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College of DuPage
Practical Nursing Program
Application Packet for Class Starting
January 2009
All admissions material must be admitted by August 11 at 8:00 AM, 2008. Further details found within
packet.
This program is funded in part (39 percent) by a $1.4 million U.S. Department of Labor,
President’s Community-Based Job Training Grant.
The Practical Nursing program at College of DuPage has been approved by the Illinois Community
College Board (ICCB) and the Illinois Department of Financial and Professional Regulation/Board of
Nursing, 320 W. Washington, 3rd Floor, Springfield, IL 62786, (217) 785-0800.
The Practical Nursing program is a candidate for accreditation through the National League for Nursing
Accrediting Commission, 61 Broadway, 33rd Floor, New York, NY 10006 (800) 669-1656, ext. 153.
This product was funded by a grant awarded under the President’s Community-Based Job Training Grants as
implemented by the U.S. Department of Labor’s Employment & Training Administration. The information
contained in this product was created by a grantee organization and does not necessarily reflect the official
position of the U.S. Department of Labor. All references to non-governmental companies or organization, their
services, products, or resources are offered for informational purposes and should not be construed as an
endorsement by the Department of Labor. This product is copyrighted by the institution that created it and is
intended for individual organizational, non-commercial use only.
1/30/08
College of DuPage
Practical Nursing Program
The application deadline is Aug. 11, 2008,
at 8 a.m. for the class starting January 2009.
The Practical Nursing (PN) program at College of DuPage begins in January and runs 12 months
through December. Upon successful completion of the program, the student earns a certificate
from the college and is eligible to sit for the state examination (NCLEX-PN) for licensure as a
Licensed Practical Nurse.
This program packet is published for informational purposes only. The information in this packet
is not to be regarded as an irrevocable contract between the student and the program. The
program reserves the right to change, at any time without notice, program completion
requirements, fees and other charges, curriculum, course structure and content, and other such
matters as may be within its control, not withstanding any information set forth in the program
information packet in accordance with the College of DuPage policies and procedures.
This packet includes the following information and forms needed to complete the application
process for the Practical Nursing program:
Initial application procedure and requirements, including prerequisite courses, the
admissions process and other details
Explanation of provisional acceptance status
Program course, timeline and time commitment
Standard skills required for all health care programs
Professional behavior in clinical settings
Forms to be completed
Admission to the Practical Nursing program is through the Health Sciences Admissions office,
IC 1048A, (630) 942-3924. Attendance at an Advising Session (also referred to as an
Information Session) is required. Please visit: www.cod.edu/hsbs/sessions.htm for upcoming
dates, times and locations.
Information about the PN program also can be obtained by contacting the Health Sciences
Admissions office, the Practical Nursing coordinator, or the Practical Nursing faculty.
If you have any further questions after attending an Advising Session, please contact any of the
personnel listed below:
Deb Jeffay, Health Science Admissions Coordinator (630) 942-3924, Jeffay@cod.edu
Donna Badowski, PN Faculty (630) 942-4840, Badowski@cod.edu
Theresa Bucy, PN Faculty (630) 942-4813, Bucyth@cod.edu
Linda Caputi, PN Program Coordinator (630) 942-2179, Caputi@cod.edu
Note: It is the student’s responsibility to ensure that all steps have been completed and
that all information has been received. Students who submit incomplete information will
not be considered for placement in the Practical Nursing program.
1/30/2008 2
Introduction
Thank you for your interest in the College of DuPage Practical Nursing program. You are
applying for a “limited enrollment” program, which means that not everyone who applies will be
admitted into the program. There are a number of entrance requirements; completion of all these
requirements makes the student eligible for consideration, but DOES NOT guarantee admission
to the program. All information in the students’ application files is considered in the aggregate
when selecting applicants for admission. Selection criteria are determined by the Admissions
Committee and are based on information relative to the total applicant pool. In addition, priority
is given to applicants who reside within College of DuPage District #502.
Please note: applicants who work in-district but reside out-of-district are considered out-of-
district for admissions purposes. Working in-district but residing out-of-district allows students
to attend College of DuPage and pay in-district tuition. Students who works in-district but live
out-of-district must work full-time in-district to be eligible for in-district tuition rates. Note: It is
extremely difficult to succeed in the Practical Nursing program while employed in a full-time
position.
