Updated 09/05/17 mk

Licensed Practical Nursing Application

(LPN)

5520 Lakewood Ranch Blvd. Bradenton, FL 34211 Richard Conard Medical Dental Building

Kathy Matthews, Program Counselor (941) 752-8100 x 2127

matthewsk@manateeschools.net

MTC Fax Number (941) 727-6257

Kathy Matthews’ Fax Number (941) 209-6215

Please note:

Classes that do not meet minimum enrollment requirements may be cancelled or postponed.

All fees associated with this application process are non-refundable.

If you do not register for the program that you are applying for, admission documents will be

shredded 30 days after course start date. If you are planning to reapply, you should make

arrangements to pick up these documents within this time frame.

No employee, student, applicant for admission or applicant for employment, volunteer, vendor, or member of the public, shall, on the basis of race, color, national

origin, sex, gender orientation, disability, marital status, age, religion, or any other basis prohibited by law, be excluded from participation in, be denied the benefits of or be subjected to discrimination or harassed under any educational programs, activities, services, or in any policies or practices by the School District of

Manatee County. Lack of English language skills will not be a barrier to admission and participation. The district may assess each student’s ability to benefit for

specific programs through placement tests and counseling, and, if necessary, will provide services or referrals to better prepare students for successful participation.

Date submitted: ___________________________________

Application Due Date: ______________________by NOON

Kathy Matthews, Career Counselor

Practical Nursing Application

Manatee Technical College-East Campus

5520 Lakewood Ranch Blvd.

Bradenton, FL 34211

PH: (941) 752-8100 x 2127

Kathy FX: (941) 209-6215

School FX: (941) 727-6257

E-mail: matthewsk@manateeschools.net

PRACTICAL NURSING

PROGRAM

APPLICATION

Applying for the PROGRAM BEGINNING:

Month _________________Year _________________

Check one: Full-Time: Day_____ Executive: Every Friday & 2 weekends per month_____

Please Print:

Name ____________________________________________________________ Date________________________________

Other name(s) under which records may be listed ______________________________________________________________

Address _______________________________________________________________________________________________

Street City State Zip Code

E-mail Address __________________________________________________ (used as a communication tool, please provide.)

Home Ph_____________________________ Cell Ph__________________________ Work Ph____________________________

Date of Birth _________________________________________Social Security #_____________________________________

Person to contact in case of an emergency:

Name ___________________________________________ Relationship to you _____________________________________

Home Phone Number ______________________________ Work Phone Number ____________________________________

Do you have a high school diploma? _______Yes _______No Do you have a GED? _______Yes _______No

T.A.B.E. Scores: Reading _______________ Math _______________Language______________ Form Taken _____________

Date T.A.B.E. taken ____________________________ Where taken _______________________________________________

FOR STUDENT USE

PLEASE PROVIDE COPIES

___ Apply to the College at

http://www.manateetech.edu/apply.html

Click new application

___ PN Application Form ____ fee receipt $40

___ Transcript of HS or GED (provide copy)

___ Residency documents (2) & Form (copies)

___ TABE Scores (copy) or official college transcript

___ Completed Physical & Form

___ Immunizations

MMR__Tdap __PPD__Pox___Hep B__

___ Stamped self-addressed envelope (1 stamp)

___ VECHS Form

___ TEAS Receipt

___ Medical Term Online class enrollment

___ Official Transcript for Course Transfer Credit

(If applicable)

All criteria must be met in order for your application to be

submitted to the admissions committee. It is your

responsibility to ensure that your application is complete.

Write a short description of the types of nursing experiences you have had and the types of duties you performed.

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

________________________________________________________________________________________________________

Please attach an additional page, if more space is needed.

