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Practical Nursing Application

Application for entry consideration for the Practical Nursing program.

"*" indicates required fields

Name*
Address*
Permanent Address*
Educational Information: High School name & location of last high school attended: (Must submit copy of transcript)*
Name of high school
City
State
Year graduated from high school or last year in school
 
General Educational Development (GED) Information: (Must submit copy of score & certificate)*
Score:
Date Taken:
Testing Location:
 

Applicants graduating from a high school outside the United States must complete the GED test.

List other schools attended: (Include career tech, colleges, universities, etc.*
School Name
School City
School State
 
Record of Employment:*
Name of Employer
Address or Phone Number
Dates of Employment (List most recent first)
May we contact
 

Applicants may submit up to 3 reference letters from employers and/or past professors/teachers. Applicants will receive points for each letter submitted.

MID-DEL SCHOOL DISTRICT STATEMENT OF NONDISCRIMINATION

The Mid-Del Public School District No. I052 does not discriminate on the basis of race, color, national origin, sex, pregnancy, gender, gender expression or identity, religion, veteran status, sexual orientation, disability, age, or genetic information in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups. The following person has been designated to handle inquiries regarding the non-discrimination policies: Mid-Del Schools Assistant Superintendent of Teaching & Learning Address: 7217 SE 15th 15th Street, Midwest City, OK 73110 Phone: 405.737.4461 x1225 Email: kdunn@mid-del.net

Questions, Comments, and Suggestions

"*" indicates required fields

Name*
Course Type

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