UNIVERSITY OF HOLY CROSS DEPARTMENT OF NURSING APPLICATION FOR ADMISSION TO NURSING
A non-refundable application fee of $55.00 is required at the conclusion of this application in order to submit. Payment can be made via credit card or PayPal.
Personal Information
Legal First and Last name
*
First Name
Middle Name
Last Name
Permanent Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your Current Address different from your Permanent Address?
*
Yes
No
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
*
Please enter a valid phone number.
Email:
*
example@example.com
Date of Birth:
*
-
Month
-
Day
Year
Date
Place of Birth (City and State):
*
EX: New Orleans, La
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Statistics Purposes and Emergency Contact
Gender:
*
Male
Female
Other
Race:
*
Please Select
Asian (not of Hispanic origin)
Black or African American (not of Hispanic origin)
American Indian or Alaskan Native
Hispanic or Latino
White (not of Hispanic origin)
Married Status:
*
Single
Married
Divorced
Widowed
Legally separated
Religion:
*
Number of Children:
*
Ages of children:
*
Emergency Contact Name:
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell/Home phone:
*
Please enter a valid phone number.
Relationship to applicant:
*
Education History
List every University, College, or Vocational School (with dates of attendance, major area of study) you have ever attended. Begin with your current school first.
*
Have you ever previously been enrolled in a nursing program?
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Yes
No
Which type:
LPN
Diploma
A.D.
B.S.N
Reason for leaving:
Are you a licensed health care worker?
*
Yes
No
What type of license do you hold?
*
Do you hold an unencumbered license?
Yes
No
Has your license ever been probated?
Yes
No
Has your license ever been suspended?
Yes
No
Have you previously submitted an application to the Nursing Program at UHC?
*
Yes
No
Year Submitted:
Enter your 4-digit year
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Current Enrollment:
Have you applied and been accepted to UHC?
*
Yes
No
You will need to apply to the University of Holy Cross before applying to the Nursing Program.
Please apply at https://apply.uhcno.edu/apply/ contact the Admissions department at (504) 398-2175.
Are you currently enrolled at UHC?
Yes
No
Who is your pre-nursing advisor at UHC?:
You must contact your pre-nursing advisor for a copy of your transcripts and GPA sheet to be sent to Mrs. Kish. Your pre-nursing advisor will need time to prepare the sheet so contact them as soon as possible.
Select all periods where you were or plan to be enrolled for class
Fall 2024
Spring 2025
Summer 2025
List courses (with CREDIT HOURS) you are/were enrolled in for Fall 2024.
School:
List courses (with CREDIT HOURS) you are/were enrolled in for Spring 2025. This obligates you to register and complete the courses listed. Dropping or failing to register in these courses listed below could delay your admission into the Department.
School:
List courses (with CREDIT HOURS) you are/were enrolled in for Summer 2025. This obligates you to register and complete the courses listed. Dropping or failing to register in these courses could delay your admission into the Department.
School:
List any Honors, Awards, Scholarships/community involvement:
Please list any other pertinent information that may relate to this application.
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Public Notification Drug Policy for the Department of Nursing
The Department of Nursing has implemented a drug screening for illegal drugs, and an elevated alcohol level. The screening is required of all nursing students who enroll in the Department of Nursing and all nursing students enrolled are subject to random screening. The screening may also be required for cause. Nursing students who have a confirmed positive drug test will be reported to the Louisiana State Board of Nursing.
*
Acknowledge reading this policy
Personal Commentary
In the space below, type a personal commentary addressing the reason(s) for desiring entry into the nursing profession.
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In the space below, type a personal commentary addressing the reason(s) for desiring admission to the Department of Nursing at University of Holy Cross.
*
References
Please request three persons (excluding relatives) to complete the Department of Nursing Reference Form on your behalf and email to KKish@uhcno.edu.
Your application is not complete until all three references are received
*
I understand my application is not complete until all three references are received.
I hereby certify that the information given in this application is true and complete.
Signature
*
Date
*
-
Month
-
Day
Year
Date
Nursing application fee:
*
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Application Fee
$
55.00
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Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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