List any arrests or convictions other than minor traffic violations. Being completely truthful is to your advantage._____________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

How did you hear about MTC’s Practical Nursing program?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

ALL FEES ASSOCIATED WITH THE APPLICATION PROCESS

ARE NON-REFUNDABLE

Signed Statement: I understand that if I have ever been arrested for an offense other than a minor traffic violation (regardless of adjudication), I will

be required to report this to the State Board of Nursing before being allowed to take the license exam. Likewise, I understand that

if I have been convicted of a felony and my civil rights have not been fully restored, I will not be eligible for licensure in the State

of Florida until my rights have been fully restored. Likewise, if I have ever been convicted of a sexual misconduct or sexual

abuse, I understand that I will not be eligible for licensure in the State of Florida. I understand that final admission is at the

discretion of the selection committee. Likewise, I affirm that the information provided within my application is the truth to the

best of my knowledge and that any misrepresentation will be cause for immediate dismissal. I have read and understand the

admission and retention policies for this class and the State of Florida laws regarding nursing employment.

________________ __________________________________________________________

Date Signature of Applicant

APPLICATION REQUIREMENTS for

Practical Nursing

1. Attend an Information Session

a. Apply online at http://www.manateetech.edu/apply.html and click new application

b. Prepare to take the Test of Adult Basic Education (TABE) with www.khanacademy.org

c. Schedule the TABE Test: (see TABE Test schedule) Cost is $25.00.

Competitive Score is a 12.9

Minimum scores required: Reading 11.0 grade level

Math 11.0 grade level

Language 11.0 grade level

The test (Survey Level A) is offered at MTC (all campuses) several days a week. Call the campus

where you intend to take the test to reserve a test time.

If TABE scores are below required levels, discuss testing options with the program counselor

immediately. Students are allowed to re-test within guidelines. Remediation courses are also held at

MTC (All campuses)

The test is waived for those holding an AAS or AA college degree or higher from a U.S. institution.

You must submit a sealed, original transcript of your highest degree to qualify for this exemption.

(BA, BA, MS, etc.)

TABE scores are viable for two years. If the test was taken at another institution, you must provide

copies of your test results via email from the institution or a sealed official copy.

d. Prove Florida Residency- Copies of 2 approved documents & completed form

2. Turn in Practical Nursing Application Form and all required documents by deadline date.

A. Completed Physical Examination & Proof of Immunizations

1. Physical Exam must be done within 1 year of the course start date. Acceptable proof of immunity includes documentation of immunizations from physician records,

school records or a titer lab report. If documentation is not available, immunizations must be repeated.

2. MMR (Measles-Mumps-Rubella)

2 doses are required

A positive blood titer for all three components including lab reports

NOTE: a doctor’s statement “had disease” is not adequate.

3. Tetanus/Diphtheria/Pertussis (Tdap) within last 10 years.

B. Tuberculosis - Tine test is not accepted.

1. We require two negative PPD test results within one -three weeks of one another.

Or

2. QuantiFeron test is acceptable

Or

3. Chest X-Ray

C. Varicella (chickenpox)

a) 2 doses required (2nd dose at least one month following the first dose)

b) OR a positive blood titer including lab report

c) NOTE: A doctor’s statement “had disease” is not acceptable.

D. Hepatitis B vaccine series (HIGHLY RECOMMENDED)

a) Series is 3 doses

b) Positive titer acceptable with lab report.

c) Students may sign a declination form.

3. Proof of High School transcript or GED transcript

4. Stamped self-addressed #10 envelope with 1 forever stamp.

5. Completion of Medical Terminology Online Course -

6. Nursing Entrance Examination – TEAS

a. Date & time will be assigned

b. $55 fee must be paid with application

TRANSFER CREDIT INFORMATION:

Medical Terminology Following criteria must be met:

Official school transcript stating # of course hours

80% or higher grade, 15 hours or one college credit

Class completed within 24 months of application date

NOTE: Official Transcript must be turned in with PN application by

deadline date or no credit will be given.

Florida Residency Classification

To receive in-state tuition rates, students must prove that they have maintained Florida residency for at least 12

complete months prior to their first day of school. (See approved documents listed on back).

