Nursing Application - Track 4: Part-Time Evening & Weekend Advanced Placement Option for LPN Transition Name * Required First Last * Required Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Student ID * Required Phone * RequiredEmail * Required Enter Email Confirm Email This is the method you will be notified of status.Have you lived in the Virginia jurisdiction of Lee, Wise, Scott, Dickenson County, or the City of Norton OR the Tennessee jurisdiction of Sullivan County or the City of Kingsport during the last consecutive 12 months? * Required Yes No Did you attend credit classes at MECC before Fall Quarter 1984? * Required Yes No Please list all colleges attended since high school.Last College AttendedStateDegree ReceivedLast Year AttendedI have previously turned in college transcripts to MECC Enrollment Services. * Required Yes No If no, please have them sent to Enrollment Services at enroll@volamdolong.comTranscripts from other Virginia Community Colleges are not required; however, any Virginia Community Colleges attended must be listed on this application. I have previously turned in high school/home school/GED transcripts to MECC Enrollment Services. * Required Yes No If no, please have them sent to Enrollment Services at enroll@volamdolong.comI am requesting to use previous TEAS testing scores. I understand that the testing date must be within the last 5 years, they must meet the minimum acceptable score and the ATI TEAS Individual Performance Profile transcript must be attached to this application. * Required Yes No Attach ATI TEAS Individual Performance Profile Transcript here. * Required Drop files here or Select files Max. file size: 50 MB. Students will not be able to submit their application without attaching the transcript. Please note that the red "x" is the option to remove the file once uploaded.Please attach the Information Change Form (required if you have had to change your name, mailing address, or phone number.Max. file size: 50 MB.Please visit yinlumou.volamdolong.com/forms for the Information Change FormI understand after submission, I will contact Deb Clarkston, program director by email at dclarkston@volamdolong.com to verify your program application has been received. She will be glad to confirm. Confirmation of the receipt of your program application is the responsibility of the student. * Required Please check I request that my name be placed in consideration for admission to the Nursing program for the academic year. I understand that I must submit an application/reapply for each year I wish to be considered. I understand that I must satisfactorily complete (with a grade of “C” or better) all prerequisites and I must meet all admission requirements in order to be eligible for consideration. I have read and understand the residency requirements as well as the Nursing Application Process information. I understand that if I do not meet jurisdiction requirements that I should meet with a faculty advisor to discuss other educational opportunities. I also understand that if I do not have all required documents submitted with this application and have all requirements met by the deadlines specified, processing of my Nursing (RN) application will be suspended.NameDateEmailThis field is for validation purposes and should be left unchanged.