Nursing Program Applications - Clackamas Community College

2015-2016 

Associate of Applied Science Nursing Degree Program 

Thank you for your interest in the Nursing program at Clackamas Community College! The Nursing 

program is both exciting and challenging; offering graduates the opportunities for employment in a variety of 

settings and for a lifelong career that is personally fulfilling. The program demands may pose unique personal as 

well as academic challenges. Most students have multiple responsibilities in addition to going to school (i.e., 

relationships, family, job). Success in the program takes a firm commitment from each student and Clackamas 

Community College (CCC) offers many services that will help you succeed. Nursing is a demanding field and 

admission to nursing schools is a very competitive process. We strongly suggest you prepare well by talking with 

nurses in various settings, talking with an advisor in order to help you with your career plans, and by reading 

through the application materials thoroughly. 

The Consortium-The Clackamas Community College Nursing Program has joined with nine other Oregon 

community college programs and all campuses of the Oregon Health & Science University in a unified approach 

to nursing education. This coalition of statewide nursing educators and programs is known as the Oregon 

Consortium for Nursing Education (OCNE). Nursing educators from all OCNE schools actively collaborated in 

the developing of a new competency-based curriculum that is shared in all consortium schools. The evaluation 

process of the curriculum is on-going and performed at each partner school as well as in the aggregate. In 

addition, OCNE schools share the same prerequisites and have comparable application processes for students. 

Program Competencies -The competencies of the OCNE curriculum address the need for nurses to be skilled in 

clinical judgment and critical thinking, evidence-based practice, relationship-centered care, interdisciplinary 

collaboration, assisting individuals and families in self-care practices for promotion of health and management 

of chronic/acute illness, end-of-life care, as well as teaching, delegation, leadership and supervision of 

caregivers. 

Degree Options - Acceptance to the program allows for co-admission to Clackamas Community College and 

Oregon Health & Science University (OHSU) nursing programs. Co-admission is an agreement that applicants 

who are admitted to Clackamas Community College would be accepted by transfer to OHSU without an 

additional competitive application process. The co-admitted student would be entered into the OHSU student 

record system on transfer to OHSU enrollment following completion of 6 terms of the core nursing curriculum at 

Clackamas Community College. 

Length of Program — The program is designed to provide students the opportunity to earn their Associate of 

Applied Science degree from Clackamas Community College after 6 terms of study and then continue on for an additional 

3 terms to earn a Bachelor's of Science with a Focus in Nursing from OHSU. As such, the course work is outlined in a 

framework over four years. 

• Year One: The first year of the OCNE program of study is devoted to prerequisite and/or preparatory 

courses (45 quarter credits) required for admission to the nursing program. 

• Years Two and Three: The second and third year of the OCNE program is comprised of identical 

nursing courses for associate's degree and bachelor's degree work. 

• Year Three: At the completion of this year, students earn an Associate of Applied Science degree and are 

eligible to lake the NCLEX-RN licensure test. At the completion of this year, students may also choose to 

continue on to OHSU to earn their Bachelor's degree through various pathways.* 

• Year Four: Upper division nursing coursework through OHSU. At the end of this year, students will earn 

a Bachelor of Science with a Focus in Nursing degree. 

*There is a nursing faculty liaison that will outline options/pathways available to students for those interested in 

completing a Bachelor's degree at OHSU.

Demands of the Program – It is important to understand the mental and physical demands of the nursing 

program and the career of the nurse. Applicants to the nursing program must be physically and mentally able to 

cope with the rigors of the curriculum and the demanding nature of the health professions. Nursing students must 

be able to grasp scientific concepts, set up and answer basic math and algebra problems and communicate well 

verbally and in writing. Physically, students must be able to remain on their feet for extended periods, lift up to 25 

pounds, hear heart and breath sounds, read fine print and identify skin tones such as pale, ashen, gray or bluish. 

Established academic and clinical requirements essential to the program of instruction apply to all students and 

cannot be waived. Attempts will be made to accommodate and retain qualified applicants with disabilities unless 

results of evaluations indicate that given reasonable accommodation an individual will still be unable to perform 

the essential functions required by the program. Persons with questions concerning particular qualifications are 

encouraged to contact the Disability Resource Center to arrange an appointment for individual consultation and 

advice prior to application. 

