Griffin Hospital School of Allied Health Careers (Under Implementation)

1186 New Haven Rd., Naugatuck, CT 06770

Practical Nursing Program Application

 

 Application Requirements:

 

All applicants who meet the minimum stated requirements listed above and pass the initial application review must undergo an admissions interview prior to the school rendering a decision regarding the applicant’s acceptance. Acceptance offers will be contingent upon the applicant obtaining a sufficient score on the HESI A2 Entrance Exam and receiving favorable screening results from the physical health and drug/toxicity screens.

 

 Applicant Information:

 

Name:

 

Address:

 

Contact:

 

Emergency Contact:

 

 Background Information:

If yes, please attach a separate page (typed) that includes the date of each incident, explains the circumstances, and reflects upon what you learned from the experience.

 

Additional demographic information: The questions in this section are optional. Information you provide will not be used in a discriminatory manner and is not factored into acceptance decisions.

For each question, please select all that apply to you and your identity.

With what gender do you identify?

 

With what race and/or ethnicity do you identify?

 

 Education

High/Secondary School:

 

College/ University:

 

Other:

 

 Work & Other Related Experiences

 

 Personal Statements

 

Part I
On a separate page, submit a typewritten essay answering one of the questions listed below. A
typewritten essay will help us become acquainted with you and demonstrate your ability to organize
and process your thoughts when expressing yourself. Your essay should be 500-600 words in length.
Please choose from one of the following topics, and indicate which question you are answering:
   
   1. Describe a significant experience, achievement, or ethical dilemma you have faced and its
impact on you.
   
   2. The lessons we take from obstacles we encounter can be fundamental to later success.
Recount a time when you faced a challenge, setback, or failure. How did it affect you, and
what did you learn from the experience?
   
   3. Describe a problem you’ve solved or a problem you’d like to solve. It can be an intellectual
challenge, a research query, an ethical dilemma – anything that is of personal importance, no
matter the scale. Explain its significance to you and what steps you took or steps that could
be taken to identify a solution.
   

 

Part II
On a separate, typewritten page, write one to two paragraphs discussing why you want to attend
nursing school.

 

 Additional Documentation

Please attach the following documents to your application:

 

 Application Fee

All applications must be accompanied by the $100 non-refundable application fee.


Applications cannot be reviewed until the fee is paid.


Please indicate below how you plan on paying the application fee:

  School of Allied Health Careers Practical Nursing Program
  Practical Nursing Program
  1186 New Haven Road
  Naugatuck, CT 06770

**The School of Allied Health Careers is NOT responsible for payment sent & lost in the mail**

 

 Attestation & Signature

I certify that my answers are true and complete to the best of my knowledge.


If this application leads to acceptance, I understand that false or misleading information in my application or interview may result in release from the Griffin Hospital School of Allied Health Careers Practical Nursing Program.

By submitting this form, you agree to receive text messages regarding schooling at the cell number you provided. You may reply STOP to opt out of SMS messaging. Msg and data rates may apply

 

 

Griffin Hospital School of Allied Health Careers does not discriminate, nor will tolerate from other disciplines, discrimination on the basis of race, color, national or ethnic origin, religion, age, gender, marital status, sexual orientation, handicap, veteran status, gender identify or any other basis prohibited by law in the administration of its educational policies, admission policies, scholarship and loan program, and other programs administered by the School of Allied Health Careers.


Thank you for applying to the Griffin Hospital School of Allied Health Careers Practical Nursing
Program. We look forward to reviewing your application.