Dependent or Independent Student? Please check the appropriate classification

_____ I am an independent person and have maintained legal residence in Florida for at least 12 months. A student who meets any of the following criteria shall be classified as an independent student for the determination of

residency for tuition purposes:

1. The student is 24 years of age or older by the first day of classes of the term for which residency status is sought at a Florida

institution;

2. The student is married;

3. The student has children who receive more than half of their support from the student;

4. The student has other dependents who live with and receive more than half of their support from the student;

5. The student is a veteran of the United States Armed Forces or is currently serving on active duty in the United States Armed

Forces for purposes other than training;

6. Both of the student’s parents are deceased or the student is or was (until age 18) a ward/dependent of the court;

7. The student is working on a master’s or doctoral degree during the term for which residency status is sought; or

8. The student is classified as an independent by the financial aid office at the institution.

Applicants under age 24 can claim independence with proof of acceptable income and based on strict guidelines from Florida Statues. See:

http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=1000-1099/1009/Sections/1009.21.html

_____ I am a dependent person and my parent or legal guardian has maintained legal residence in Florida for at

least 12 months.

_____ I am a dependent person who has resided for five years with an adult relative other than my parent or legal

guardian, and my relative has maintained legal residence in Florida for at least 12 months. (Required: A copy of most

recent tax return on which you were claimed as a dependent or other proof of dependency).

_____ I am married to a person who has maintained legal residence in Florida for at least 12 months. I have now

established legal residence and intend to make Florida my permanent home. (Required: A copy of marriage

certificate, claimant’s voter registration, driver’s license and vehicle registration).

Residence in Florida must be as a bonafide domicile rather than for the purpose of maintaining a residence incident to enrollment

at an institution of higher education. To qualify as a Florida resident, you must be a U.S. Citizen or an eligible non-citizen.

Living in or attending school in Florida will not, in itself, establish legal residence. Students who depend on out-of-state parents

for support are presumed to be legal residents of the same state as their parents.

Person claiming Florida Residency must complete this section and sign.

If student is a dependent, documents and signature must be from a parent/guardian.

Include photocopies of two documents from approved list on back.

Name of student ____________________________________________________________________________

Person claiming FL residency ______________________________________ Relationship to student______________

I do hereby swear or affirm that the above named student meets all requirements indicated in the checked category above for

classification as a Florida resident for tuition purposes. I understand that a false statement in this affidavit will subject me to

penalties for making a false statement pursuant to 837.06, Florida Statues, and to Rule 6C-7.005 F.A.C.

Signature of person claiming FL Residency ______________________________________ Date _________________

In-State Tuition for MTC Students

State statutes require that all adult students who attend MTC pay for tuition rates based on whether or not the

student, or parent/guardian for a dependent student, has resided in Florida for the past 12 months.

What is Proof of Residency?

Two documents are required. At least one (1) must be from First Tier; the second document may also be

from First Tier or may be from Second Tier.

First Tier

Florida Driver license or State of Florida identification card

Florida voter registration card

Florida vehicle registration

Proof of purchase of a permanent home in Florida that is occupied as a primary residence of the

claimant

Transcripts from a Florida high school for multiple years if Florida high school diploma or GED was

earned within last 12 months

Proof of permanent full-time employment in Florida (one or more jobs for at least 30 hours per week

for a 12-month period)

Second Tier

A Florida professional or occupational license

Florida incorporation

Documents evidencing family ties in Florida

Proof of membership in Florida-based charitable or professional organizations

Utility bills and proof of 12 consecutive months of payments

Lease agreement and proof of 12 consecutive months of payments

State or court documents evidencing legal ties to Florida

Benefit histories from Florida agencies or public assistance programs

Declaration of domicile in Florida (12 months from the date the document was sworn and subscribed

as noted by the Clerk of Circuit Court)

Unacceptable Documents that May NOT be Used

Hunting or fishing licenses

Library cards

Shopping club/rental cards

Birth certificate

Passport

Social Security Card

PLEASE PROVIDE COPIES OF ALL DOCUMENTS

Criminal Background Concerns

On your Practical Nursing application you are asked if you have ever been arrested and/or

convicted of a crime, (except for minor traffic violations not related to the use of drugs or

alcohol). If you have, you must answer yes, and submit an explanation of why you answered

yes. Include any final disposition records for all offenses. If the situation requires extensive

explanation, attach a separate sheet of paper to the application form.