Application Process 

Initiating the Application Process: 

• Download the Nursing application for admission and supporting materials from the following website: 

http://www.clackamas.edu/HealthSciences/Nursing/ 

• Thoroughly read the Nursing Application Packet. 

• Attend a Nursing Group Advising Session for information and academic planning. For dates and times 

check the following website: http://depts.clackamas.edu/advising/Pre-NursingAdvising.aspx 

• Begin prerequisite coursework. 

• Complete the Nursing Application and submit with supporting documentation by the filing deadline 

of February 13, 2015 by 5:00 p.m. 

Application and Enrollment Eligibility Criteria 

• Students are eligible to apply for admission to the nursing program after completion of a minimum of 30 

quarter credits of courses from the prerequisite list. The 30 credits must include BI-231 and Math 

competency (MTH-095 or higher). 

• Application to the nursing program requires a minimum GPA of 3.0 for all prerequisites completed. All 

completed prerequisites will be counted toward the prerequisite GPA (45 maximum quarter credits). 

• Completion of all prerequisite courses must be with a letter grade of "C" or better. Plus and minus 

grades will not be factored into the GPA calculations. All prerequisites must be completed by the end of 

summer term 2015. 

o While not required for application or admission to the Nursing program, students are strongly 

encouraged to complete BI-234 and a course with genetics content (BI-112 meets this requirement) 

prior to beginning the Nursing program. Scheduling of classes and rigor of the nursing program make 

completion of these courses during the nursing program difficult to accomplish. 

• If a course has been taken more than once, the most recent grade received will be the course considered for 

GPA calculation. 

Application and Admission Process 

• Applicants may submit their nursing application once the application is complete. 

o Only complete applications will be processed. 

o Only prerequisites completed by the end of Fall Term 2014 will be counted. 

o Submitting an application does not guarantee that applicants have satisfied minimum criteria. 

o Submit applications with all supporting documentation to Harmony Campus by the filing deadline.

• FILING DEADLINE is no later than February 13, 2015 by 5:00 p.m. 

• After the filing deadline has passed, admissions personnel will evaluate each application for completeness 

and eligibility. Applicants will be notified of their eligibility for a group interview via email. 

• An invitation to the group interview process will be emailed to eligible applicants. Selected applicants will 

be determined based on space availability and applicants meeting minimum eligibility criteria. 

• Selected applicant will schedule his/her own group interview time on the Nursing Department website. 

o The group interview process assesses the student’s readiness for the rigor and nature of the CCC 

Nursing Program. Communication, values, problem-solving and critical thinking skills are the major 

qualities evaluated as well as motivational fitness, coping mechanisms and self-care strategies. No 

further information regarding the interview process will be given. 

Please note: If a selected applicant fails to schedule an interview time or does not attend the scheduled 

interview he/she is no longer eligible for application and/or interview. There is only one interview cycle per 

application year. An applicant will be eligible for a maximum of two interview cycles to be considered for 

admission to the program. 

• Each applicant will be notified of his/her status regarding admission into the nursing program by email. 

Alternates will be notified if space becomes available. The applicant is responsible for indicating his/her 

correct email address on the nursing application and for checking that email for communication regarding 

the nursing admission process. 

Offers of Admission 

• Students offered admission to the nursing program must indicate their acceptance of admission by signing 

and returning a Letter of Intent to enroll no later than the deadline indicated on the offer of admission. 

• A mandatory orientation meeting for admitted applicants will be held in late spring, 2015. If you are unable 

to attend due to extenuating circumstances you must notify the nursing department administrative assistant 

at christym@clackamas.edu prior to the orientation date. If you do not attend this orientation and have not 

previously notified the nursing department, the next eligible alternate will be given your assigned place in 

the program. The exact date and time of the orientation will be provided on the offer of admission letter. 

• A Health History and Physical Examination form will be given to accepted applicants at the 

orientation meeting. The completed form, with verification of immunizations, must be processed as 

outlined on the Health History form by the assigned due date or the applicant's space may be given to 

the next eligible alternate. 

