Vocational Nursing | Admission Application Packet

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Please review the Selective Admissions Process and the pre-requisite requirements prior to completing the application.
I have reviewed the information provided by the hyperlinks above and understand the requirements for application and admission:*field type checkbox
I have reviewed the information provided by the hyperlinks above and understand the requirements for application and admission:Yes

Pre-requisite courses required for your application to be considered complete.
The following course must be completed prior to applying for your application to be complete. Courses that you are currently enrolled in are not considered. For science courses, only the first two attempts in the same course will be considered (the highest grade will be used in GPA calculation). Online science lab courses are not accepted. A minimum grade of C must be made in all general education and Nursing courses.
Course Title Complete*(?)field type radio button Grade*field type drop-down
BIOL 2401 - Anatomy and Physiology I Complete*(?)field type radio button
CompleteYesNo
Grade*field type drop-down
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Applicant must meet Texas Success Initiative (TSI) requirements. For additional information, visit TCC Advisement: Texas Success Initiative (TSI)

Only Anatomy & Physiology 1 must completed for application, however it is strongly recommended that the student have all general education courses completed. If the remainder of the general education courses listed below are not completed prior to enrollment in the Vocational Nursing courses, they must be completed to meet graduation requirements.
- ENGL 1301 English Composition I
- PSYC 2301 Introduction to Psychology
- Humanities/Fine Arts Elective (Complete one 3-hour course)
Do you have the following documents available in an upload-able format?
To be considered for the nursing program, the Tarrant County College Division of Nursing must be able to verify the HESI scores you submit. Students who select ‘No’ will be disqualified. Please check the appropriate answer: I grant permission to Tarrant County College Division of Nursing to view my HESI scores through the Elsevier (HESI) database.*field type radio button
To be considered for the nursing program, the Tarrant County College Division of Nursing must be able to verify the HESI scores you submit. Students who select ‘No’ will be disqualified. Please check the appropriate answer: I grant permission to Tarrant County College Division of Nursing to view my HESI scores through the Elsevier (HESI) database.YesNo
HESI A2 Scores?*field type radio button
HESI A2 Scores?YesNo

Course Title	Complete*(?)field type radio button	Grade*field type drop-down
BIOL 2401 - Anatomy and Physiology I	Complete*(?)field type radio button CompleteYesNo	Grade*field type drop-down

HESI A2 Scores

	Math*field type number	Reading*field type number	Grammar*field type number	Vocabulary*field type number	A&P*field type number
row 1	Math*field type number	Reading*field type number	Grammar*field type number	Vocabulary*field type number	A&P*field type number

HESI A2 Scores Upload*field type file upload
Accepted files: PDF, JPEG, PNG, Word Doc, TIFF
TCC Nursing Program Degree Audit?*(?)field type radio button
TCC Nursing Program Degree Audit?YesNo
TCC Nursing Program Degree Audit:*field type file upload
Accepted files: PDF, JPEG, PNG, Word Doc, TIFF
Current Immunization Record from Your Physician?*(?)field type radio button
Current Immunization Record from Your Physician?YesNo
Upload a copy of your Immunization Record*field type file upload
Accepted files: PDF, JPEG, PNG, Word Doc, TIFF

The Texas Administrative Code (TAC) and the Dallas-Fort Worth Hospital Council Foundation Community Standards (PDF will open in a new window) require that all students in health-related programs complete the following immunizations before applying to programs where patient contact is a component.
In order to be eligible to apply, you will need to have proof that you have completed the following immunizations:

Immunization	Completed*field type radio button
1. Measles, Mumps, Rubella (MMR): 2 doses required or (+) titer	Completed*field type radio button CompletedYesNo
2. TDAP: every 10 years	Completed*field type radio button CompletedYesNo
3. Varicella(Chicken Pox): either (+) titer or 2 injections	Completed*field type radio button CompletedYesNo
4. Hepatitis B: a series of 3 doses required(takes 6 months to complete or (+) titer.*	Completed*field type radio button CompletedYesNo
5. Hepatitis A: a series of 2 doses required(takes 6 months to complete or (+) titer	Completed*field type radio button CompletedYesNo

*All immunizations mentioned above must be complete prior to application.
Stop Here
Please save your Nursing Application as a Draft by clicking on the "Save as Draft" button at the bottom of the page and enter a valid email address. A generated link will be sent to the provided email address for you to resume your application when you have acquired all required documentation. Please note that we are not able to regenerate the provided link. Please save the automated email.

