Nursing Program Information Session Sign-up

First Name:
Last Name:

Interested in Full/Part-Time study: Part Time Full Time

Address:
City:
State:
Zip Code:
Phone Number (please include area code):
Email:

Employer:
Type of Associate Degree (check all that apply): ADN
AAS-T
AA
AS
Other
Type of Bacheolor's Degree BA BS Other

Hospital Diploma (leave blank for none):
Year of graduation from Nursing program:

Select your Information Session (check all that apply): Tuesday, January 8th, 9-10:30am
Thursday, January 24th, 7-8:30pm
Tuesday, February 5th, 9-10:30am
Tuesday, February 19st,  7-8:30pm
Tuesday, March 12th, 9-10:30am
Tuesday, March 26th, 7-8:30pm
Tuesday, April 9th, 9-10:30am
Thursday, April 25th, 7-8:30pm


How did you find out about these sessions? Received information in the mail Received information from my college Received information from my employer Read an article in a newspaper or newsletter Learned about the program from a friend or family Found information by doing an Internet search Other