• A criminal background check and urine drug screen will be required as outlined at the orientation prior to 

beginning fall term classes and annually thereafter. Nursing students must meet state statutory mandates for 

healthcare providers regardless of individual institution policy. Anyone with a criminal record may not be 

allowed in a healthcare facility as a student. The purposes of statutory mandates are to prevent abuse 

situations with vulnerable adults and children. Because it is not possible to meet the objectives of the 

program without having clinical experience, anyone with a positive criminal or abuse history may not be 

eligible for acceptance into the Nursing Program. Drug use and/or conviction of a felony may result in 

denying licensure upon graduation. 

Immunizations: 

Evidence requires documented receipt of vaccine or documented immunity via titer or valid history of disease, or 

a record from the Oregon ALERT Immunization Information System. 

Required Hepatitis B (Hep B) 

Required Measles, mumps and rubella (MMR) 

Required Tetanus, diphtheria, pertussis (Tdap) 

Required Varicella 

Required Polio 

Required Influenza (seasonal flu)

Screenings: 

Tuberculosis (TB) IGRA Blood test 

Substance Abuse 10-panel drug screen, which must include screens for the following eight substances: 

Amphetamines, including methamphetamines; Barbiturates; Benzodiazepines; Cocaine; Marijuana; Methadone; 

Opiates; Phencyclidine. 

*A marijuana card for inhaled use is not accepted at Clackamas Community College Nursing Program. 

Criminal Background Check: Must include Social Security Number trace, state/national criminal background 

history, sex offender registry check, and OIG LEIE check. 

Trainings: 

CPR/Basic Life Support (BLS) for healthcare providers. It is recommended that trainings comply with the 

American Heart Association standard and remain current throughout the nursing program. 

Students should understand that although co-admitted to the Oregon Health Sciences University School of 

Nursing, those who choose to transition from the Clackamas Community College Nursing Program to OHSU will 

have to undergo a Criminal Background Check for OHSU at the time of transition and ability to enroll in OHSU 

courses may be negatively impacted by any criminal history in their background. 

Applicants are encouraged to complete a CCC financial aid And FAFSA by February and CCC 

scholarship application by April 30, 2015 for the academic year 2015-2016 regardless of whether 

he/she has been officially accepted into the Nursing program. 

Clackamas Community College reserves the right to modify the criteria and the process for selection as needed. 

Application Deadline: 

Friday February 13, 2015 by 5:00 p.m. 

(Postmarks not acceptable) 

CCC Admission Policy Statement 

Clackamas Community College supports an open door policy and welcomes all students who can benefit from the instruction 

offered, regardless of their educational background. Prospective students are eligible for admission if they are a high school 

graduate, have a GED, or are over 18 years of age. Admission to the College does not guarantee entrance to all programs. 

Students seeking to enter a special admit program must meet additional admission criteria. 

Students under the age of 18 that have not yet graduated from high school or obtained their GED are not admitted but are 

allowed to enroll in selected courses under ORS 339.030. Specific enrollment permissions may be required.

Oregon Consortium for Nursing Education (OCNE) 

Clackamas Community College 

Nursing Prerequisites for the 2015-2016 Academic Year 

Minimum application requirements: 

• At least 30 of the 45 credits of prerequisites must be completed by the end of fall term 2014. 

• BI-231 and Math Competency must be completed by the end of fall term 2014. 

• The remaining prerequisites must be completed by the end of summer term 2015. 

Grade requirements: 

• Cumulative GPA of prerequisite courses must be at least a 3.0. 

• Individual prerequisite courses must be taken for a letter grade and must be completed with a grade of "C" or higher. 

Prerequisite Courses: 

• BI-231, 232 & 233 Anatomy and Physiology I, II & III 12 Credits 

o BI-231 must be completed by the end of fall term 2014, but not before summer term 2010. 

o BI-232 & 233 must be completed by the end of summer term 2014, but not before summer term 2010. 

o BI-231, 232, and 233 constitute a full sequence of human anatomy and physiology with laboratory, inclusive of 

all body systems. This sequence must be taken in its entirety. Note: Chemistry or Biology maybe required prior 

to the A &P sequence at some institutions. 

o Students who took the A&P courses without these prerequisites do not have to take them to be eligible to apply 

at Clackamas. 

