Sunrise School of Nursing
4600 Northwest 9th Court* Suites 1-6, Plantation, FL 33317
Application
Student Information
Program
...
Nursing Assistant (NA)
Practical Nursing (PN)
Associate of Science in Nursing (ASN)
Associate of Science in Nursing- LPN to RN (ASN-A)
First Name
Middle Name
Last Name
Social Security No
Citizenship Status
...
US Citizen
Permanent Resident
Alien #
If not a US Citizen: What is your country of origin?
Birth Date
Ethnicity
...
White/Caucasian
Black or African American
Asian
Hispanic or Latino
Native American or Alaska Native
Native Hawaiian or Pacific Islander
Two or More Races
Email
Home Phone
Cell Phone
Street
City
Zip/Postcode
Please indicate High School Attended
Residency Status
...
Florida
Non-Florida
I give permission for Sunrise School of Nursing to disclose my grades/transcripts for any Dual Credit courses for the academic year to my area College/High School
Date