Initial Application Procedure
Initial application to the Practical Nursing program requires that the following items be
completed and submitted no later than 8 a.m. on Monday, Aug. 11, 2008.
1) Complete an Admission Form for College of DuPage at SRC 2046 or online at
www.cod.edu/AdRegRec/Admiss/Admissio.htm (curriculum code: 4160). This is an
Admission Form for College of DuPage only; it is not an application to the Practical Nursing
program. You must complete this form before applying to a specific program within the
college. If you have taken courses at College of DuPage previously, you have already
completed this step.
2) Complete a Certified Nursing Assistant course and pass the CNA certification exam
administered by the Illinois Department of Public Health. Submit a copy of the Certified
Nursing Assistant certificate you received from the Illinois Department of Public Health
registry that indicates you have passed your CNA certification exam. This document must be
less than five years old. If your CNA certificate is more than five years old, then you must
submit a copy of the certificate AND provide a signed letter from an employer verifying
employment as a CNA within the last five years. Submit this documentation to the Health
Sciences Admissions office, IC 1048A.
3) Complete Psychology 1100 or equivalent with a grade of C or higher.
4) Complete Psychology 2237 or equivalent with a grade of C or higher.
5) Complete, within the last seven years:
Anatomy and Physiology 1500 OR
Anatomy and Physiology 1551 AND 1552 OR
Anatomy and Physiology 1571 AND 1572 OR
An equivalent course with a grade of C or higher
***Please Note: Anatomy and Physiology 1500 is NOT accepted as a prerequisite for the
Associate Degree Nursing (ADN) program at College of DuPage. Do not enroll in this course
if you plan to apply to that program in the future.
6) Send official copies of your transcripts from high school OR GED scores and other
colleges/universities attended to the College of DuPage Records office, College of DuPage,
SRC 2015, 425 Fawell Blvd., Glen Ellyn, IL 60137.
1/30/2008 3
***Please Note: If you are submitting an international transcript as proof of any of your credit,
the transcript must be evaluated by an approved current National Association of Credential
Evaluation Services (NACES) member.
7) Complete the Practical Nursing Application Form on pages 10 and 11 of this document.
Submit this form to the Health Sciences Admissions office, IC 1048A.
8) Complete the Cashier’s Form on page 12 of this document and submit it with the mandatory
$50 non-refundable Practical Nursing program application fee to the College of DuPage
Cashiers office, SRC 2049A.
9) Complete the College of DuPage Reading Placement Test (within the last five years) with a
score of “Category One.” Contact the Testing office, (630) 942-2400, or visit:
www.cod.edu/testing/placement_testing.htm. Note: All applicants MUST take the Reading
Placement Test regardless of having completed English courses or having taken any
number of college credit hours. This college exam is used in lieu of other proprietary
entrance exams to save students additional costs for these tests. The Health Sciences
Admissions office will obtain your results from the C.O.D. Testing office.
10) Complete the College of DuPage Math Placement Test (within the last 5 years). Contact the
Testing office, (630) 942-2400, or visit: www.cod.edu/testing/placement_testing.htm. Note:
All applicants MUST take the Math Placement Test regardless of having completed
math courses or having taken any number of college credit hours. This college exam is
used in lieu of other proprietary entrance exams to save students additional costs for these
tests. The Health Sciences Admissions office will obtain your results from the Testing office.
11) Sign the Audit Form on page 12 of this document and submit it to the College of DuPage
Records office, SRC 2015.
12) Attend a Practical Nursing Advising Session and sign the attendance document distributed at
that session. You must sign one of these forms that will be kept in your file. This signed form
is necessary for admission. You must also provide proof of identification with a government-
issued document such as a driver’s license. You must attend the entire session to fulfill this
requirement. Visit www.cod.edu/hsbs/sessions.htm for upcoming dates, times and locations.