• FN-225 Nutrition 4 Credits 

o Class should cover biological functions, dietary sources of essential nutrients and the relationship 

of diet to health. 

• PSY-215 Human Development 4 Credits 

o The developmental process of human life covering the full life span. Courses that cover only part of the life 

span will not be accepted. 

• WR-121 & WR-122 English Composition 8 Credits 

o Class should cover the development and support of ideas through the medium of written English. 

o Remedial English such as sentence structure and punctuation will not be accepted as sufficient to 

meet the prerequisite. 

o These courses are preparation for scientific or technical writing which will be required later in the Nursing 

program. 

o WR-121 & WR-122 will be waived if the applicant has earned a bachelor's degree. 

o Note: when taken for 4 credits each, WR-121 & WR-122 are sufficient for the AAS degree in 

nursing. If taken at a school that awards 3 credits for each course, WR-123 or WR-227 must be also 

eventually be completed for graduation from the program. 

• Humanities, Social Science or Natural Science 14 Credits 

o At least 6 of the14 credits must come from the Social Science area. 

o Courses may come from the following subjects. Please see CCC catalog, 

Associate of Arts Oregon Transfer Degree for specific CCC courses. 

5

• Elective credit Variable 

o Students may need to take elective credits in order to meet the minimum of 45 credits required for entry to 

nursing school. 

o Elective credits may come from any subject and must be 100 level or higher. 

Competencies: 

• MTH-095 or higher 4-5 Credits 

o 

Students must demonstrate math competency by the end of Fall term 2014 by: 

• Passing MTH-095 or higher with a "C" or better. 

• Placing into MTH-105/111 as determined by CCC placement test dated after 6/15/10. (No credit 

given) 

• Completed MTH-095 & higher credits can be applied toward the 45 credits of prerequisites and will be calculated in the 

prerequisite GPA. 

• MTH-095 credits will not count toward the BSN degree. 

Admission Points 

• Prerequisite GPA 40 Points 

o A maximum of 40 points will be awarded. 

o The applicant must provide transcripts from each accredited college or university where prerequisite courses 

were taken. 

o A minimum of 30 quarter credits of prerequisites is needed to apply. 

o Only the prerequisites (up to 45 quarter credits) will be calculated in the GPA for assignment of points in the 

admission process. 

o Clackamas Community College transcripts do not need to be included. 

o The most recent grade will be used for any repeated courses. Pluses and minuses will not be considered. Points 

will be assigned using a linear equation: Points = 24*GPA - 56. 

• Completion of A&P sequence 3-5 Points 

o If the full sequence of A&P courses (I, II and III) has been completed with a grade of C or better, 5 points will 

be awarded. 

o If two courses (I and II, or I and III) in the A &P sequence have been completed, with a grade of C or better, 3 

points will be awarded. 

• Prior Degree 1 Point 

o Applicants who hold a prior degree will be awarded a maximum of 1 point for having previously earned an 

associate degree or higher. Include an official transcript for proof of prior degree. 

• Completion of All Prerequisites 3-5 Points 

o 5 points will be awarded if all 45 credits of prerequisites have been completed by the application deadline. 

o 3 points will be awarded if at least 37 credits have been completed by the application deadline. 

• Discretionary Points 13 Points 

o A maximum of 13 points will be awarded for the following : 

• Currently employed in the healthcare field in direct patient care 3 points 

• Completion of BI 234 Microbiology 3 points 

• Completion of a CCC Allied Health program or EMT course 3 points 

• Active duty or veteran of U.S. military services 3 points 

• Completion of gerontology course at CCC 1 point 

See the Discretionary Points Worksheet for required documentation. 

• Proctored Essay/Interview 36 Points 

o A maximum of 36 points will be awarded to applicants who are invited to the Essay/Interview. 

Total Admission points possible 

100 Points 

6

Date: 

Birthdate * 

MM DD YYYY 

If you’re under 18, additional permissions may be required before you can register for 

classes 

CLACKAMAS COMMUNITY COLLEGE 

NURSING APPLICATION FOR ADMISSION 

CCC Student I.D.# or SS# 

Providing your Social Security Number (SSN) is voluntary. If you provide it, the 

College will use your SSN for keeping records, doing research, aggregate reporting, 

extending credit and collecting debts. Your SSN will not be given to the general 

public. If you choose not to provide your SSN, you will not be denied any rights as a 

student. Providing your Social Security Number means that you consent to the use 

of the number in the manner described. 