For further clarification, go to the Florida Board of Nursing website:

www.floridasnursing.gov/licensing, then to: Conviction Record Guidelines for

applicants for Licensure

If you have additional questions, please call Joan Barrese, Health Education Coordinator at

941-752-8100 x 2168.

Acceptance into the Practical Nursing program is contingent upon a clear

background check. This test is completed after you receive your acceptance letter.

“At Your Service” is the company we use to process the level- two, FBI live-scan

fingerprint check. The cost is up to $58 payable to them. They accept cash, check,

money order, deferrals, credit or debit cards. (Discover card not accepted)

“At Your Service” will be on campus for this screening – the date will be included

with your acceptance packet. PLEASE call to schedule an appointment time for that

day – 941-780-6161

Complete the paperwork during your appointment time and your results will be electronically

sent to our nursing department. MTC will contact you if your results prohibit you from

participation in clinicals, licensure and or future employment in the field.

Bring Photo ID to your appointment

Appointment Date___________________________ Time_______________________

Manatee Technical College Health Programs Pre-Entrance Physical Examination Form

This section to be completed & signed by applicant before examination & reviewed with physician

Name ________________________________________________ Phone ___________________________________

Address_________________________________________________________________________________________

Street No. or P.O. Box City State Zip Code

Medical History: Do you now have or have you ever had any of the following:

Condition ………… Yes No Condition ………… Yes No Condition ………… Yes No

Asthma

Epilepsy Tuberculosis

Alcoholism

Fainting Spells Varicose veins

Arthritis

Heart condition High Blood Pressure

Back Trouble

Hepatitis Severe Headaches

Drug dependency/ Addiction

Hypertension Emotional/Psychiatric Disturbance

Diabetes

Kidney disease

If you answered “Yes” to any of the above, please give details

_______________________________________________________________________________________

________________________________________________________________________________ List any allergies__________________________________________________________________ Have you had any serious injuries or operations? ________________________________________ List with approximate dates_________________________________________________________ List any medications taken regularly: _______________________________ __________________

In the last 5 years, have you been enrolled in, required to enter into, or participated in any drug or alcohol recovery

program or impaired practitioner program _______Yes _______ No. If Yes, please explain _____________________________________________________ ________

In the last 5 years, have you been treated for or had a recurrence of a diagnosed mental disorder or impairment? ____Yes ___No If yes, please explain ____________________________________________________________________________________ In the last 5 years have you been treated for or had a recurrence of a diagnosed physical impairment? ___Yes ___No If yes, please explain ___-____________________________________________________________________________________ In the last 5 years, have you been treated for or had a recurrence of a diagnosed addictive disorder? ____Yes ___No If yes, Please explain ___________________________________________________________________________________ Student/Applicant Signature: ________________________________________________

Applicant Name: ______________________________________________________________________________________

Hgt ____________Wgt ____________Blood

Pressure______________Temp.__________Pulse___________Resp.___________ Visual Acuity: Right with / without corrective lenses _______________/_________________

Left with / without corrective lenses _______________/_________________ Are there any abnormalities of the following systems? Describe fully on separate sheet and attach

System ……………………… No… Yes.. Comments………………………………………………………………

1. Respiratory

2. Cardiovascular

3. Gastrointestinal

4. Hernia

5. Eyes/Ears

6. Genitourinary

7. Musculoskeletal

8. Metabolic/Endocrine

9. Neuropsychiatric

10. Skin

Name of examiner: _______________________________________ Phone Number: __________________________

