Forms

Application Packet Forms

To apply to the Nursing program, begin with the checklist. Please contact us to receive the necessary forms to complete your application packet, which are listed below.

  • Nursing Program Application
  • Statement of Student Responsibility
  • Brookhaven/Texas Board of Nursing Information
  • Immunizations Form
  • Dosage Calculations Workshop Score
  • Nursing Information Session Verification
  • Ranking for Admission (Word document - 21 KB)​
  • HESI A2 Cumulative Score
  • Eligibility Requirements for RN Licensure in the State of Texas
  • Bring your original Social Security card
  • Bring your current, valid Texas driver's license

Fourth-Semester Nursing Student Forms

  • Referral Letter Request Waiver

Submit your packet to the Health and Human Services Division Office, located in Building X, Room X-1082, by the deadline found on the Admission Schedule and Deadlines page. Applications are not accepted by mail. If you have questions about your packet, we would be happy to look it over.