IMPORTANT INFORMATION
1. All prerequisite courses and CNA certification noted above must be completed by December
23, 2008. If the student does not have these prerequisites completed by the admission
deadline of August 11, 2008, the student must provide evidence by August 11, 2008 of
enrollment in these courses during the fall, 2008, semester. Evidence of enrollment is due by
August 11, 2008. The student must then submit a transcript at the end of fall semester
indicating successful completion of the courses with a grade of C or higher to be accepted
into the program starting January, 2009.
2. In-district residents (students who live within the college district boundaries) who meet all
admission requirements are given priority over out-of-district residents.
3. All admission materials must be submitted by 8 a.m. on August 11, 2008, for consideration
for the class starting the following January. No materials will be accepted after that date and
time.
4. It is entirely your responsibility to confirm with the Health Sciences Admissions coordinator
that your application is complete.
5. The content of the PN Admission Packet is the official information used as the source of
evidence in the event of misunderstandings or miscommunications.
6. Because the number of applicants to the PN program exceeds the number of students the
college can admit due to limitations of clinical space and other resources, completion of the
1/30/2008 4
above requirements determines eligibility for consideration for admission, but does not
guarantee admission into the PN program.
Provisional Admission
If you are one of the applicants selected for admission, you will be required to complete
additional steps. This is known as “provisional admission” because final admission is determined
by successful completion of these additional requirements. An overview of some of these
requirements is listed below. Specific information about these additional requirements will be
provided when the student receives a letter of selection for provisional admission.
1) Earnest deposit fee of $100. This non-refundable deposit will be applied to your tuition bill
and will hold your place as a student in the Practical Nursing program.
2) Proof of completion of any perquisites courses taken during the Fall, 2009 semester. Must
earn a C or higher in these courses.
3) Proof of state certification as a Certified Nursing Assistant if certification was not submitted
by August 11, 2008, because the student is enrolled in a CNA course during the Fall, 2008
semester.
4) Health history and physical examination. Applicants admitted to the PN program must
complete and submit a health history and physical examination certifying that their health
status will allow them to safely pursue the educational objectives of the Practical Nursing
program.
5) Proof of immunization against a number of communicable diseases and evidence of having
received the Hepatitis B vaccine
6) TB test or chest X-ray
7) Mandatory drug screen
8) Proof of completion of CPR for Health Care Providers
9) Criminal background check. A student found to have a disqualifying offense will not be
admitted to the program. Criminal convictions (both felonies and misdemeanors) that
disqualify an individual from working in a direct care position include the following:
Battery, domestic battery, aggravated battery
Assault
Forgery
Receiving or using another person’s debit or credit card without permission
Financial identify theft
Theft, retail theft
Robbery, armed robbery, aggravated robbery
Burglary, residential burglary
Armed violence
Criminal trespass to a residence
Financial exploitation of an elderly or disabled person
Murder, homicide, manslaughter
Kidnapping, child abduction
Unlawful restraint, forcible detention
Indecent solicitation of a child, sexual exploitation of a child
Tampering with food, drugs, or cosmetics
Aggravated stalking
Home invasion
Sexual assault, sexual abuse
Endangering the life or health of a child
1/30/2008 5
Abuse or gross neglect of a long-term care facility resident
Criminal neglect of an elderly person
Ritual mutilation, ritualized abuse of a child
Vehicular hijacking, aggravated vehicular hijacking
Arson, aggravated arson, or residential arson
Unlawful use of a weapon
Manufacture and delivery of controlled substances (drugs) or cannabis (Marijuana)
Possession with intent to deliver (either drugs or marijuana)
Illegally receiving, selling, or using credit or debit cards
Note: You may have been convicted but not sent to jail. People are often fined or given
probation or conditional discharge rather than jail time, but these are still considered convictions.
If you are unsure as to whether an arrest resulted in a conviction, contact the county in which you
were arrested and speak to a representative in the Circuit Clerk or State’s Attorney’s office, or
your attorney.
Please note: If you have been found guilty of a felony, you may have difficulty obtaining a
license and/or becoming registered to practice in this profession.