Address: _______________________________________ City: __________________ State: ____ Zip: ____________

Signature of Examiner, Physician or Nurse Practitioner: ______________________________________

Date of exam: _______________________________

Immunizations Date Given or Results Signature of Doctor or Nurse

Measles/Mumps/Rubella

1st MMR

2nd MMR

Or Positive Titer (for all 3) with lab report

Tdap (within last 10 yrs)

Tuberculosis (for health care providers)

PPD Skin Tests #1

PPD Skin Tests #2

OR QuantiFeron Gold

OR statement of negative chest x-ray and statement

of “no current symptoms” (within 2 years)

Varicella (Chicken pox)

1st varicella

2nd varicella

OR positive titer with Lab report

Hepatitis B (strongly recommended, series of 3)

Current Flu Shot (in flu season)

NOTE: The Hepatitis B vaccine is highly recommended for the profession for which you are training. Clinical/field internships may expose you to carriers of the Hepatitis B strain.

PROOF OF IMMUNITY: 1) Documentation of immunization will consist of a written dated statement by a physician on this form or on his/her stationary that

specifies the date seen and states that the person has had the specific vaccines listed above. All immunizations are required regardless of age.

2) Laboratory (serology) evidence of measles, mumps, rubella and chicken pox immunity would be acceptable Lab report required

Rev 2/10 kpm/mgk 8/17

ATI- TEAS VI B Test Entrance Exam for Manatee Technical College

Frequently asked questions

Where can I find study materials to prepare for the ATI TEAS test? Go on line to

the ATI website, www.ATItesting.com or other Internet resources many of which are

free.

DO THIS IMMEDIATELY!

When do I take the test? Test times and dates will be assigned to applicants when

they turn in their completed PN application.

Do I need to register to take the TEAS test? Yes, you must create an account with

ATItesting.com at least 24 hours prior to testing. When registering DO NOT select

register for TEAS, instead select create an account.

What subject areas does the TEAS test consist of? MTC Practical Nursing requires

Reading, Math, English and Science.

How long is the test? Plan to be with us for 4 hours.

What can I bring into the testing site? Photo ID, receipt of payment, pencils and

reading glasses and car keys only. Scrap paper and pencils will be provided.

What are the passing scores? 58 percentile

How long must I wait to retake the TEAS test? 4 months

If I took the TEAS test previously, will MTC accept it? MTC will accept an official

copy of your previous TEAS test within 3 years of our programs test date, and it must

come directly to us from ATI. The cost is $27.00

If I took the TEAS test previously and it did not include the Science portion, do I

have to take it again? If you tested within the last 3 years, (see above) and can prove

(with an official transcript) that you completed A & P, I & II, with an 80% or higher

grade, we will accept your official TEAS test from ATI.

If I can prove with an official transcript that I completed A & P, I & II with an

80% or higher grade, do I still have to take the science portion of the TEAS test?

If you haven’t taken the TEAS before, you must take all 4 portions of the TEAS test.

When will I know if I am accepted into the program? Acceptance letters will be

mailed out approximately two weeks after taking the test.

Will I get a copy of my test results? You may request an unofficial copy from ATI.

Only ATI can provide an official copy for a fee.

TEAS STUDY AIDS VERSION VI TEAS TEST

ATI is our testing agency. They offer a large variety of books and study guides for various prices.

On their website, select Product Solutions, then Pre-Program, then Test Essential Academic Skills.

At MTC East Campus, Mrs. Barcena is available at different times of the day, Monday through

Thursdays for a one-time fee of $45.00. This includes one-on-one tutoring, access to a study site on

your home computer which is coordinated with the TEAS study guide. This does not, however,

cover the science portion of the test.

GOOGLE:

TEAS YouTube for a large selection of videos with tips on how to study, what to study, and what

these people did to pass the TEAS.

TEAS Telephone Apps – open flashcards – there are a lot of free or inexpensive options for your

smartphone available through ITunes or other.

