Associate Degree Nursing Program LVN-ADN Transition Program Application

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Associate Degree Nursing Program LVN-ADN Transition Program

Deadline: March 1

Student ID (V#)

First Name

Last Name

Middle Name (optional)

Are there any other names which might appear on a transcript? If so, please list:

First Name

Last Name

Middle Name (optional)

Mailing Address:

City:

State:

Zip:

Cell Phone

Home Phone

VC Student Email

Emails regarding your LVN-ADN Program application status will be sent to your Victoria College email address listed above.

Have you ever been enrolled in a Victoria College Nursing Program?

Yes

Please give information concerning high school graduation or GED completion:

Name of High School or GED Institution

City/State of High School or GED Institution

Type:

Diploma

GED

Have you ever been enrolled or ever attended another college, university, vocational or allied health schools?

Yes

Name of College or University

Dates Attended

Total hours earned

Name of College or University

Dates Attended

Total hours earned

Name of College or University

Dates Attended

Total hours earned

Statement of Nondiscrimination

Victoria College does not discriminate on the basis of race, color, religion, national origin, gender, pregnancy, age, disability, genetic information, marital status, amnesty, veteran’s status, or limited English proficiency. It is our policy to comply, fully, with the nondiscrimination provision of all state and federal rules and regulations.

By clicking the check box, I attest that the information provided is true and correct.

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