‚ÄčIntent to Return (Part-Time Nursing)
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Name *

Phone Number *

E-mail Address *

Availability *

Program(s)/Semester(s) of Interest *

Area of Expertise *

Preferred Work Environment *

4th Semester Preceptor *

Please specify if you would be interested in becoming a preceptor for 4th semester ADN students.

Referrals for Preceptors or Part-Time Faculty

Please list the name, phone number, and employer of individuals you would recommend for PT faculty or as a 4th semester preceptor. Those names listed will be contacted for recruitment purposes.

Validation *

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