Quizlet – Create a Free Account Search for TEAS – flashcards, audio option, games and practice tests.

QUIZLET – TEST MODE

Today we’re proud to announce that Test Mode – which allows you to use any study set as a practice

test is now available in the Quizlet App for iPhone/iPad and Android. It’s one of the most popular

study modes on the Quizlet website and the #1 requested feature by Quizlet mobile learners.

For iPhone/iPad

https://quizlet.com/help/does-quizlet-have-an-ios-application

For Android

https://quizlet.com/help/does-quizlet-have-an-android-application

With Test Mode, you can customize a practice test with multiple choice, true/false, or written

questions. You’ll get a score at the end to show how you might perform on an in-class test. If you’d

rather not wait until the end of the test, just turn on our new “Instant Feedback” option that provides

real-time feedback on right/wrong answers as you go – a feature available only in the mobile apps.

This site has a nice free review course for the TEAS Test:

http://www.mometrix.com/blog/free-teas-test-prep-course/

It has over 8 hours of free video tutorials and practice questions for the TEAS. You might want to

link to it as a resource.

Medical Terminology Course Information Month: ________________ Year: ________________

To PURCHASE the Med Term Online Prerequisite Course:

1. Google: Evolve

2. Select: Evolve/Home

3. The first time, you will see “Let’s Get Started” – choose “I am a student” (this will not appear again)

4. In top window, “Search below to find and access Elsevier products etc.” enter 9781455772667

5. Go

6. IF YOU NEED THE BOOK, under RECOMMENDED PRODUCTS, Paperback, click on Medical

Terminology (if not, skip to 9)

7. Click: ADD TO CART

8. Arrow back 2 times to ENROLL screen

9. Click ENROLL In your instructor’s course

10. Enter: __________________________________________________in “Redeem and Access Code or Enter an

Evolve Course ID” window

11. Submit

12. Proceed

13. CHANGE Promotion code to: 03731

14. Confirm “Are you sure you want to remove…..” OK

This should bring the price for the book and the access cost to $64.42

15. Click on REDEEM/CHECKOUT to pay. You will be given access to the course after you pay.

If you have not previously created an Evolve Account, you will do so on this screen.

Username______________________________________

Password_______________________________________

To ACCESS the course in the future, go to Evolve

Click on: My Evolve

Enter your username and password to log in

This course opens on ______________________ and

MUST be completed by ______________________.

If you have problems registering, call Customer Support at 1-800-222-9570 or visit online tech support.

Does this course require me to purchase a textbook?

You may wish to purchase a textbook, especially if you are unfamiliar with medical

terminology

How do I report my final grade?

You can copy, or take a snapshot of the screen and paste it into Word to give to the

admissions counselor. (The instructor has access to your examination grades.)

What happens if I do not pass this course with an 80% grade?

You will need to pay and re-register to take the course again under another course

ID number provided by the admissions counselor.

If I took a Medical Terminology course elsewhere, will I have to take this prerequisite?

Transfer credit will be given if you successfully passed a 15 hour (one college credit)

course, received an 80% or higher grade and can prove that with an official transcript.

The course must have been taken within two (2) years of the PN program start date.

What does the course consist of?

The course consists of six (6) quizzes and seven (7) examinations and takes, on

average, approximately six (6) weeks to complete. It must be completed by the date

given to you by the admissions counselor.

How much does the course cost?

No more than $75.00. You may be able to use the coupon code: 03731 for

a limited time to receive 25% off and free shipping & handling.

Additional IMPORTANT Information

This is a content-protected course, so you cannot copy, paste or print materials.

You can access the unit Quizzes as many times as you wish.

You can only access the unit Examinations one (1) time. Therefore, only open the

unit examinations when you are ready to pass them. The unit examinations are timed for

60 minutes.

You must take all quizzes, tests and case studies to complete this course.

DO NOT attempt this coursework during a thunderstorm!

