General Information

Abington Memorial Hospital Dixon School of Nursing
2500 Maryland Road
Suite 200
Willow Grove, PA 19090
(215) 481-5500
AMH-dixonson@amh.org

Please complete the following contact form and a representative from the Dixon School of Nursing will contact you as soon as possible.

First Name:
Last Name:
Address:
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Zip:

Day Telephone:

Eve Telephone:

Cell phone:

Fax:
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Best method to contact you: Telephone     E-mail
If by phone, best time to contact you:

How did you hear about Abington Memorial Hospital Dixon School of Nursing?
(check all that apply)
Friend or Relative     Mailing    E-mail   
School Counselor/College Fair    Abington Memorial Hospital
Dixon School of Nursing Information Session
Radio AD     Newspaper AD     Web site    Other

Are you interested in applying to nursing school for entry in:
Year     day option    Eve/weekend option
Undecided at this time

Which of the following best describes your situation:
A high-school student graduating in
A student with a post-secondary degree (not necessarily medical related)
An LPN looking for RN completion
A transfer student from another college, university, or nursing school
Non-USA citizen with Permanent USA Residence
Other

I have questions about the following:
Day Option
Evening/Weekend Option
Financial Aid Assistance

The following questions are for prospective students who have attended an information session.

If you attended an Information Session, please tell us about your experience
The session met my objectives. Yes     No
Speakers were knowledgeable. Yes     No
If no, please explain:

Information provided was useful. Yes     No
If no, please explain:

Tour was helpful and informative. Yes     No
Facility and Room were comfortable. Yes     No

Additional comments or questions: