Personal Information: By submitting this application you certify that you have not knowingly withheld or given false information on this application. You understand statements in the application process must be truthful and honest, and that any misrepresentation or false statement will disqualify you immediately and permanently from enrollment in the Cochran School of Nursing (CSN). You are aware that if you have ever been convicted of a misdemeanor or felony charge in any court, it is possible that your application for licensure as a Registered Nurse will be delayed or denied by the NYS Department of Education. CSN prides itself on the diversity of its students. CSN has a non-discrimination policy and promotes equal opportunities. Candidates for admission are considered without discrimination on the basis of race, color, creed, religion, national origin, age, gender, sexual orientation, martial status, or disability.

To Apply, you must have no more than one(1) outstanding pre requisite.
Name - First
Middle
Last

Expected Degree
Associate of Applied Science

Home - Address

City
State / Province
Zip Code

Home - Area
Phone

Cell - Area
Phone

Work - Area
Phone

Email Address


    required and     optional