Personal Information
Legal Name
Demographic Information
THESE ITEMS ARE OPTIONAL – This information is requested for statistical use
only in accordance with applicable federal regulations.
Emergency Contact Information
Educational and Character Information
Please note: Test of English as a Foreign Language (TOEFL) may be required for applicants
who are non-native speakers of English to measure their ability to use and understand
English as it is spoken, written and heard. Please contact the Admissions Office
at 484-526-3443 for more information.
Education and Character Information Continued
Compliance Information
NOTICE OF NON-DISCRIMINATION POLICY
The St. Luke’s School of Nursing is in compliance with applicable federal, state
and local laws, regulations and ordinances governing equal opportunity and non-discrimination,
including without limitation, Title VI of the Civil Rights Act of 1964, Title IX
of the Education Amendments of 1972, as amended, Section 504 of the Rehabilitation
Act of 1973, as amended, the Americans with Disabilities Act of 1990, and
the Age Discrimination Act of 1975. The School of Nursing provides equal educational
opportunity to qualified applicants and students and does not discriminate on the
basis of age, sex, ancestry, race, color, national origin, religion or disability
in recruitment and admission, educational programs and policies, housing, scholarships
and loans programs, or nonacademic services such as recreation, counseling, or social
activities. The Director is responsible for the implementation and coordination
of equal opportunity in the School of Nursing.
APPLICANT ACKNOWLEDGEMENT
As an applicant to St. Luke's School of Nursing ("St. Luke's"), I understand that
all of the information I have provided on my application for admission and otherwise
in connection with the application process will be relied upon by St. Luke's to
determine my qualifications for admission. I hereby acknowledge that all of the
information I have provided in response to inquires on this application for admission
and all information I have provided otherwise in connection with the application
process are true, correct and complete. I understand that any false, misleading,
or incomplete answer, statement or implication made by me in connection with this
application or the application process, or any failure to disclose any relevant
information, shall result in the denial and/or revocation of admission to St. Luke's,
including dismissal from St. Luke's, if matriculated, and may also lead to future
denial and/or revocation of licensure in Pennsylvania as a Registered Nurse.
I hereby grant St. Luke's permission to investigate my personal, criminal, educational
and employment background and history and to contact persons, organizations, institutions
or government agencies who may have knowledge of me. In consideration for St. Luke's
reviewing my application for admission, and intending to be legally bound, I hereby
release St. Luke's School of Nursing, its parent, subsidiaries, affiliates, trustees,
officers, employees and agents (collectively hereinafter referred to as "St. Luke's"),
from any and all claims or liability, known or unknown, arising from St. Luke's
investigating my background and all persons, organizations, institutions or government
agencies supplying such information.
Finally, it is my understanding that I shall not be considered for admission to
St. Luke's until I have submitted all credentials and otherwise satisfied all requirements
for a timely and complete application for admission. I further understand that an
applicant who satisfies all application requirements is not guaranteed admission
into St. Luke's diploma program. I agree to inform St. Luke's of any changes in
the information I have provided on this application or otherwise in connection with
the application process. If St. Luke's offers me admission, and I decide to matriculate,
I agree to comply with any and all of St. Luke's policies, rules and regulations,
as amended from time to time.