ASSOCIATE DEGREE LVN TO RN (ACCELERATED RN) PROGRAM APPLICATION
June 2026
^
The information noted with this symbol will in no way affect your ability to enter the Nursing and Allied Health Programs; it is obtained for statistical purposes ONLY. It will be kept confidential and used to gather data needed to receive state and federal funding.
APPLICANT INFORMATION
Last Name
*
First Name
*
Middle Name
Previous Name(s)
First Name
Last Name
MyCuesta Email Address
*
Confirmation Email
This MUST be your @my.cuesta.edu address. Example: cougie_cougar@my.cuesta.edu
Personal Email Address
*
Confirmation Email
Confirm Email
Cuesta Student ID Number
*
9-Digit ID Number
Primary Phone Number
*
Format: (000) 000-0000.
Secondary Phone Number
Format: (000) 000-0000.
Current Mailing Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Is your current address the same as your permanent Address?
*
Please Select
Yes
No
California Residency^
Please Select
Yes
No
If yes, how many years?
Permanent Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
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
Race/Ethnicity^
*
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
Russian
Spanish
Tagalog
Various languages of Indian Subcontinent and Southeast Asia
Various languages of the African continent
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 RN Program before?^
*
Please Select
Yes
No
If yes, what year(s) did you apply?
Have you ever been admitted to an RN Program before?^
*
Please Select
Yes
No
If yes, please enter the names of the programs you have attended
1. ACADEMIC DEGREE OR RELEVANT CERTIFICATE
Education
Please Select
Master's Degree or Higher
Bachelor’s Degree
Associate’s Degree
Licensed Health Care Worker
Indicate your highest level of education obtained by the application deadline
College/University Attended - Other than Cuesta College
Rows
School
City
State
Dates Attended
1.
2.
3.
4.
5.
2.
PREREQUISITE COURSEWORK & MATH
*Online and Distance Education labs are not accepted. Exception- Online labs accepted Spring 2020- Spring 2022 only.
Rows
School
Course # (e.g. BIO 205)
Term/Year (e,g Spring/2025
Credits
Grade
Microbiology with lab* (Bio 204) or equivalent
Human Anatomy with lab* (Bio 205) or equivalent
Human Physiology with lab* (Bio 206) or equivalent
English Composition (Eng 201A)
Math Competency (Math 127/128 or Higher)
2a.
REPEATS IN SCIENCE AND ENGLISH PREREQUISITE COURSES
For the LVN to RN program, there is no penalty for repeats.
Repeat includes the following grades of C-, D, F, I, NP, FW. Please indicate the number of course repeat(s):
*
Rows
Number of Repeats
Human Anatomy with Lab
0
1
2
3
Human Physiology with Lab
0
1
2
3
Microbiology with Lab
0
1
2
3
English Composition
0
1
2
3
Repeat Total:
2b. One Current General Education Pattern MUST BE COMPLETED BY DECEMBER 31, 2026
From the drop down menu next to each GE Pattern, please select from the following choices: Completed or Completing in Fall 2026 or N/A (not applicable)
*
Rows
General Education Pattern for AS Degree
Completed
Completing in Fall 2026
N/A (not applicable)
Cal-GETC Certification - Transfer General Education Pattern
Completed
Completing in Fall 2026
N/A (not applicable)
CSU General Education Pattern
Completed
Completing in Fall 2026
N/A (not applicable)
IGETC General Education Pattern
Completed
Completing in Fall 2026
N/A (not applicable)
Completion of a Bachelor's Degree or Higher
Completed
Completing in Fall 2026
N/A (not applicable)
3. CALIFORNIA LVN LICENSE & WORK EXPERIENCE
Upload required documentation below.
PDF format only
.
California LVN License
Upload a File
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of
Work Experience Verification Form
Upload a File
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Professional Resume
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Two Letters of Recommendation from Health Care Supervisors
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Personal Statement
Browse Files
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APPLICANT ACKNOWLEDGMENT AND AGREEMENT
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