Download PART 1:​​To be completed by the College Advisor​. Part 1 must

PART 1:​ ​To be completed by the College Advisor​. Part 1 must be completed before proceeding to Part 2.
Students with an incomplete portfolio will not be considered for admission into the practical nursing program. It
is recommended that applicants retain a copy of their portfolio for their personal records.
EGTC Admissions:
__________ EGTC Admissions Application completed at ​www.emilygriffith.edu​.
Assessment Tests: Scores are valid up to one year after test date. First test is free. Fee for re-tests.
Two tests allowed per subject within a six month time period.
__________ Copy of Reading TABE assessment results: 12.0 or greater
__________ Copy of Math EGTC Practical Nursing assessment results: 80% or greater
Prerequisites: Official transcripts with a C grade or higher or EGTC Challenge Test results required.
__________ HPR 178: Medical Terminology (1 Credit)
__________ BIO 106: Anatomy & Physiology (4 credits) taken within the past 7 years (Anatomy and
Physiology courses at or above BIO106 may be accepted from institutions approved for incoming
transfer
credit as defined in the EGTC catalog)
Other Documents:
__________ Copy of government issued photo ID
__________ Official copy of U.S. High School transcript with graduation date, U.S. High School Equivalency
certificate,
or Associate’s degree or higher transcript with graduation date from a U.S. college
approved for incoming
EGTC transfer credit. Please see the PN Admission Policy for documentation required for education
completed outside of the U.S.
__________ Copy of Certified Nursing Assistant (CNA) license or official transcript of completion of a Medical
Assistant (MA) program
__________ Two (2) letters of recommendation, including the contact information of the person providing the
recommendation
I declare that the information provided is true and correct. I acknowledge and understand that the requirements
for admission may change during the time between portfolio submission and official notification of program
admission.
Student Signature: ________________________________________________
Date: _______________________________________
Advisor Signature: ________________________________________________ Date: _______________________________________
PART 2:​ ​To be completed by EGTC Health Science department.​ Part 2 is completed after admission to the
practical nursing program. Refer to your admissions acceptance letter for deadline information.
Immunization Requirements:​ 2 Series MMR: (1) ____________, (2) _____________ Annual Influenza: _____________
TB Skin test or X-Ray expiration date: _______________ DPT within 10 years or Tdap within 5 years: ________________
Pre-admission/PN Portfolio Checklist [Revised 12/2/16]
HEP B series of 3: (1) __________, (2) ___________, (3) ___________ Varicella (Chickenpox): _______________________________
Required Documents:​ Drug Screen: ______________________________ Background Check: ____________________________
Expiration date of Liability Insurance: _______________________________ BLS Cert. Expiration Date: _____________________
Signature of DNEP or designee: ___________________________________________________________
Pre-admission/PN Portfolio Checklist [Revised 12/2/16]
Date:_____________________