Vocational Nursing | Admission Application Packet

Vocational Nursing Program Eligibility Questions

Please review the Eligibility Questions here: Texas Board of Nursing and answer the 4 questions below. If you answer "no" to the questions please sign below. If you answer "yes" to any of the questions. You will need to be cleared by the Texas Board of Nursing Declaratory Review Board. This review process can take a minimum of three months to two years depending on the case. This petition is a formal disclosure to the Board of any eligibility issues that may disqualify you from taking the NCLEX examination for licensure. You are required to submit the letter from the Board which states you have successfully completed the Declaratory Order process, once the review is completed.
1. Are you currently the target or subject of a grand jury or governmental agency investigation?*field type radio button
1. Are you currently the target or subject of a grand jury or governmental agency investigation?NoYes
2. Has any licensing authority refused to issue you a license or ever revoked, annulled, cancelled, accepted surrender of, suspended, placed on probation, refused to renew a professional license, certificate or multi-state privilege held by you now or previously, or ever fined, censured, reprimanded or otherwise disciplined you?*field type radio button
2. Has any licensing authority refused to issue you a license or ever revoked, annulled, cancelled, accepted surrender of, suspended, placed on probation, refused to renew a professional license, certificate or multi-state privilege held by you now or previously, or ever fined, censured, reprimanded or otherwise disciplined you?NoYes
3. Within the past five (5) years have you been addicted to and/or treated for the use of alcohol or any other drug?*field type radio button
3. Within the past five (5) years have you been addicted to and/or treated for the use of alcohol or any other drug?NoYes
4. Within the past five (5) years have you been diagnosed with, treated, or hospitalized for schizophrenia and/or psychotic disorder, bipolar disorder, paranoid personality disorder, antisocial personality disorder, or borderline personality disorder?*field type radio button
4. Within the past five (5) years have you been diagnosed with, treated, or hospitalized for schizophrenia and/or psychotic disorder, bipolar disorder, paranoid personality disorder, antisocial personality disorder, or borderline personality disorder?NoYes
Attestation

I, the NCLEX ® Candidate whose name appears within this Application, acknowledge this document is a legal document and I attest that I understand and meet all the requirements for the type of licensure requested, as listed in sections 301.252, 301.253, 301.452, 301.453, 301.454 and 304.001 of the Nursing Practice Act; 22 TAC §§ 213.27, 213.28, 213.29, 213.30; 22 TAC §§ 217.11 and 217.12.

Further, I understand that it is a violation of the 22 TAC § 217.12 (6)(I) and the Penal Code, sec 37.10, to submit a false statement to a government agency; and I consent to release of confidential information to the Texas Board of Nursing and further authorize the Board to use and to release said information as needed for the evaluation and disposition of my application. I understand that if I have any questions regarding this affidavit I should contact an attorney or the appropriate professional health provider. I will immediately notify the Board if at any time after signing this affidavit I no longer meet the eligibility requirements.

	Applicant Printed Name:*field type single line	Applicant Signature:*field type signature	Date:field type date
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Vocational Nursing | Admission Application Packet
Texas House Bill 1508 Compliance Statement

As a point of information required by Texas HB 1508 and the Texas Occupations Code 58.001,
if you are applying for admission to a program that may prepare an individual for an initial occupational license as defined under Texas Occupations Code 58.00 l and/or if you later decide to change to a program that prepares you for an initial occupational license as defined under Texas Occupations Code 58.001, in accordance with state law, please be advised of the following:
1. An individual who has been convicted of an offense may be ineligible for issuance of an occupational license upon completion of the educational program;
2. Each licensing authority that may issue an occupational license to an individual who completes an educational program must establish guidelines which state the reasons a particular crime is considered to relate to a particular license and any other criterion that affects the decisions of the licensing authority.
3. Local or county licensing authorities may issue additional guidelines related to criminal history. Applicants should contact their respective local or county licensing authority for more details.
4. A person may request a criminal history evaluation letter regarding the personal eligibility for a license issued by a licensing authority under Texas Occupations Code 53.102
Applicants are encouraged to review all applicable eligibility requirements related to the respective occupational license. Questions related to eligibility requirements should be directed to the applicable licensing authority.

My signature verifies that I am aware of and understand House Bill (HB) 1508 and its implications.
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Vocational Nursing | Admission Application Packet

Statement of Student Responsibility

I acknowledge that this application contains policies, regulations, and procedures in existence at the time of publication. I also acknowledge that Tarrant County College and the Department of Nursing reserve the right to make changes at any time to reflect current Board of Trustees policies, administrative regulations and procedures, and applicable State and Federal regulations. Furthermore, I understand that the information included in this packet does not constitute a contract expressed or implied, between any applicant, student, or faculty member, and Tarrant County College.

I have read and understand the admission process for the Nursing Program. By submitting an application, I agree to abide by the admission requirements of the Nursing Program. I accept full responsibility for submitting a complete nursing admission packet prior to or by the designated application filing deadline, and I understand that I cannot be accepted into the Nursing Program until I have completed all of the admission requirements.

Once I have submitted my application packet, I understand that it is my responsibility to inform the nursing office personnel of any change in my status, email address, address, telephone number, intentions to enter the program, or any other information that would affect my entrance into the Nursing Program.

I acknowledge that once admitted to the program, I will be assigned to clinical rotations at area health care facilities, which will require proof of personal health care insurance coverage and proof of immunizations and/or immunity to selected communicable diseases, as well as tuberculosis screening.

