{"id":188,"date":"2021-10-12T16:31:51","date_gmt":"2021-10-12T23:31:51","guid":{"rendered":"https:\/\/forms.bellevuecollege.edu\/nursing\/?page_id=188"},"modified":"2021-10-22T12:21:35","modified_gmt":"2021-10-22T19:21:35","slug":"adnacceptance","status":"publish","type":"page","link":"https:\/\/forms.bellevuecollege.edu\/nursing\/adnacceptance\/","title":{"rendered":"ADN Acceptance Form"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_13' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_13'  action='\/nursing\/wp-json\/wp\/v2\/pages\/188' data-formid='13' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_13' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_13_2\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_13_2'>\n                            \n                            <span id='input_13_2_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.3' id='input_13_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_13_2_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_13_2_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.6' id='input_13_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_13_2_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_13_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_3'>BC Student Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_13_3' type='email' value='' class='medium'   placeholder='@bellevuecollege.edu' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_13_12\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_12'>ctcLink ID<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_12' id='input_13_12' type='number' step='any'   value='' class='large'    placeholder='ctcLink ID' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_13_5\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >For which program cohort were you offered acceptance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_5'>\n\t\t\t<div class='gchoice gchoice_13_5_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Winter 2026 Full-time Program' checked='checked' id='choice_13_5_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_5_0' id='label_13_5_0' class='gform-field-label gform-field-label--type-inline'>Winter 2026 Full-time Program<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_5_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Spring 2026 Part-time Program'  id='choice_13_5_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_5_1' id='label_13_5_1' class='gform-field-label gform-field-label--type-inline'>Spring 2026 Part-time Program<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_5_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Fall 2026 Full-time Program'  id='choice_13_5_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_5_2' id='label_13_5_2' class='gform-field-label gform-field-label--type-inline'>Fall 2026 Full-time Program<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Acceptance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_6'>Please indicate your desire to accept or decline your seat in the Associate Degree Nursing (ADN) program by checking the applicable box<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_6'>\n\t\t\t<div class='gchoice gchoice_13_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='I ACCEPT your offer of admission to the program'  id='choice_13_6_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_6\"   \/>\n\t\t\t\t\t<label for='choice_13_6_0' id='label_13_6_0' class='gform-field-label gform-field-label--type-inline'>I ACCEPT your offer of admission to the program<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='I DECLINE your offer of admission to the program'  id='choice_13_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_6_1' id='label_13_6_1' class='gform-field-label gform-field-label--type-inline'>I DECLINE your offer of admission to the program<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Decline<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_9'>Please indicate your main reason for declining your seat in the Associate Degree Nursing (ADN) program by checking the applicable box<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_9'>\n\t\t\t<div class='gchoice gchoice_13_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='I was accepted to another nursing school.'  id='choice_13_9_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_9\"   \/>\n\t\t\t\t\t<label for='choice_13_9_0' id='label_13_9_0' class='gform-field-label gform-field-label--type-inline'>I was accepted to another nursing school.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='BC was not my top choice for nursing school.'  id='choice_13_9_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_9_1' id='label_13_9_1' class='gform-field-label gform-field-label--type-inline'>BC was not my top choice for nursing school.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_9_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='My plans have changed, and I no longer want to become a Nurse.'  id='choice_13_9_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_9_2' id='label_13_9_2' class='gform-field-label gform-field-label--type-inline'>My plans have changed, and I no longer want to become a Nurse.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='My financial situation has changed, and I cannot attend school currently.'  id='choice_13_9_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_9_3' id='label_13_9_3' class='gform-field-label gform-field-label--type-inline'>My financial situation has changed, and I cannot attend school currently.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_9_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='gf_other_choice'  id='choice_13_9_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_9_4' id='label_13_9_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_13_9_other' class='gchoice_other_control' name='input_9_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_7\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Contract<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_7'>By &#8220;checking&#8221; each statement, you are signaling to us that you understand and accept all statements. It will be your responsibility to understand and fulfill all program requirements. <\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_7'><div class='gchoice gchoice_13_7_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.1' type='checkbox'  value='I acknowledge that my acceptance is contingent upon the completion of any\/all admissions requirements for the Associate Degree in Nursing by the due date specified by the program.  This includes prerequisite courses, immunizations, BLS CPR certification at the Provider level from the American Heart Association, and any others specified by the program.'  id='choice_13_7_1'   aria-describedby=\"gfield_description_13_7\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_7_1' id='label_13_7_1' class='gform-field-label gform-field-label--type-inline'>I acknowledge that my acceptance is contingent upon the completion of any\/all admissions requirements for the Associate Degree in Nursing by the due date specified by the program.  This includes prerequisite courses, immunizations, BLS CPR certification at the Provider level from the American Heart Association, and any others specified by the program.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_7_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.2' type='checkbox'  value='I will work with the Nursing Program Manager to develop an educational plan to complete all program requirements, including corequisite courses (if needed).'  id='choice_13_7_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_7_2' id='label_13_7_2' class='gform-field-label gform-field-label--type-inline'>I will work with the Nursing Program Manager to develop an educational plan to complete all program requirements, including corequisite courses (if needed).<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_7_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.3' type='checkbox'  value='I acknowledge that completion of the program is contingent on completing all coursework with a &quot;C&quot; grade (2.0) or higher.&lt;br&gt;'  id='choice_13_7_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_7_3' id='label_13_7_3' class='gform-field-label gform-field-label--type-inline'>I acknowledge that completion of the program is contingent on completing all coursework with a &#8220;C&#8221; grade (2.0) or higher.<br><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_7_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.4' type='checkbox'  value='I acknowledge that if I deviate from my educational plan I put myself at risk of not completing the program within the projected timeline.'  id='choice_13_7_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_7_4' id='label_13_7_4' class='gform-field-label gform-field-label--type-inline'>I acknowledge that if I deviate from my educational plan I put myself at risk of not completing the program within the projected timeline.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_7_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.5' type='checkbox'  value='I acknowledge that any changes to my educational plan must be discussed with the Program Chair and approved in writing.'  id='choice_13_7_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_7_5' id='label_13_7_5' class='gform-field-label gform-field-label--type-inline'>I acknowledge that any changes to my educational plan must be discussed with the Program Chair and approved in writing.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_7_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_7.6' type='checkbox'  value='I understand that it is my responsibility to keep my contact information up to date and to check my BC email regularly in order to receive important program information. Furthermore, I understand that faculty and staff will not respond or communicate via personal email addresses.'  id='choice_13_7_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_7_6' id='label_13_7_6' class='gform-field-label gform-field-label--type-inline'>I understand that it is my responsibility to keep my contact information up to date and to check my BC email regularly in order to receive important program information. 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By signing, you are articulating that all fields completed above are correct and true. <\/div><div class='ginput_container ginput_container_text'><input name='input_8' id='input_13_8' type='text' value='' class='large'  aria-describedby=\"gfield_description_13_8\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_11\" class=\"gfield gfield--type-number gfield--input-type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_11'>Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_11' id='input_13_11' type='number' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_13_13\" 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