Non-Discrimination Policy
The college will not discriminate in its programs and activities on the basis of race, color,
religion, creed, national origin, sex, age, ancestry, marital status, sexual orientation, arrest record,
military status or unfavorable military discharge, citizenship status, physical or mental handicap
or disability (Board Policy #5010, web site: www.cod.edu/nondiscrimination.htm).
The following persons have been designated to handle student inquiries regarding the non-
discrimination policies:
Vice President for Enrollment and Student Affairs
Instructional Center (IC), Room 2115, (630) 942-2485
For Americans with Disabilities Act accommodations call (630) 942-2141 (voice) or
(630) 858-9692 (TDD).
Note: Please do not call the numbers above for information about the Practical Nursing
program.
1/30/2008 6
The PN Program Schedule
The Practical Nursing program begins every January and runs continuously through December,
including the spring, summer and fall semesters.
Below is a listing of the courses. Please note the number of hours spent in class every week.
These hours do NOT include time for completing homework assignments, reading and studying
for exams. Please carefully consider this time commitment when making your decision to apply
to the Practical Nursing program.
Spring 2008 – 16 weeks
[25 hours per week in class]
Two classes are taken concurrently:
Practical Nursing 1101: Practical Nursing Concepts and Skills I
10 credit hours (4 clinical; 4 lecture; 2 lab)
Practical Nursing 1102: Pharmacology for the Practical Nurse
4 credit hours (3 lecture; 1 lab)
Summer 2008 – 8 weeks
[18 hours per week in class]
Practical Nursing 1103: Practical Nursing Concepts and Skills II
5 credit hours (2 clinical; 3 lecture)
Fall 2008 – 16 weeks
[First 8 weeks = 27 hours per week in class]
[Second 8 weeks = 25 hours per week per class]
First 8 weeks – Practical Nursing 1104: Practical Nursing Concepts and Skills III
7 credit hours (2 clinical; 4 lecture; 1 lab)
Second 8 weeks – Practical Nursing 1105: Practical Nurse Role Transition
5 credit hours (3 clinical; 2 lecture)
16-week course – Practical Nursing 1106: Issues and Trends in Practical Nursing
3 credit hours (3 lecture)
1/30/2008 7
Standard Skills in Health Care Programs
To participate in any Health Career program at College of DuPage which has a direct patient care
or clinical education component, applicants must possess additional non-academic skills. These
occupational standards are consistent with the duties of the entry-level professional in that field
and are set by the individual program. These skills which protect the health and well-being of
patients may include but are not limited to the ability to:
1. Lift and carry 30 pounds of weight.
2. Lift and transfer patients to and from wheelchairs, stretchers, beds and imaging tables.
3. Move, adjust and manipulate equipment.
4. Position patients for exams.
5. Respond appropriately to sounds, such as the patient's voice and movements, at a normal
conversational volume.
6. Respond appropriately to equipment signals such as sound and light.
7. Manipulate the necessary hospital equipment for patient care such as dials, switches, push
buttons and keyboards.
8. Perform for a prolonged period without breaks in a typical shift of eight hours.
9. Communicate orally and in writing with patients, physicians and other personnel clearly
and effectively. Must be able to follow verbal and written directions.
Students who do not meet these standards may be considered ineligible for the PN program and
can be withdrawn from all program classes. If you are unsure whether you can meet these
requirements, you are advised to consult an adviser, counselor or member of the program faculty
to discuss the situation and/or schedule an appointment with your physician prior to making
application or enrolling for classes.
If an acute condition arises while enrolled in the PN program, a written statement must be
obtained by the student from the physician stating the student’s ability to move, lift and transfer
patients without restriction. The above requirements also pertain to pregnancy.
Please Note: Conviction of a felony will not prevent your admission to this program but may
make it difficult for you to obtain a license to practice. You may wish to clarify this situation
with the program coordinator before you apply. All applicants for the licensure exam
(NCLEX-PN) are required to have a criminal background check and fingerprinting for licensure.