I am aware that, according to Dallas - Fort Worth Hospital Council Guidelines, I will be required to undergo a criminal background check and mandatory drug screening prior to admission to the Nursing Program. I understand that clinical facilities require, for each clinical rotation, written verification that students, listed by name, meet all criteria required by the Dallas - Fort Worth Hospital Council Guidelines, to include:
- Negative criminal background checks
- Negative drug screen
- Current immunizations, and TB screening, physical exam
- Current Healthcare Provider BLS (CPR & AED) Program completion card from American Heart Association
- Successful completion of Dallas-Fort Worth Hospital Council Standard Hospital Student Orientation Test
- Current Health Insurance
I understand that the purpose of this program is to prepare me to be eligible to write the NCLEX-RN licensing examination to become a registered nurse. In order to be eligible, I must hold a high school diploma or General Education Development certificate. Furthermore, it is my responsibility to notify the Texas Board of Nursing prior to admission to the Nursing Program, if I have ever been denied licensure by a licensing authority for nurses; have ever had disciplinary action taken against me by a licensing/certifying authority; have ever been convicted of a crime other than a minor traffic violation; am unable to safely practice professional nursing due to physical or mental disability/illness which may endanger the health and safety of persons under my care; have been hospitalized or treated for chemical dependency within the past five years; am currently an intemperate user of drugs or alcohol; have ever been issued a Declaratory Order by the Board of Nurse Examiners for the State of Texas; or if I have ever taken the State Board Test Pool Examination, National Council Licensure Examination for Registered Nurses, or the Canadian Nurses Association Testing Service Examination. If so, I will need to petition in writing, and provide requested documents to the Board of Nurse Examiners for the State of Texas in order to be eligible to take the NCLEX-RN examination. This review and eligibility approval may take 12-24 months to obtain from the Board of Nurse Examiners for the State of Texas who will assess a fee to the individual for review. Board of Nurse Examiners for the State of Texas approval is required prior to acceptance into the Nursing Program.
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Vocational Nursing | Admission Application Packet

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Emergency Contact Information

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Vocational Nursing | Admission Application Packet

College/University

	School Name:field type multi line	Certificate:field type drop-down	From:field type date	To:field type date
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Vocational Nursing | Admission Application Packet

Previous Application Information

Have you ever attended TCC nursing program?*field type radio button
Have you ever attended TCC nursing program?NoYes
Semester:*field type drop-down
Year:*field type number

Vocational Nursing | Admission Application Packet

Demographic Information

Gender:*field type radio button
Gender:MaleFemalePrefer not to disclose
Race:*field type radio button
Race:American/Alaska NativeAsianBlack or African AmericanHawaiian/Pacific IslanderHispanic/LatinoInternationalMultiRace UnknownWhitePrefer not to disclose
Is English your native or first language:*field type radio button
Is English your native or first language:YesNo
If You are an international student, do you possess an F1Visa?*field type radio button
If You are an international student, do you possess an F1Visa?YesNo
TOEFL-iBT/IELTS Instructions
If you did not graduate from a high school in the United States or a high school on a US military installation where English was the primary language used:

Provide documentation of graduation from high school from an English speaking country such as Canada (other than Quebec), Great Britain, Australia, New Zealand, South Africa, and Ireland. If graduated from English speaking high school in a country not listed above in #2, provide official transcripts and a notarized letter from the headmaster/principal of the high school stating that English was the primary language of the courses taught.
If English was NOT the primary language of your high school you must provide documentation of proof of English proficiency by submitting the results of either of the following:
1. TOEL - iBT - Test of English as a Foreign Language-Internet Based Test - passing score of 83. This is the recommended score to apply for licensure from the Texas BON (Board of Nursing) http://www.ets.org/toefl/
2. IELTS - Academic version- International English Language Testing System -IELST Band Score - over all 6.5 with a minimum score of 6 in all areas. This is the recommended score to apply for licensure from the Texas BON (Board of Nursing).
TOEFL-iBT/IELTS Supporting Documentation Upload:*field type file upload
Accepted files: PDF, JPEG, PNG, Word Doc, TIFF
U.S Associates or U.S Healt Care License is acceptable documentation for ESL students.
Are you bilingual/multilingual:*field type radio button
Are you bilingual/multilingual:YesNo
Which languages do you speak?*field type checkbox
Which languages do you speak?Chinese, MandarinEnglishSpanishArabicBengaliHindiRussianPortugueseJapaneseGermanChinese, WuJavaneseKoreanFrenchTurkishVietnameseTeluguChinese, YueMarathiTamilItalianUrduChinese, Min NanChinese, JinyuGujaratiPolishUkrainianPersianChinese, XiangMalayalamChinese, HakkaKannadaOriyaPanjabi, WesternSundaPanjabi, EasternRomanianBhojpuriAzerbaijani, SouthMaithiliHausaBurmeseSerbo-CroatianChinese, GanAwadhiThaiDutchYorubaSindhi
By providing your electronic signature below, you agree that you have read the application, in its entirety, and that you have accurately filled out the application to the best of your knowledge.
Applicant Signature:*field type signature Date:field type date
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	Applicant Signature:*field type signature	Date:field type date
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HESI A2 Scores

Vocational Nursing Program Eligibility Questions

Statement of Student Responsibility

Emergency Contact Information

College/University

Previous Application Information

Demographic Information

By providing your electronic signature below, you agree that you have read the application, in its entirety, and that you have accurately filled out the application to the best of your knowledge.