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The application deadline for August 2023 has passed. All applications submitted after May 19, will be process for the February 2024 class. Thank you
PERSONAL INFORMATION
Class Desired**
- February 2024
First Name*
Complete Middle Name*
Last Name*
Maiden Name
Current Address*
Street Address City State ZIP Code
Phone*
Date of birth*
Month
Day
Year
Email*
Please Confirm Email*
Social Security Number**
Please Confirm Social Security Number*
Mother's Maiden Name*
Are you a U.S. citizen?**
- Yes I am a U.S. Citizen
- No but I am an eligible non-citizen
- No I am not a citizen or eligible non-citizen
Gender
- Female
- Male
- Transgender
- Gender-queer
- Gender-Non-binary
- Other
- Prefer Not to Answer
Ethnicity
Marital Status
Please list any Cities, States and Counties you have lived in the past 5 years
EMERGENCY CONTACT
Name
First Last
Phone
Relation
Address
Street Address City State ZIP Code
EDUCATION
Do you graduate from a state recognized school or get a GED*
Name of High School*
Year of graduation or GED
College
Dates attended college
How did you hear about us?
EMPLOYMENT INFORMATION
Present employer
Position
Dates of employment
Please write a short statement of why you want to be a practical nurse.**
Have you ever been convicted of any criminal offense in any state or in federal court (other than for minor traffic violations?**
- Yes
- No
If yes, please list below:
I understand that false statments or omission on any part of the application may be considered sufficient cause for denial of admission or dismissal from the program.**
- Yes, I understand.
By checking this box, you understand that NO APPLICATIONS WILL BE ACCEPTED WITHOUT THE $75 APPLICATION FEE*
- Yes, I understand and will submit payment with my application
***Applications submitted without payment will be discarded. ***
By checking the box below, you acknowledge and agree that the Capital Area School of Practical Nursing Application Fee of $75.00 is non-refundable. No application will be reviewed without payment. You acknowledge and agree to not submit registration for pre-entrance exam until Application Fee has been received.*
By checking the box below, you acknowledge and agree that the Capital Area School of Practical Nursing Application Fee of $75.00 is non-refundable. No application will be reviewed without payment. You acknowledge and agree to not submit registration for pre-entrance exam until Application Fee has been received.
- I agree to the statement above regarding my payment
Product Name
Price:
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Apply Online
Adult CNA Courses
CPR Course Information
CPR Registration
Expenses
TEAS Testing
Opportunities for CASPN Students

Admissions packet

In addition to your online application, we’ll also need several other documents completed and returned to us. You may download and print the documents here.

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2201 Toronto Road, Springfield, IL 62712

(217) 585-1215

info@caspn.edu

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