Transcription of Associate Degree Nursing Program
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Associate Degree Nursing Program
Mail to: Attn: Applications Bakersfield College Nursing Department 1801 Panorama Drive Bakersfield, CA 93305. Associate Degree Nursing Program Application Form New Applicant Prior Applicant: When? List all dates: _____. Re-entry Applicant: Last Semester/Year Attended? _____ Advanced Placement Admission to: Fall Semester Spring Semester Year_____. Nursing Semester: 1st Semester 2nd Semester 3rd Semester 4th Semester Are you registered with Bakersfield College as a Veteran or spouse/dependent eligible for military benefits? Yes No If you answered yes, attach DD214 form and, if applicable, Certificate of Eligibility. Personal Information Student ID #: @_____ BC email address: _____. Full Name: _____. Last First Previous Last Name Address: _____. Street Address Apartment/Unit #. City State Zip Code Birth Date: ____/____/_____ Cell/Day Phone: (_____) _____ Alternate Phone: (_____) _____.
Technician (EMT) or Phlebotomy (AUMT) 6 1e. Certified/Licensed Health Care Worker (less than 18 week program) – Non BC Programs number, date issued, and (NA, EMT, Medical Assistant, Phlebotomist) 4 Copy of current California Certificate/License with certificate expiration date. No points will be awarded
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