Student Information Collection Form

Practical Nursing Application

Ben Hill; Coffee, and Valdosta Campuses
Practical Nursing (LPN) General Description

The Practical Nursing program is designed to prepare students to write the NCLEX-PN for licensure as practical nurses. The program prepares graduates to give competent nursing care. This is done through a selected number of occupational courses providing a variety of techniques and materials necessary to assist the student in acquiring the needed knowledge and skills to give competent care. The nursing program covers all theoretical content areas outlined in Georgia Board Rule 410-9-06( 5a & 5b). A variety of clinical experiences is planned so that theory and practice are integrated under the guidance of the clinical instructor. Program graduates receive a practical nursing certificate and have the qualifications of an entry-level practical nurse.
Name*

First NameLast Name
WGTC Email*
example@example.com
WGTC Student ID (900#)*
Phone Number*
Please enter a valid phone number.

HESI A2 Information -Please Read Carefully!

The HESI A2 exam must be taken at Wiregrass. Scores from other institutions will not be accepted. Both the cumulative and critical thinking portion of the exam must be completed. HESI scores are valid for 2 years and must be valid at the application deadline date. Applicants have 3 attempts per 2 years to complete the HESI A2 exam.
Do you have a valid HESI with WGTC that is no older than 2 years old by the application deadline for the respective campus and term? (AND) Is the Cumulative score 60 or better ?*
Please Only Enter Your HESI Cumulative Score *

Bonus Points: Applicants may be awarded up to 5 additional points on their ranking score for possessing any of the following items:

No other criteria will be considerd or awarded points.
- Certified Paramedic License
- CMA through AAMA Certification
- Certified Nursing Assistant (CNA License)
- Certified EMT/AEMT
- AMT/ASCP Certification (Phlebotomy)
- Degree or Diploma (from a college, university, or other postsecondary
  institution accredited by a regional or national accrediting agency recognized by the U.S. Department of Education at the time the course was taken.
  In the event of multiple licensure/certification, college diploma, or degree, points will only be applied once (maximum of 5) to the ranking score once.
  Tiebreaker- Applicant may earn an additional 5 points for active licensure, certificate, diploma, or degree to be utilized only as a tiebreaker.
What Bonus Point Consideration Are You Requesting?*

Certified Paramedic LicenseCMA through AAMA CertificationCertified Nursing Assistant (CNA License)Certified EMT/AEMTAMT/ASCP Certification (Phlebotomy)Degree or Diploma (from a college, university, or other postsecondary institution accredited by a regional or national accrediting agency recognized by the U.S. Department of Education at the time the course was taken.No Points Requested
Please upload your supporting documentation for Bonus Point consideration.

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Practical Nursing Application