issued it.
It must contain an official seal.
The document must be in English.
For any foreign transcripts, an evaluation is required from an approved independent transcript evaluation company. The evaluation report must be sent directly to CSPN by April 30, 2026.

Mailing Address:

Central School of Practical Nursing
1330 N. Military Highway
Norfolk, VA 23502
Are you a high school graduate?*

YesNo
Name of High School*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Post High School Education and Experience

Please identify the name, courses, degree, and/or dates of attendance for any post secondary education experience.
College
Technical School or Apprentice program
Experience in Nursing, if any:
How did you learn about CSPN?*

Employment History

List your two most recent work experiences.
Employer Name (E1)*
Dates of Employment (E1)*
Type of Work (E1)*
Address (E1)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer Name (E2)*
Dates of Employment (E2)*
Type of Work (E2)*
Address (E2)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Professional References

List three individuals (not relatives) who have worked with you, supervised you, or instructed you during the past three years. These references are confidential.
Reference Name (R1)*

First NameLast Name
Relationship (R1)*
Phone Number (R1)*
Please enter a valid phone number.
Email (R1)*
example@example.com
Reference Name (R2)*

First NameLast Name
Relationship (R2)*
Phone Number (R2)*
Please enter a valid phone number.
Email (R2)*
example@example.com
Reference (R3)*

First NameLast Name
Relationship (R3)*
Phone Number (R3)*
Please enter a valid phone number.
Email (R3)*
example@example.com

Disclaimer and Signature

I hereby certify that all information provided in this application is accurate and complete to the best of my knowledge. I authorize CSPN to obtain any information necessary to verify the details I have submitted.

I voluntarily waive my right to review any reference materials provided on my behalf. I also agree not to attempt, directly or indirectly, to access or review any references submitted by individuals or organizations.

By entering the Applicant Name and Parent/Guardian Name in the fields below, you acknowledge and agree that this constitutes your digital signature for this application.
Signature*
Should be Empty: