Why I Want to Be a Nurse Essay

1096 WordsJul 27, 20125 Pages
4. counsElor inFormation To be completed by the high school guidance counselor. Please provide current student transcripts, as well as IEP/ETR documents. EFCTS Data: Do Not Write in this Box Student Name Current Grade/Rank q Freshman q Sophomore Date Received q Junior q Senior q MD For admission for 2012-2013 School Year Desired Program IEP Designation (optional) q AUT q CD application q ECC q ED q HI q SLD q 504 Plan q OHI q OI q SI q TBI q VI Current Number of Credits Earned q FCC q Satellite Student ID Date Accepted Accepted Program Pending Credits SSID# Guidance Counselor Comments OGT Scores: Reading: Science: Math: Writing: Social Studies: Guidance Counselor Signature 5. EmErgEncy mEdical Form To be completed by the parent/guardian. In the event that reasonable attempts to contact me at the listed phone numbers have been unsuccessful, I hereby give my consent for (1) the administration of any treatment deemed necessary by my preferred physician/preferred dentist, or in the event the designated preferred practitioner is not available, by another licensed physician or dentist; and (2) the transfer of my child to my preferred hospital, or any hospital reasonably accessible. This authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentists, concurring in the necessity for such surgery, are obtained prior to the performance of such surgery. Emergency Contact Information Emergency Contact Name Relationship to Applicant Daytime Phone Number Alternate Phone Number Preferred Physician Phone Number Preferred Dentist Phone Number Preferred Hospital Application Timeline: q Check here if you do not give consent for emergency medical treatment of your child. In the event of Round 1-

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