Nursing Application
Program applying for:
ASN
ABSN
BSN
LPN-ASN
RN-BSN
Location applying for:
LMU Corbin – Corbin, KY
LMU Tampa – Tampa, FL (Fast Track)
Main Campus – Harrogate, TN
Cedar Bluff – Knoxville, TN
Location applying for:
LMU Corbin – Corbin, KY
LMU Tampa – Tampa, FL
Main Campus – Harrogate, TN
Cedar Bluff – Knoxville, TN
Location applying for:
Cedar Bluff – Knoxville, TN (
Fast Track
)
Chattanooga, TN (
Fast Track
)
Lexington, KY
(
Fast Track
)
LMU Tampa – Tampa, FL (
Fast Track
)
Cedar Bluff – Knoxville, TN (Traditional and Fast Track)
Main Campus – Harrogate, TN (Traditional)
Location applying for:
Cedar Bluff – Knoxville, TN
(Bachelor's degree required)
Location applying for:
Online
Hybrid (online and seat)
Start term:
Spring (January)
Start term:
Summer (May)
Start term:
Fall (August)
Start term:
Fall (August)
Start term:
Spring (January)
Fall (August)
Start term:
Spring (January)
Summer (May)
Start year:
Please select...
2025
Start year:
Please select...
2026
I. Demographics
Name:
Last
First
Middle
Date of Birth:
Social Security Number:
Home Address:
Number and Street
City
State
Zip Code
Telephone Number:
Cell Phone Number:
Email:
Citizenship
Are you a U.S. Citizen?
Yes
No
If no, Country of Birth:
Country of Citizenship:
Do you currently have a U.S. Visa?
Yes
No
If yes, what type?
Ethnicity - Optional
American Indian
Black or African American
Pacific Islander
Asian
Non-resident Alien
White
Other
Gender
Female
Male
II. Education (Please enter all previously attended college institutions)
Name of Institution
Year Attended
Major
Degree Awarded (If Applicable)
Year Awarded (If Applicable)
Please select...
AA
AS
BA
BS
MA
MS
Other
Please select...
AA
AS
BA
BS
MA
MS
Other
Please select...
AA
AS
BA
BS
MA
MS
Other
Please select...
AA
AS
BA
BS
MA
MS
Other
Please select...
AA
AS
BA
BS
MA
MS
Other
Have you ever applied to a nursing program at LMU?
Yes
No
Have you attended a previous nursing program or taken nursing courses
?
Yes
No
If yes, where?
When?
If nursing degree not completed, why?
III. Professional or Business Experience
Name and Location of Agency
Start Date
End Date
Description of Duties
IV. Emergency Contact
First Name
Last Name
Relationship
Phone Number
Address:
Number and Street
City
State
Zip Code
V. Confidential Information
Has any academic or disciplinary action been taken against you at any college or university you have previously attended?
Yes
No
Please explain:
Are you currently on probation, parole, under court restriction or have you ever been convicted of a crime other than a minor traffic violation?
Yes
No
Please explain:
Clinical rotations are a requirement to complete the nursing program. Facilities in the AdventHealth system (formerly Florida Hospital) are currently providing the majority of the clinical rotations for the Tampa extended site. Have you ever been employed by AdventHealth System?
Yes
No
If yes, are you eligible for rehire?
Yes
No
Contact Information