Practical Nursing Application Practical Nursing Program Application Admission to the practical nursing major is a separate process from admission to NTC and is required in order to enroll in NTC nursing courses. "*" indicates required fields Today's Date* MM slash DD slash YYYY Name* First Last Star ID or NTC Tech ID:* Email* Phone*Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Consent*Under certain circumstances, federal and state laws authorize release of private information without your consent: - to other schools in which you seek or intend to enroll, or are enrolled; - to federal, state or local officials for purposes of program compliance, audit or evaluation; - as appropriate in connection with your application for, or receipt of, financial aid; - to your parents, if your parents claim you as a dependent student for tax purposes; - if the information is sought with a subpoena, court order, or otherwise permitted by other state or federal law, and; - to an organization engaged in educational research or an accrediting agency. Minnesota State Colleges and Universities abide by the provisions of Title IX and other federal and state laws forbidding discrimination on the basis of sex, race, color, national origin or handicap and all other state and federal laws regarding equal opportunity. This document can be made available in alternate formats, such as large print or cassette tape, upon request by calling one of the numbers above. If you have been arrested, charged or convicted of any criminal offense, you should investigate the impact that the arrest, charge or conviction may have on your chances of employment in the field you intend to study or on your chances to obtain federal, state, and other higher education financial aid. I certify that the information provided in this application is true & complete to the best of my knowledge.