Acknowledgement of Essential Functions Form - Practical Nursing

If you see this don't fill out this input box.

Acknowledgment of Essential Functions- Practical Nursing

Without reasonable accommodations

With reasonable accommodations (documentation must be attached)

Please check one

By signing below, I acknowledge that I have read and understand the Essential Functions for the Practical Nursing Student. I believe to the best of my knowledge that I have the ability to learn and perform the Essentials Functions*

Date (mmddyyy)*

Which program are you applying for?*