1/30/2008 8
Policy for Professional Conduct
Health Science Programs
POLICY FOR PROFESSIONAL CONDUCT AT CLINICAL SITES
Revised Fall 2005
Socialization of students to appropriate professional conduct is a significant component of the Health Science Programs of
College of DuPage (the “Programs”). Students in the Programs are expected and required to be reliable and competent, exercise
sound judgment, act with a high degree of personal integrity, represent College of DuPage (the “College”) in a respectful manner,
and observe all the rules and regulations of the clinical sites to which they are assigned. Students also have a responsibility to
protect the welfare and safety of the patients/clients for whom services are being provided.
In accordance with these expectations, when assigned to clinical sites, students in the Programs must adhere to the following
Policy for Professional Conduct. This Policy is in addition to the Student Code of Conduct outlined in College catalogs and/or
policy. The Policy of Professional Conduct includes, but is not limited to,
1. Providing competent and reliable services to patients/clients using sound judgment and discretion. Students are
expected to:
a. be on time
b. refrain from excessive absenteeism
c. remain in assigned work areas, leaving only with permission
d. not leave patients unattended
2. Demonstrating respect and courtesy to patients/clients and their families
3. Demonstrating respect and courtesy to instructors, supervisors and all other members of the health care provider team
at the site
4. Cooperating with faculty, staff and peers without insubordination
5. Providing care and/or services on a non-discriminatory basis
6. Performing only procedures and/or services authorized by supervisor(s) in accordance with accepted professional
standards.
7. Observing the rules and regulations of all clinical facilities including
a. Proper use of equipment and other property
b. Not removing property of clinical facilities
c. Not distributing, possessing illegal drugs or controlled substances,
d. Not possessing or being under the influence of alcohol, and
e. Complying with drug testing requirements*
8. Maintaining the confidentiality of patient/client information in accordance with recognized professional and
institutional rules; without unauthorized release and/or misuse of patient/client information or institutional data
9. Maintaining proper dress, appearance, hygiene and decorum in accordance with the standards set by the program,
clinical site, and professions
10. Complying with the ethical and professional standards set by the profession and the Programs including:
a. Never taking prescription blanks or writing prescriptions
b. Never falsifying documents regarding student performance or the care of patients
The penalty for violating the Policy for Professional Conduct will be discipline up to and including suspension or
dismissal from the Programs. Due to the sequential design of the curriculum in most Health Science programs, any
period of suspension or dismissal may result in a delay in program completion.
If the disciplinary action is suspension or dismissal from one of the Programs, the student may appeal that disciplinary
action to the Health Sciences Professional Conduct Review Board within 10 days of the discipline imposed. This appeal
must be in writing using the Request of Professional Conduct Review forms available in the Health Sciences Division
Office. The form must be submitted to the Associate Dean for Health Sciences.
The student will not be permitted to participate in the Programs during the appeal process. The appeal will result in a hearing
before the Health Sciences Professional Conduct Review Board, comprised of faculty from other COD health science
programs within 30 days of the date the appeal is filed with the Associate Dean. Both the student and faculty involved in the
disciplinary action may make an oral presentation to the Board in addition to written comments. There is no further appeal;
the decision of the Board is final. If the decision to dismiss or suspend a student from a Program is upheld, no refund of
tuition or fees or for equipment or books will be provided.
*Students are advised that College of DuPage will begin drug testing of Health Science students in all programs with direct
patient contact in the fall of 2003. College of DuPage Health Services will perform this drug testing at the student’s
expense. Drug testing will precede clinical experience in all cases and will be required prior to admission in some
programs. Positive results on a drug screen or misrepresentation regarding drug use will lead to immediate dismissal from
the Programs.
Students are responsible for reading the Policy for Professional Conduct and signing of the Acknowledgment found on the
back of the Application for Admission.
1/30/2008 9
PRACTICAL NURSING (PN) Program Admission Application
Applying for PN Program for Spring 2009
PLEASE RETURN THIS TO: Health Sciences Admissions Office, IC 1048A
College of DuPage, 425 Fawell Blvd., Glen Ellyn, IL 60137
Name: / /
Last First Previous
Mailing Address:
City: State: Zip:
Home Phone: ( ) Work Phone: ( )
E-mail Address:
Social Security Number: ___ - _ - _ Date of Birth:
Citizenship/Visa Status:
__ U.S. Citizen __ Permanent Resident of U.S.
__ F-1 or J Student Visa __ Work Visa (H, L or AuPair Visas)
__ Tourist/Visitor/B-1, B-2 Visa __ Refugee __ Other
Ethnic Origin:
__ Native American __ Alaskan Native
__ Hispanic __ Asian Pacific Islander
__Caucasian/Non-Hispanic __ Black/Non-Hispanic
Last High School Attended:
Graduation Year: GED:
College(s) Attended Dates Attended Degree Earned Major
__________________ _______________ ______________ ______________
__________________ _______________ ______________ ______________
__________________ _______________ ______________ ______________
*Be sure to include C.O.D. courses, certificates or degrees.*
You are responsible for ensuring that all C.O.D. transcripts have been sent to and received by
the Health Sciences Admissions Office, IC 1048A, before 8 a.m. on Aug. 11, 2008, to be
considered for admission into the PN program.
Applied to Program Previously ___ YES ___ NO YEAR: _________
Transcripts Sent: To Records Office
1/30/2008 10
Complete the following information concerning admission requirements.
Course Grade/Score Date Completed College Where Taken
Certified Nursing
Assistant
Psychology 1100
Psychology 2237
A&P 1500 or
A&P 1551 and 1552 or
A&P 1571 and 1572
Placement Tests – Required (These tests are Date Completed
required regardless of college-level courses
taken.) Must be taken no more than five years
prior to application.
Reading Placement Test
Math Placement Test
ACKNOWLEDGEMENT
I acknowledge receipt of the Health Sciences Programs Policy for Professional Conduct. I have
read and understand the statement and agree to abide by the standards and rules set forth therein.
I understand that failure to abide by the Policy for Professional Conduct may result in my
suspension or dismissal from the Programs. I understand that I will not receive a refund of tuition
or fees or for books, supplies or equipment purchased should I be dismissed from the Programs
for violating this policy.
Signature Date
Also, I give my permission to the Health Science Admissions office to request copies of my
College of DuPage transcripts to be sent to the Health Science Admissions office for admission
and retention purposes.
Signature Date
Name (Please Print)
NOTE: THIS APPLICATION IS FOR USE BY THE PRACTICAL NURSING PROGRAM ONLY. IF YOU ARE NOT
CURRENTLY A STUDENT AT COLLEGE OF DUPAGE, YOU MUST APPLY TO THE COLLEGE IN THE
ADMISSIONS OFFICE.
RETURN THIS FORM TO: College of DuPage
Health Sciences Admissions (IC 1048A)
425 Fawell Blvd.
Glen Ellyn, IL 60137
1/30/2008 11
PRACTICAL NURSING 2009 Certificate Code #4160
Cashier’s Office
If you have completed an application for admission to the Practical Nursing program, the next step is to submit your
$50 non-refundable application fee to the Cashier’s office, SRC 2049A, at College of DuPage with the top portion
of this page. Your $50 fee must be paid before submitting the Audit Form to the Records office. (You may use your
credit card and pay over the phone.)
_______________________________________ FORM OF PAYMENT
Name (Please Print) CASH CHECK
CREDIT APPROVED
________________________________
Social Security Number
-------------------------------------------------------------------------------------------------------------------------------
(Cut Here)
Health Sciences Adviser Audit Form 2008 Certificate Code #4160
Records Office
College of DuPage Practical Nursing
This adviser Audit Form is a formal request to have your transfer credits and high school credits evaluated and/or
sent to the Health Sciences Admissions office, IC 1048A, for Practical Nursing from the College of DuPage Records
office.
IMPORTANT: Complete and return this form AFTER your transfer credits and high school credits have arrived
at the College of DuPage Records office. To verify arrival of transcripts, contact the Records office, (630) 942-3829.
Social Security Number:
Student name:
Previous name(s):
Daytime telephone: __________________________E-mail:
If needed, name of high school: Year graduated:
Names of colleges/universities/ACE/military transcripts to be sent:
==================================================================================
For Office Use Only
Prior Folder Grad
RETURN THIS FORM TO: College of DuPage
Records Office, SRC 2015
425 Fawell Blvd.
Glen Ellyn, IL 60137
1/30/2008 12
