LICENSED VOCATIONAL NURSING PROGRAM APPLICATION
Applications accepted online January 2-30, 2026
Deadline to submit application is January 30, 2026 at 4:00 PM.
APPLICANT INFORMATION
Last Name
*
First Name
*
Middle Name
Previous Name(s)
First Name
Last Name
MyCuesta Email Address
*
example: cougie_cougar@my.cuesta.edu
Personal Email Address
*
Cuesta Student ID Number
*
9-Digit ID Number
Primary Phone Number
*
Secondary Phone Number
Current Mailing Address
*
Street Address
Street Address 2
City
State
Zip Code
Is your current address the same as your permanent?
*
Please Select
Yes
No
California Residency ^
*
Please Select
Yes
No
Permanent Address
*
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Date of Birth^
*
/
Month
/
Day
Year
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Age at time of application^
*
Gender ^
*
Please Select
Female
Male
Transgender
Non-binary
Other
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Race/Ethnicity^
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Please Select
American Indian/Native American/Alaska Native
Asian-Asian Indian
Asian-Cambodian
Asian-Chinese
Asian-Filipino
Asian-Indonesian
Asian-Japanese
Asian-Korean
Asian-Laotian/Hmong
Asian-Malaysian
Asian/Pakistani
Asian-Thai
Asian-Vietnamese
Asian-Other
Black-African American or African
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White/Caucasian/European/Middle Eastern
Other not listed
Primary language spoken at home^
*
Please Select
American Sign Language
Arabic
Chinese
English
Farsi
Languages of Indian Subcontinent and Southeast Asia
Russian
Spanish
Tagalog
Other
Are you a veteran?^
*
Please Select
Yes
No
Are you the spouse of a veteran?^
*
Please Select
Yes
No
Have you applied to the Cuesta College Licensed Vocational Nursing Program before?
*
Please Select
Yes
No
If yes, what year(s) did you apply?
Have you applied to the Cuesta College Registered Nursing Program before?
*
Please Select
Yes
No
If yes, what year(s) did you apply?
1. HIGH SCHOOLS AND COLLEGES ATTENDED
School
City
State
Dates Attended
1.
2.
3.
4.
5.
2. PREREQUISITE COURSEWORK
PRE-REQUISTITE COURSES COMPLETED WITH A ‘C’ OR BETTER: NOTE: If you are entering a Biology course that has lab incorporated into the class, enter the course information in the first row and skip the second row.
School
Course (e.g. BIO 212)
Term/Yr (e.g. Fall/2019)
Credits
Grade
Human Biology (BIO 212) OR HIGHER:
Human Biology Lab (BIO 212L) OR HIGHER:
College Reading & Writing (ENGL 156/180) OR HIGHER:
Intermediate Applied Algebra (MATH 127/128) OR HIGHER:
3. CALIFORNIA NURSING ASSISTANT CERTIFICATION
REQUIRED: Copy of your current California Nursing Assistant (CNA) certification card (or verification of state certification) MUST BE IN PDF FORMAT
*
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OPTIONAL: Credit for CNA Work Experience Verification Form. MUST BE IN PDF FORMAT
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4.
CREDIT FOR REPEAT ELIGIBLE APPLICANTS:
Applicants who have previously submitted two eligible LVN program applications in the past three application cycles (2022, 2024, 2025) but were not selected for admission, will have their name placed twice in the random draw to increase chances of being selected. Applicants must maintain proof of eligible applicant letters each year to submit with the online application.
Check below the 2 years you applied and were eligible but not offered admission.
2022
2024
2025
Program entry into fall:
Must submit at least TWO Eligibility Without Admission letters from the dates above to have your name placed twice in the random draw. DO NOT SUBMIT LESS THAN TWO LETTERS. MUST BE IN PDF FORMAT.
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APPLICANT ACKNOWLEDGMENT AND AGREEMENT
Signature
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