PRACTICAL NURSING PROGRAM

Course Content

The Practical Nursing Program consists of 1350 hours. The program prepares students for licensure and

employment as practical nurses. The PN course encompasses the study of biological and behavioral

sciences; administration of treatments and medications in the care of the ill, infirm, or injured; the

maintenance of health; and prevention of illness. Half of the program is in clinical settings at local hospitals,

long term care facilities, and community health agencies. Upon satisfactory completion of this course, the

student will be eligible to take the state board examination for licensed practical nurses (please note: you

must have a social security number in order to be licensed as a practical nurse in the state of Florida). PNs

work under the direction of a registered nurse, a licensed physician, a licensed osteopathic physician, a

licensed podiatrist, or a licensed dentist.

Accreditation and Faculty

Manatee Technical College is a part of the Manatee County Schools. The school is an accredited member of

the Council on Occupational Education. Governing agencies for this program include the Florida State

Department of Education and the Florida State Board of Nursing. The faculty members of the Practical

Nursing Program are qualified nurse educators. They are registered nurses who have met the requirements

for teacher certification as well as being experienced practitioners.

Acceptance

Completed applications should be submitted to the career counselor by application deadline.

Incomplete applications will not be processed.

Applicants should pay special attention to the quality and completeness of their applications. After review

by the admission committee, acceptance/non acceptance letters will go out two weeks after taking the TEAS

Test. The acceptance letter will include important dates for registration, payment, and orientation

information. Please fax your response letter by the date indicated in the letter confirming your continued

interest in attending and stating that you have secure finances to pay for the program after receiving your

acceptance letter.

If an applicant is not selected for the upcoming class, he/she must come in and pick up the submitted

application, get any updated program changes and reapply in order to be considered for a later class. It is

suggested that you consult with the career counselor on how you can improve your chances of acceptance.

and update your admission documents if needed. Materials in your application packet will be released to

you personally with a signed release or will be shredded after 30 days. Background checks will not be

released.

Approximate Fees - See Current Handout

Financial Aid - See Handouts

All potential students are encouraged to apply for financial aid early.

MTC cannot offer Student Loans

Drug Screening

Nursing students are drug screened at random during the program. Positive results on the drug test will

result in immediate dismissal from the program. Drug screening is random. You may be tested at any time.

Any payment of lab fees, books or materials are non-refundable. Applicants with positive drug test results

must wait a minimum of one year to re-apply to the nursing program and must show documents of drug

counseling.

Background Check and Arrest Records

Any applicant who has an arrest and conviction record should provide letters of reference that document

good moral character and any rehabilitation done since the conviction. If the charges are related to drug

abuse, documentation of recovery is required (such as letters from counselors, etc.). Any arrests that occur

after the background check has been submitted or while in the program MUST be reported to the Health

Education Coordinator, Mrs. Joan Barrese. Additional paperwork may be required.

Your background check must be performed by the date stated in your acceptance letter. Background

check fees are paid directly to the company performing the scan. Your acceptance is dependent on a

clear background.

Insurance

Students are strongly encouraged to carry accident insurance. Manatee Technical College is not liable for

medical expenses if a student is injured.

Please Note:

Certification and Licensure in Florida requires a valid social security

number.

MTC cannot offer student loans

Manatee Technical College Admission and Retention Policies

Licensed Practical Nurse

Admission to the Practical Nurse program at MTC requires basic skills and aptitudes necessary for potential success in

the chosen field. In addition to the application requirements, applicants must also meet the following conditions for

admission.

I. Health Risks

To ensure that the applicant’s career choice will not pose a detriment to his/her physical or mental well-being

or be a safety risk factor for the student and/or the patient, each applicant’s health questionnaire and physical

exam will be thoroughly evaluated.

A. A medical release will be necessary for certain medications and physical conditions. These conditions

that require a release include, but are not limited to, the following:

1. Back problems

2. Pregnancy

3. Seizure activity

4. Cardiac problems

5. Hypertension

6. Uncontrolled endocrine problems

7. Neuromuscular disorders

B. Students with medical problems must assume all personal liability for their health.

Please note: Students must be able to lift a minimum of 50 pounds.

