COTC Nursing Information Meeting
Required for students interested in COTC's Nursing Program
First Name:
*
Last Name:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
Phone Number
*
-
Area Code
Phone Number
How did you hear about the COTC Nursing Information Meetings?
*
Choose One
COTC Website
Admissions Representative
Academic Advisor
Email Communication
Phone Call
Other
Please describe:
*
Which campus will you be attending your information meeting?
*
Newark
Pataskala
Coshocton
Knox (Mount Vernon)
Pataskala Campus Dates:
*
Newark Campus Dates:
*
Knox (Mount Vernon) Campus Dates:
*
Coshocton Campus Dates:
*
Submit
Should be Empty: