Skip to main content
Lawrence Memorial Regis College
Menu
Faculty
Prospective Students
LOGIN
Applicant
Student
Administration
Create Online Application
Complete and submit this form to create an online application. All fields are required. If you have ever been issued an ID and PIN at this school you may use them to create a new application by using the form below.
Required *
Choose Application to Apply for
Associate Degree Nursing - Day Division
Associate Degree Nursing - Evening/Weekend
First Name
Middle Name
Last Name
Pref. Pronouns
They/Them
She/Her
He/Him
Unspecified
Phone
Birthdate
Email Address
Confirm Email
Please create a PIN as follows: 8-16 characters; at least one uppercase letter, lowercase letter, number and special character/symbol. Be sure to write down your PIN in a secure but accessible-to-you place so you always have it readily available when you need it.
PIN
Confirm PIN
Submit
Clear
If you have ever been issued an ID and PIN at this school you may use them to create a new application. Otherwise complete the form above.
Choose Application to Apply for
Associate Degree Nursing - Day Division
Associate Degree Nursing - Evening/Weekend
ID
PIN
Email Address
Submit
Clear