You are on page 1of 3

Application for the Orange County

New Grad RN Transition Program



Funded by the Health Workforce Initiative
CA Community College Workforce and Economic Development Program
Grant #13-156-001

Application Due Date: _April 25, 2014 by 5 pm_______
Review of applicants will occur between April 28- May 8 , 2014
Notification of acceptance will occur by _May , 2014.
Program Dates: June 2- August 15, 2014 (actual start date depends on assigned facility)
College Orientation May 30th from 2-4 pm HS 112 in the Health Sciences Building at Saddleback
College (required attendance for those accepted)
Due to state funding, only applicants who graduated from State- supported nursing schools in the
Orange County/Long Beach region will be accepted. Applicants must also live in the Orange
County/Long Beach area.
Minimum Qualifications: Graduate of RN program from May 2013-December 2013
Active CA RN License before acceptance to program; Minimum 3.0 GPA for NURSING courses.
Clinical facilities will require interview before final acceptance.
If accepted, participant agrees to provide Social Security number and birth date.
Participants are required to send updated contact information for a minimum of 2 years.

ONLY EMAILED APPLICATIONS WILL BE ACCEPTED. You will be notified by email when your
application is received. SAVE application as New Grad-Your last name. doc or docx, rtf or pdf
Email completed application with scanned attachments of Letter of recommendation (Nursing
Director, FT Faculty, or Preceptor), unofficial transcript, and Right to Work documentation (if
applicable) to:
Please send emailed applications to Mary OConnor moconnor@gwc.cccd.edu

Name (first and last)
Email Address
Phone number
Mailing Address


Nursing Program School
Graduation Date
Cumulative GPA (Nursing courses)
CA RN License number Number: Exp Date:
Country of birth (if not USA, provide
Right to Work documentation)


Male

Female
Caucasian Asian
Black Filipino
Hispanic Multi-ethnic
Other

Interest in Clinical areas: I would be willing to have my Cooperative Work Experience in the following:
(Please RANK TOP 3 preferences with 1 being most desired)
Not all Units will be available
Medical Surgical___ Telemetry___
Labor-Delivery___ Pulmonary/Renal___
Mother-Baby___ Critical Care___
Emergency___ Mental Health___
Neuro DOU ___ Step-down/DOU ___
NICU ___ Pediatrics___

Personal Information: In each category, please circle the answers that describe you and fill-in
additional information
Are you currently working? No Yes Number of hours/week
Are you enrolled in a BSN or
MSN program?
No Yes
Health Care Experience
(employment only)
Facility: Duties: Years: Months:
Multilingual (language
spoken in addition to
English)
List Languages
(Fluent only)

Certifications acquired with
expiration date


Short Answer Questions: Your answers will be rated based on clarity, organization, relevance,
motivation and future plans (your answers should be limited to 250 words per question)

Briefly explain why you should be selected to participate in the Orange County RN Transition
Program?


What skill/attributes do you have that will enhance your success in this program and your
professional role as a nurse?


Southern CA is a culturally diverse area to practice nursing. Please briefly describe a few ways
that you have enhanced your own cultural competency.


Describe your participation in any volunteer activities over that last 4 years.


What are your professional goals?





Thank you for your interest in the RN Transition Program. The Committee reviewing your application
will utilize ranking rubrics to evaluate candidates. The top rated applicants will be notified and will be
interviewed by the clinical facilities before acceptance into the program.

If accepted into the program, you will be required to provide your Social Security number and birth
date. Your Information will not be kept but will be used to generate a unique identifier for you for
data analysis. You will also be required to register for the Cooperative Education program at
Saddleback College and pay the College registration fee. This is a 4 unit course at $46/unit. The
course is not listed in the college catalog. You will be given college registration information when you
are accepted into the program.

The program requires 240 hours in an unpaid clinical externship (approximately two-12 hour
shifts/week), completion of a weekly experience reflection journal, and participation in simulation
experiences at the college. You will also be required to attend the College Orientation and the
Hospital Orientation.

You must provide proof of physical exam, BLS, background check, malpractice insurance,
immunizations and other requirements of clinical agency, prior to the start of the program.

Checklist: Before submitting application via email, please check that all components listed are
included in the email.

Please send ONE EMAIL with all attachments. SUBJECT: New Grad-Last name
Completed Application attachment (Save as New Grad-Your Last Name doc or docx or rtf or pdf)
Short Answer Questions in Word or Text Document attachment
Unofficial transcript (Scan and attach)
Director/FT Faculty/Preceptor letter of recommendation (Scan and attach)
Right To Work documentation (Scan and attach if applicable)

Failure to follow directions may result in disqualification

You might also like