Admission Application All application information is confidential. All application materials, once submitted, are the property of Pacific College of Health and Science and cannot be returned to the applicant. 1 Personal info 2 EDUCATION 3 Demographic 4 Payment Select the campus you're applying toSan DiegoChicagoNew YorkOnline Applying for Chicago ProgramSelect An OptionAcupuncture Program - Entry LevelNon-Matriculated Student Applying for New York ProgramSelect An OptionAssociate of Occupational StudiesAcupuncture Program - Entry LevelBachelor of Science, Nursing (Pre-Licensure)Certificate in Chinese Herbal Medicine (CCHM)Non-Matriculated Student Applying for San Diego ProgramSelect An OptionMassage Therapy/Asian BodyworkAssociate of Applied Science, Holistic HealthAcupuncture Program - Entry LevelNon-Matriculated Student Applying for Online ProgramSelect An OptionMedical Cannabis CertificateCosmetic Acupuncture CertificateHolistic Nursing CertificateBachelor of Science, Nursing (RN to BSN)Master of Science in Nursing (MSN)Doctorate of Acupuncture - (Transitional Doctorate)Doctorate of Acupuncture & Chinese Herbal Medicine -Transitional Doctorate Are you enrolling Full-time or Part-time?Full-timePart-time Desired Term StartSelect An Option2025 Winter (January)2025 Spring (May)2025 Fall (Sept) Are you currently a practicing nurse?YesNo Please indicate place of employmentno-icon Personal Information First Nameno-icon Last Nameno-icon Have you applied previously to Pacific College?YesNo Year previously appliedno-icon Former Last Name/ Family Nameno-icon Your Address Addressno-icon Cityno-icon StateSelect a stateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingOther Zipno-icon Primary Phoneno-icon Emailemail Date of Birthdate_range Date of Birthno-icon GenderMaleFemaleOther Please specifyno-icon Citizenship US CitizenYesNo Do you have a Social Security Number?YesNo Social Security Numberno-icon Country of CitizenshipSelect a countryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia And HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic Of TheCook IslandsCosta RicaCote D'ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-bissauGuyanaHaitiHeard Island And Mcdonald IslandsHoly See (vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic OfIraqIrelandIsraelItalyJamaicaJapanJordanKazakstanKenyaKiribatiKorea, Democratic People's Republic OfKorea, Republic OfKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacauMacedonia, The Former Yugoslav Republic OfMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States OfMoldova, Republic OfMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian Territory, OccupiedPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint HelenaSaint Kitts And NevisSaint LuciaSaint Pierre And MiquelonSaint Vincent And The GrenadinesSamoaSan MarinoSao Tome And PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia And The South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard And Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province Of ChinaTajikistanTanzania, United Republic OfThailandTogoTokelauTongaTrinidad And TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.s.Wallis And FutunaWestern SaharaYemenZambiaZimbabwe Country of BirthSelect a countryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia And HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic Of TheCook IslandsCosta RicaCote D'ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-bissauGuyanaHaitiHeard Island And Mcdonald IslandsHoly See (vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic OfIraqIrelandIsraelItalyJamaicaJapanJordanKazakstanKenyaKiribatiKorea, Democratic People's Republic OfKorea, Republic OfKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacauMacedonia, The Former Yugoslav Republic OfMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States OfMoldova, Republic OfMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian Territory, OccupiedPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint HelenaSaint Kitts And NevisSaint LuciaSaint Pierre And MiquelonSaint Vincent And The GrenadinesSamoaSan MarinoSao Tome And PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia And The South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard And Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province Of ChinaTajikistanTanzania, United Republic OfThailandTogoTokelauTongaTrinidad And TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.s.Wallis And FutunaWestern SaharaYemenZambiaZimbabwe Do you have or will you apply for a student (F-1 or M-1) Visa?YesNo The i-20 should be sent to the address the above?YesNo Mailing Addressno-icon What resource(s) will you use to fund your education?VA BenefitsFinancial AidCashOther Sponsorship My financial sponsor isno-icon Relationshipno-icon Will you be bringing your spouse and/or children?YesNo Prior Education Please chronologically list your high school and all colleges and universities attended Have you completed your secondary education?High SchoolGED Have you previously attended a nursing program?Failure to disclose this could result in being disqualifiedYesNo Select your highest level of educationGED / High School DiplomaSome CollegeAssociate's DegreeBachelor's DegreeMaster's DegreeDoctorate DegreeProfessional Certification(s) Name of Institutionno-icon Degree type/Estimated # unitsno-icon Year graduated / attendedno-icon Name of Institutionno-icon Degree type/Estimated # unitsno-icon Year graduated / attendedno-icon Name of Institutionno-icon Degree type/Estimated # unitsno-icon Year graduated / attendedno-icon Name of Institutionno-icon Degree type/Estimated # unitsno-icon Year graduated / attendedno-icon Demographic info Racial/ Ethnicity statusWhiteBlack/African AmericanAmerican Indian/Alaska NativeHispanic or LatinoAsianNative Hawaiian/Other Pacific IslanderRace and ethnicity unknown2+ racesPrefer not to answerNonresident alien Have you ever been convicted of a felony or a first degree misdemeanor?YesNo Additional infomationno-icon Have you served in the military?YesNo Branch & year I hereby make Application for Admission to Pacific College of Health and Science, and certify that all information given on this application is true.I authorize Pacific College to investigate all statements on my application.By signing this application electronically, I certify under penalty of perjury that my selections are correct and complete to the best of my knowledge.I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature. Thank you for your service! Your application fee is waived. Event Information (Optional)no-icon Full Nameno-icon Dateno-icon $ [field81]Stripe Card PlaceholderEnter Pacific College Accepts: price maskno-icon Submit keyboard_arrow_leftPrevious Nextkeyboard_arrow_right