Rockefeller Career Center School of PN Application

2027–2028 LPN Program Application

Program: LPN

Length of Program: 11 Months

Estimated Start Date: August 2, 2027

Estimated Ending Date: June 29, 2028

Pre-Entrance Exam: $100.00

Important: You will receive a response by email within 7 days of application submission. Please watch your junk/spam folder.

It is the policy of the Hancock County Board of Education not to discriminate on the basis of sex, race, religion, color, or national origin in its education programs.

Applicant Information

Date of Application

Full Name (Last, First, Middle, Maiden)

Address

County

SS# (no dashes needed)

Birth Date

Home Phone

Work Phone

Cell Phone

Emergency Contact (Name, Phone, Relationship)

Education Information

High School (Name & Address)

Entrance Date

Graduation Date

GED Testing Facility (If Applicable)

Year Passed

College(s) Attended

Previous Health Care Education?

Yes

If Yes, Please Explain:

Work Experience

How Many Positions Have You Held Prior

Have you ever been convicted, plead guity, or plead no contest to a felony or misdemeanor? If yes, explain:*

I verify the information on this application is true to the best of my knowledge. I give permission to the Rockefeller Career Center School of Practical Nursing to verify this information.

Thank you for your interest in our program. All communication regarding your application will be sent via email. Please monitor your inbox regularly and be sure to check your spam or junk folder to ensure you do not miss any updates.