Fort Hays Tech | North Central Practical Nursing Application

I am applying to the Practical Nursing Program on the following campus:

Beloit Campus

Hays campus

Both Campuses

First

Last

Maiden Name (if applicable)

Date of Birth

Current Address

City/Town

State

ZIP/Postal Code

Permanent Address (if different than current address)

City/Town

State

ZIP/Postal Code

Email Address

Cell Phone

What is your primary language?

Optional Information

Ethnicity

White

Black/African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

Multiracial

Other…

Gender

Female

Male

Choose not to indicate

Self-Reported Pre-Requisite Information

You will need to send your official transcript(s) to Fort Hays Tech | North Central to make your application process complete. Information provided in this section does NOT take the place of official transcripts.

Please indicate if the course is complete (with a C or better), in progress, if you have not yet taken the course, or if you are unsure if the course you took at another institution is transferrable as the same course.

Human Anatomy & Physiology with Lab (5 credit hrs)

General Psychology

Human Growth & Development

Principles of Nutrition

Intermediate OR College Algebra

Do you currently have an active CNA license in Kansas?

Do you currently have an active CMA license in Kansas?

Have you taken the TEAS test?

If so, what was your score?

Have you applied for admission to the college for Fall 2025? If not, please do so at fhtechnc.edu/admissions/how-apply

Education

High School Name

High School Graduation Year:

Name of Previous College Attended (if applicable) - #1

Name of Previous College Attended (if applicable) - #2

Name of Previous College Attended (if applicable) - #3

I certify that to the best of my knowledge all statements that I have made on this application are complete and accurate. Additionally, I have completed the items on this application in their entirety and will provide Fort Hays Tech | North Central the documents required as a condition of admission and enrollment.

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Fort Hays Tech | North Central Practical Nursing Application

Optional Information

Self-Reported Pre-Requisite Information

Education

Grow your grit