Full Legal Name 

Mailing address 

Telephone 

Last First (i.e. Anthony) Middle Preferred (i.e. Tony) 

Address City State County Zip 

Home Cell Work 

Email address 

Residency/Student Type 

Required for tuition purposes 

In State (US citizen or permanent resident of 

Oregon, CA, ID, WA, or NV 90 days prior to first 

day of class.) 

Immigrant Refugee Other 

Out of State: 

US citizen and permanent resident outside of 

Oregon, CA, ID, WA, or NV 

International visitor (B, J, H or other 

nonstudent Visa) 

International student (requires I-20) 

CCC would appreciate your response to the 

following: 

Gender Male Female 

What will you be studying? (program title and code). 

AAS - Nursing 

Program Title 

Program Code: AAOT ASOT X AAS AGS CC NA 

Educational Goals 

Earn a degree/certificate 

Transfer classes 

Learn job skills 

Update job skills 

High school completion/GED 

Explore career/academics 

Reading/writing/math skills 

Learn English language 

Personal interest 

Other 

Clackamas is required 

by the U.S. Federal 

Government to ask the 

following: 

Ethnicity 

Hispanic or Latino 

Not Hispanic or Latino 

Race 

(Choose all that apply) 

American Indian or 

Alaska Native 

Asian 

Black or African 

American 

Native Hawaiian or 

other Pacific Islander 

White 

High School/GED Completion 

Received High School Diploma 

Name of School Location Graduation Date 

I certify that I have graduated from high school or passed the GED exam. 

Previous Colleges Attended 

/ / CCC releases student “directory 

Name of School Dates Location Award 

/ / 


information” which includes 

enrollment status, verification 

of certificate or degree award, 

residency status, major and 

athletic participation. If you do 

not want information released, 

/ / please contact the Registrar’s 


Please answer the following questions: (For statistical purposes only) 

1. Are you the first person in your family to attend college? Yes No 

2. What is your household income? $0-$15,000 $15,000-$30,000 $30,000-$50,000 $50,000+ 

3. What is your employment status? Employed 35 hrs/week or more Retired 

Employed less than 35 hrs/week 

Not employed 

4. Are you a veteran of the U.S. Military or do you have a family member who is a veteran? Yes No 

Certification of application information and academic standards policies. 

I have read and understand the admission enrollment criteria for the Clackamas Community College Nursing program. I verify that all statements on this 

application are complete and true. I accept and agree that I will be required to sign an Individual Professional Standards Acknowledgement form prior to 

my entry into the program. Further, I certify that I am aware that I must have physical and mental abilities necessary to provide safe client care, visual 

acuity, hearing, speech, manual dexterity and endurance to be successful in the program. I will complete and submit a Health History form prior to the start 

of classes. 

Office and request the Restrict 

Directory Information form. 


does not discriminate on the 

basis of race, color, religion, 

gender, sexual orientation, 

marital status, age, national 

origin/ancestry, disability, 

family relationship or any 

other protected status in 

accordance with applicable 

law. The college’s commitment 

to nondiscrimination applies 

to curriculum activity and all 

aspects of operation of the 

college. 

Signature 

Date 

Print Name 

Clackamas Community College, 7738 SE Harmony Road, Milwaukie, OR 97222 

Website: http://www.clackamas.edu/HealthSciences/

2015-2016 



PREREQUISITE GPA WORKSHEET 

NOTE: Official (sealed) transcripts from all institutions where prerequisite courses have been taken must be attached to 

this application. (Clackamas Community College transcripts do not need to be attached). Only courses completed by the end of 

Fall term 2014 with a letter grade of “C” or better will be used. 

