Which Program Are You Applying For? * Choose a Program Adult Cardiac Diagnostic Medical Sonography – Fall 2024 Full-Time program Associate Degree Nursing – Fall 2024 Full-Time Program Associate Degree Nursing Hybrid Online – February 2024 Full-Time Program Medical Assistant – Fall 2024 Full-Time program Medical Laboratory Technology – Fall 2024 Full-Time program Practical Nursing – Fall 2024 Full-Time Program Surgical Technology – Fall 2024 Full-Time program
JALC Student ID *
Phone Number with Area Code *
Preference is given to in-district and CAREER Agreement applicants. Will you be a legal resident of JALC College District #530 or have an approved CAREER Agreement from your community college on file by the admission deadline? * Yes No
Preference is given to in-district applicants. Will you be a legal resident of JALC College District #530 by the admission deadline? * Yes No
High School attended or currently attending. If GED received, enter GED *
Are you transferring courses taken at another college for consideration within the ADN program guide? * Yes No
Are you transferring courses taken at another college for consideration within the ADN hybrid online program guide? * Yes No
Are you transferring courses taken at another college for consideration within the DMS program guide? * Yes No
Are you transferring courses taken at another college for consideration within the MDA program guide? * Yes No
Are you transferring courses taken at another college for consideration within the MLT program guide? * Yes No
Are you transferring courses taken at another college for consideration within the PNE program guide? * Yes No
Are you transferring courses taken at another college for consideration within the STP program guide? * Yes No
Will you have pre-requisite course requirement BIO 205 completed by the start of the program? * Yes No
If YES, list all colleges from which you have requested official transcripts
Will transcripts be submitted under any other name(s)? * Yes No
If so, list names
Will you have all prerequisite course requirements completed by the start of the program? * Yes No
Will you have prerequisite courses BUS 115 and NAD 101 completed by the start of the program? * Yes No
Are you currently enrolled in a Nursing Assistant Training course? * Yes No
If NO, when (MM/YY) and where did you graduate from a Nursing Assistant Training course?
Have you graduated from or are currently attending an accredited Practical Nursing Program? * Yes No
Where did you attend or are currently attending an accredited Practical Nursing Program, as well as the date of your actual or anticipated graduation (MM/YY)? *
Do you hold a current unencumbered Illinois LPN License? * Yes No
Name of accredited Practical Nursing Program from which you graduated? *
Date of graduation from accredited Practical Nursing Program (MM/YY) *
