Cumberland University | School of Nursing

Note: All fields marked with an asterisk (*) must be completed.

*First Name:

*Last Name:

*Middle:

*Address:

*City:

*State:

*Zip Code:

*Home Phone

*Cell Phone:

*Email:

*Date of Birth:

Do you have documented disabilities and request ADA accommodations?

YesNo

Is this your first time taking the Kaplan Exam?

YesNo

If no, please list the date of previous exam:

Desired Test Date:

1st Choice:

2nd Choice:

COME HERE TO GET THERE.