Practical Nursing Application

Practical Nursing Applications, and any supporting documentation as listed on the Practical Nursing Checklist, must be received in the Admissions Office by March 6th.

The Practical Nursing program is a highly competitive selective admissions program. It is your responsibility to make sure that the application and all of the requirements and pre-requisites are completed by the application deadline. See Practical Nursing Student Handbook 2019-2020.

Practical Nursing Application

Student ID*
Number assigned to a student after college application is submitted online.
Name*
First Last
Please ensure that your name, address and telephone numbers are correct in the MYSouthwest student information system, as these will be used to correspond with you. The college is not responsible for undeliverable mail.
Address*
Street Address Address Line 2 City State ZIP Code
Phone - Home
Business or Cell Phone
First priority for acceptance will be given to applicants who reside within Southwest's service region (Buchanan, Dickenson, Russell & Tazewell counties). Secondary priority will be given to Virginia residents outside of those counties, and then out-of-state applicants.
Domicile*
Select the county or jurisdiction in which you have lived during the last consecutive 12 months.
- Buchanan, Dickenson, Tazewell, Russell
- Virginia Jurisdiction other than counties listed above
- Out of State
Colleges or Universities Attended*
Please indicate all the colleges or universities that you have attended until now, providing the college name, state, degree received if any, last year attended and your standing at each (good standing, probation, suspended, dismissed) If None, enter none attended.
Agreement*
I have read and understand ALL requirements as described in the SWCC catalog online at sw.edu and the Practical Nursing Selective Admissions Procedures checklist. (A download link to this PDF checklist is provided at the top of this page.) I also understand that I must submit this application form by the deadline for each year that I wish to be considered. It is my responsibility to make sure that all admissions requirements are met and all required documents are received by the SWCC Admissions Office by the March 6th deadline.
I agree to the statement above to apply to the LPN program at SWCC.

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