CCC NURSING PREREQUISITES 

GRADE 

(Must be 

"C" or 

better) 

CREDITS 

(At least 

30 – no 

more than 

45) 

POINTS 

A=4 

B=3 

C=2 

GRADE 

POINTS 

(credits 

x points) 

EARNED AT 

COLLEGE/UNIVERSITY 

(Official transcripts must be 

attached if taken outside of CCC) 

TERM 

& YEAR 

COMPLETED 

Completed Prerequisites 

BI-231 - Anatomy & Physiology I 

(Completed by end of Fall 2014 but not 

before Summer 2010) 

BI-232 - Anatomy & Physiology II 

(Within 5 years - Summer 2010) 

BI-233 - Anatomy & Physiology III 

(Within 5 years - Summer 2010) 

FN-225 - Nutrition 

PSY-215 - Human Development 

WR-121 - English Composition I 

WR-122 - English Composition II 

Social Science Requirement: (6 credits) 

Course: 

Course: 

Humanities, Natural/Physical Science, 

Social Science Electives: (8 credits) 

Course: 

Course: 

Course: 

To calculate GPA: Add highlighted 

columns. 

Total Grade Points (2nd highlighted column) 

divided by Total Credits (1st highlighted column) = GPA 

(Must be at least 3.0)

2015-2016 



APPLICATION VERIFICATION CHECKLIST 

Please complete this verification checklist as part of your nursing application. Be sure to attach all 

worksheets, transcripts, test scores and other supporting documentation as well as this checklist to your 

application. 

REQUIRED: 

1. I have completed, signed and attached the Nursing Program Application for Admission and understand that 

all admission decisions are final. 

2. I have attached official college transcripts (must remain sealed) from all institutions where prerequisite 

courses have been taken. (Clackamas Community College transcripts do not need to be attached). 

Colleges previously attended: 

3. I have completed and attached the Prerequisite/GPA Worksheet. Please enter ALL prerequisite courses that 

you have completed, the grade you received, where you completed the course and the date it was completed. 

4. I have met the required math competency through one of the following (proof attached): 

Completion of Math 95 with a “C” or better shown on a transcript. 

Placement into Math 105/111 on a CCC math placement test (must be dated after 6/15/10.) 

5. I have attached a $75.00 non-refundable check or money order for the Nursing Application processing fee. 

Make checks payable to CCC. 

6. I have signed and attached the Nursing Application Verification Checklist (this form.) 

OPTIONAL: 

1. I have earned points for a prior degree and have attached an official transcript as proof. 

2. I have earned discretionary points and attached the Discretionary Points Worksheet with supporting 

documentation. 

Signature Print Name Date 

I understand that it is my responsibility to meet all program and application criteria. I verify that all statements on this application are complete and true 

and I understand that falsification of any information may lead to disqualification or dismissal from the program. I give my permission for release of 

pertinent application information to the OCNE partner schools, including OHSU, as necessary to facilitate my program of study. 

Application Deadline: February 13, 2015 at 5:00 p.m. (Postmarks not acceptable) 

Mail application to: Clackamas Community College 

Harmony Community Campus 

ATTN: Nursing Application 

7738 SE Harmony Road 

Milwaukie, Oregon 97222

2015-2016 



DISCRETIONARY POINTS WORKSHEET 

• I have completed BI 234 Microbiology …………………………………........................... 3 points 

Points will be given for completion of BI 234 Microbiology or its equivalent. Course must be on a 

transcript and passed with a “C” or better within the last 5 years. Please submit an official transcript 

from an accredited college or university (CCC transcripts not needed) where the course was taken. 

• I am currently employed in the healthcare field in an area of direct patient care............... 3 points 

Please submit a letter from your employer on letterhead. The letter needs to describe the duties you 

perform that involve direct patient care, how long you have been employed in the current job and 

signed by your supervisor. 

• I have completed one of the following at Clackamas Community College within the last 5 years as 

evidenced on my transcript ................................................................................................. 3 points 

Certificate of Completion Medical Assistant 

Certificate of Completion Clinical Lab Assistant 

Certificate of Completion Dental Assistant 

Certificate of Completion Gerontology 

Certificate of Completion: 

EMT-102 or EMT-117 

NUR-100 or NUR-101 

• I am or have served in the US military services ……………………………………………. … 3 points 

Please submit a letter from your commanding officer or copy of your discharge documents for verification. 

• I have taken a gerontology course at CCC as evidenced on my transcript ................................. 1 point 

Total Discretionary Points (13 Maximum points)

Nursing Program Applications - Clackamas Community College

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