Nursing Application Form

Eastern Arizona College Nursing Program Application

Before beginning this application, please review the Nursing Program website.

This application must be completed in one sitting/session. You will not be able to save your application and complete it later. This application may take between 15 - 30 minutes to complete.

Application Requirements

Documentation of these requirements is needed to submit application. Please have them prior to beginning the application. Items must be submitted individually in .pdf (Adobe) or .doc (Word) document format.

1. Arizona Department of Public Safety, Level 1 Fingerprint Clearance Card or AZDPS receipt showing "in progress."

2. EAC Reading Placement Test score of 263 (Accuplacer Next Gen) or higher. You can find this score in your Gila Hank > Documents > Placement Scores. You must upload an EAC reading placement score. However, if your EAC Reading Placement Score is less than 263, you must also upload either: TEAS Reading (72.4% or higher) OR College Degree (Associates or higher).

3. Current American Heart Association CPR / Basic Life Support (BLS) card or transcript showing "in progress."

4. NUR 100 or Arizona Licensed Nursing Assistant (LNA) number that is current and in good standing; or AZBN receipt showing "in progress." You can find this document here: https://azbn.boardsofnursing.org/licenselookup

5. TEAS Nursing Entrance Exam with a Proficient score or higher (taken within 2 years of application) OR HESI A2 exam with a score of 850 or higher, will be accepted if completed for another institution (within 1 year of application.)

6. Unofficial Transcripts - showing completion of all pre-requisites and any co-requisites; from all institutions.

** Employer letters are no longer being requested. **

Application Deadlines

Fall Admission: Applications are due by April 1.
Spring Admission: Applications are due by November 1.

PERSONAL INFORMATION

First Name

Last Name

Birthdate

Email Address

Cell Phone Number

Mailing Address

Country

Street

City

Region

Postal Code

EDUCATION STATUS

Have you ever attended Eastern Arizona College?

Yes

No

EAC Student ID#

How many credits have you completed at EAC?

Have you previously applied to EAC's Nursing Program?

Yes

No

Which semester did you apply?

Fall

Spring

Summer

Which year did you apply?

Have you previously been enrolled in NUR 120?

Yes

No

What semester and year were you enrolled in NUR 120?

ADMISSION REQUIREMENTS

Include copies of all required documents as indicated below when submitting application.

Do you have an Arizona Department of Public Safety LEVEL 1 Fingerprint Clearance Card?

Yes

No

In Progress

What is the expiration date?

Upload a PDF copy of your card (front & back)

Upload a copy of receipt verifying payment.

Reading Placement Test score minimum of 263 (Accuplacer Next Gen) OR TEAS Reading (72.4% or higher) OR College Degree (Associates or higher)

Do you have a reading Placement Score?

Yes - ANG score is 263 or higher

Yes - ANG score is below 263

No

In Progress

Attach copy of Reading Placement Test

PDF Only

My reading placement score is not 263, so I am submitting one of the following documents:

TEAS reading score 72.4% or higher

College degree AAS or higher (transcript or diploma)

Attach copy of your TEAS exam report OR College Degree

pdf only

Current American Heart Association CPR/Basic Life Support (BLS) card. Must be Healthcare Provider level (EMT121)

Do you have an AHA (American Heart Association) / BLS CPR card?

Yes

No

In Progress

Upload a copy of CPR/BLS card. Must be AHA BLS card.

PDF only

Upload a copy of transcript/receipt showing that AHA/BLS CPR is "in progress."

pdf

Arizona Licensed Nursing Assistant (LNA) number

Do you have an Arizona Licensed Nursing Assistant (LNA) number that is current and in good standing?

Yes

No

In progress

Upload a copy of Arizona LNA number that is current and in good standing.

PDF

Attach a copy of transcript/receipt showing that NUR100 or LNA is "in progress."

PDF

TEAS Examination. TEAS level must be Proficient to be accepted.

Do you have a TEAS examination score report?

Yes

No

In Progress

Upload a copy of TEAS score verifying the overall level & breakdown score for each area or request verification.

pdf

TEAS Level

Basic

Proficient

Advanced

Exemplary

TEAS Test Date

PRE-REQUISITE COURSES

Upload unofficial transcripts for all courses completed. For courses in which you are currently enrolled, select "In Progress." For courses completed at another institution, request official transcripts to be sent to Eastern Arizona College for evaluation. Co-requisite classes may be taken while in the program. Many applicants choose to complete as many classes as possible prior to application. Classes completed at the time of application are awarded points and provide a better chance for admission.

Upload Unofficial Transcripts

PDF only

HCE 116 - Medical Dosage Calculations

Completed Course

In Progress

Not Complete

Pass Medical Dosage Challenge Exam

Which Semester and Year did you complete HCE 116?

What was your exam score?

Which Semester and Year did you complete your last math course?

Upload a copy of Math Placement Test Score

pdf

PSY 101 - Introduction to Psychology

Completed Course

In Progress

Not Complete

Which Semester and Year did you completed PSY 101?

Highest level of CHEMISTRY class completed

None taken

In-Progress (CHM 130 or 138)

CHM 130 Fundamental Chemistry

CHM 138 Introduction to General, Organic, and Biological Chemistry

CHM 151 General Chemistry I

CHM 152 General Chemistry II

CHM 235 General Organic Chemistry I

CHM 236 General Organic Chemistry II

Which Semester and Year did you complete Chemistry?

BIO 201 Human Anatomy and Physiology

Completed Course

In Progress

Not Complete

Which Semester and Year did you complete BIO 201?

CO-REQUISITE COURSES

BIO 202 Human Anatomy and Physiology II

Completed Course

In Progress

Not Complete

Which Semester and Year did you complete BIO 202?

NUR 219 Pharmacology for Nursing

Completed Course

In Progress

Not Complete

Which Semester and Year did you complete NUR 219?

BIO 205 Microbiology

Completed Course

In Progress

Not Complete

Which Semester and Year did you complete BIO 205?

HCE 240 Human Pathophysiology

Completed Course

In Progress

Not Complete

Which Semester and Year did you complete HCE 240?

ENG 101 Written Communications I

Completed Course

In Progress

Not Complete

Which Semester and Year did you complete ENG 101?

ENG 102 Written Communications II

Completed Course

In Progress

Not Complete

Which Semester and Year did you complete ENG 102?

OFFICIAL TRANSCRIPTS
If you have graduated from high school and are a current EAC student, transcripts are not needed.

If you are a current high school student, a recent high school graduate without college experience, or a transfer student from another college: Please send an official transcript to: Eastern Arizona College; Attn: Admissions & Registration Office; 615 N Stadium Avenue; Thatcher, AZ 85552.

Official transcripts must be received directly from the high school or previous college. For questions regarding official transcripts, please contact the Admissions Office at 928-428-8270.

CERTIFICATION

I certify that all the information provided by me is true, complete and accurate. I am responsible for provision of all requested information. Failure to provide proper documentation may adversely affect my evaluation. I acknowledge that admission into the program is conditional upon successfully completing all requirements by stated deadlines.

I certify that all the information provided is true, complete, and accurate.

Yes