II. Chemical Impairment

Applicants who have undergone therapy for chemical abuse (including alcohol and drug abuse) will be denied

admission or continuation in the program until one full year of stability is documented.

A. Any applicant who has been treated or received counseling for drug addiction or abuse, or excessive

alcohol use must:

1. Submit documentation of treatment from the treating agency or physician.

2. Submit a letter of recommendation from the agency or physician granting approval for

admission to the program based on the program requirements.

3. Agree to pre-admission and subsequent drug/alcohol screening (at the student’s expense)

which must be negative in order to enter or continue in the program. Refusal of screening will

result in denial of admission or withdrawal from the program, as applicable.

B. Students who show evidence of chemical impairment, or who are admitted to a facility for alcohol or

drug treatment while a student in the program, will be withdrawn. Re-admission into the program will

follow guidelines set forth under chemical impairment.

III. Mental or Emotional Illness/Instability

Applicants who have been institutionalized or received treatment for emotional or mental illness/instability

will be denied admission or continuation in the program until at least one year of stability is documented by a

physician or therapist.

A. Any applicant who has ever been treated for mental or emotional illness/instability must:

1. Submit documentation of treatment from the treating agency, physician, or therapist.

2. Submit a letter of recommendation from the treating agency, physician, or therapist granting

approval for program admission. Documentation must include the applicant’s ability to handle

stress, level of neuromuscular function, and appropriateness of affect. If the applicant is on

medication, documentation must state that the medication will not inhibit the performance of

nursing skills.

3. Agree to follow-up visits with documentation during the course of training, as required.

B. Students who are admitted to a facility for treatment of emotional or mental illness/instability or who

show evidence of unstable behavior while in the program will be withdrawn. Re-admission will be

considered based on documentation of stability from physician or therapist.

IV. Arrests

A. On your Practical Nursing application you will be asked if you have ever been arrested and/or convicted of

a crime, (except for minor traffic violations not related to the use of drugs or alcohol). If you have, you

must answer yes, and submit a self-explanation as to why you answered yes to this question. Include any

final disposition records for all offenses. If the situation requires extensive explanation, attach a separate

sheet of paper to the application form.

B. Practical Nursing students will be background tested/fingerprinted after acceptance into the program.

Falsification on application may prohibit your entry into this program.

For further clarification, go to the Florida Board of Nursing website:

www.floridasnursing.gov/licensing, then to: Conviction Record Guidelines for applicants for Licensure

If you have future questions, please call Joan Barrese, Health Education Coordinator at 941-752-8100 extension 2168.

B. Applicants who have been arrested and convicted of or who have pled nolo contendere for any

misdemeanor or felony during the year prior to application will be denied admission for at least one

year. Documentation of satisfactory work performance and references will be required prior to

admission. Length of employment and acquaintance with references of no less than six months will be

required to document successful performance.

C. Any applicant who has ever been arrested for anything other than a minor traffic offense, regardless of

adjudication, must:

1. Submit a copy of Record of Arrest

2. Submit a copy of court disposition

If no record of the arrests or court disposition is on file, the applicant must submit a letter from the

courthouse stating this. These applicants will be considered on an individual basis.

D. Students who are arrested and convicted of or who plead nolo contendere for a felony or a drug or

substance abuse incident while enrolled in the PN program will be withdrawn. Readmission will be

considered following the established arrest guidelines.

V. Falsification of Information

The admission policies of the nursing programs are based upon disclosure of information by program

applicants. The failure of an applicant to reveal information or the falsification of information related to

chemical impairment, mental instability, arrests, or health risks will be cause for denial of admission to or

immediate withdrawal from the nursing programs.

Applicants may appeal this process through the prescribed grievance procedure. See copy of Florida Statutes for

further details.