Allied Health Intent Form
Thank you for applying to a Wilson Community College Allied Health program. Please thoughtfully answer each question listed below. Make sure each answer is accurate and complete.
Email address *
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone number *
Please include area code (***) ***-****
Your answer
Are you currently listed on the North Carolina N.A. I Registry? (Not required for Transition or Surgical Technology) *
If so, spell out below exactly how your name is listed on the N.A. I Registry.
Your answer
Please list the last four digits of your Social Security number. *
Your answer
If not, will you be listed on the registry by the admissions deadline of March 15? *
Which Allied Health program(s) are you interested in applying to at Wilson Community College? *
We offer several degrees, diplomas, and certificates. Please select any of the areas of study you are interested in. Explore these programs at https://www.wilsoncc.edu/curriculum/allied-health/.
Required
In the case that you will need to take pre-requisite coursework, you will be placed into the Pre-Allied Health program. What year do you plan to enter the ADN, LPN, Surgical Technology, or LPN to RN Transition program?: *
Have you been enrolled in a Nursing or Surgical Technology program and/or taken any NUR/SUR classes here or at another institution in the past? *
If so, do you desire to readmit into a later semester or start with the Fall Cohort as a Freshman? *
Please check each general education course you have taken below.
*Please note that not all of these will apply to every program.
Please click "I Agree" only after you have read through the Wilson Community College Allied Health requirements referenced on the link below. *
Required
Please sign your name and date below. *
Your answer
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