RN Admissions | RN Admissions Form

First Name:

Middle Initial:

Last Name:

Former last names (list all)

LATC Student ID (if applicable)

Email:

Phone:

Last four digits of SSN:

Address Information

Current Address:

City:

State:

Zip Code:

LPN License Information

LPN school attended:

Year Graduated:

Have you taken the ATI Comprehensive Predictor NCLEX-PN within the last 3 years?

Yes
No

Please provide the results of your ATI Comprehensive Predictor.

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Are you a current student at Lake Area Technical College?

Yes
No

In order to continue with the application process you need to take the ATI Comprehensive Predictor NCLEX-PN.

Please reach out to the admissions office to make an appointment to take the exam.

Admissions Office
Lake Area Technical College
PO Box 730Watertown, SD 57201
605.882.5284
admissions@lakeareatech.edu

Thank you.

Have you attended a different registered nursing program in the past?

Yes
No

Please provide a letter of recommendation from the school in which you attended.

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Do you have a current unencumbered LPN license?

Yes
No

License Number:

Please provide a copy of your LPN license.

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Have you ever had any restrictions on your LPN license?

Yes
No

Please explain:

Have you ever been convicted of a felony?

Yes
No

Please explain:

Please provide the name and email of your reference.
Your reference should be:

- Current or former Employer in a health field
- Current or former faculty member

They will be contacted to provide letter of recommendation.

Reference Name:

Reference Email:

Please provide a personal letter of enlightenment with an explanation of what plans are in place to be successful in the RN Program.

Upload Personal Letter

Choose a file

RN Admissions Form

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