ACCELERATED UNDERGRADUATE NURSING APPLICATION

Transcription

1 ACCELERATED UNDERGRADUATE NURSING APPLICATION Mail application to: Undergraduate Nursing Program/Admission Application/Accelerated Option College of Nursing University of Wisconsin Oshkosh 800 Algoma Blvd, CF-112, Oshkosh, WI OR Deliver application to: Undergraduate Nursing Program office Clow Faculty Room 112 UW Oshkosh Hours 7:45 am-4:30 pm Monday-Friday Please note the deadlines below; if the date falls on a weekend, the deadline is extended to the next business day. Submit my application for: (Choose one) February Admission Cycle - Deadline is July 30 May Admission Cycle - Deadline is October 30 October Admission Cycle - Deadline is March 30 February May October Page 1

2 Checklist for Clinical Admission Requirements Note: All must be completed to apply to the Accelerated Nursing Program Have you: Yes No 1. Completed your Bachelor's degree? 2. Received admission to the University of Wisconsin Oshkosh? 3. Had your unoffical transcripts evaluated by the online pre-nursing advisor? 4. Completed four of the six science prerequisites by the application deadline? 5. Earned no less than a "C" in each of the prerequisite courses? 6. Had no more than two of the prerequisite courses repeated? 7. Completed your CNA certification? 8. Included a copy of your Current CNA license? 9. Included a completed Background Information Disclosure Form? 10. Ordered your required Castle Branch Background Check (fee paid by student)? 11. Sent all of your official transcripts from the schools you have attended to the Admissions office? 12. Included your current resume? 13. Included your completed GPA Calculation Form? 14. Sent a Transfer Disclosure Form to all the institutions attended to be returned to the program assistant? (on@uwosh.edu) Page 2

3 Applicant Information: First MI Last UWO Student ID UWO Cell Phone: Personal Alternate Phone: Address: City: State: Zip: Gender: Birthdate: Have you ever served in the Military? Yes No Have you ever applied to UWO's Accelerated Nursing Program? Yes No If yes, when? The community in which you will reside while you complete the Accelerated Online Bachelor's to BSN Option: In the event clinical placements are not available in your geographical location, please provide other locations(s) you could reside during the Accel Option: The city/area in which you intend to seek employment as a nurse after graduation: If admitted, it is expected that you complete the Accelerated program in the community you have identified on this application for both theory courses and clinical courses. It is your responsibility to notify the program assistant (on@uwosh.edu) if your residence changes. Changing location may impact your ability to be admitted to the Accelerated Option. SIGNATURE REQUIRED BY ALL APPLICANTS: By signing below I acknowledge that I have read and understand the requirements and policies as outlined in this application form. Failure to comply with requirements will deem my application ineligible and delay the application process. *Signature: Date: Page 3

4 ACADEMIC BACKGROUND REPORT FORM 1. Have you taken any courses in the past that have been transferred to UWO? Yes No If Yes, Please list the dates and school information Name of College/University Dates Attended 2. Are you currently taking classes at another campus? Yes No If Yes, Please list the courses and campus below: (If this class is a required pre-requisite nursing course it must be completed by the application deadline) Name of College/University Course#/Name Anticipated Completion Date 3. Have you ever attended or are currently attending a clinical nursing program or the clinical portion of another healthcare major and did not finish? Yes No If Yes, Please list all colleges and universities where you have attended a clinical program (nursing or other health care major) below. You must submit a letter with your application written by the Dean or the Department Chair on college letterhead indicating you left in "good standing" in both academics and conduct. Name of College/University Dates Attended 4. Please list your previous degrees below. Include degrees you might have in any other area Name of College/University Degree Earned Completion Date PLEASE NOTE: It is imperative that UW Oshkosh and transfer students taking course work elsewhere ensure that grades/ transcripts are sent to UW Oshkosh Admissions office on time to be considered for admission. Please verify necessary documents have been received and posted on UWO transcript with the appropriate office (Admission Office if transfer student or Registrar if UWO student). Course grades included on the GPA calculation form but not found on the UWO transcript will be eliminated. Page 4

5 INSTRUCTIONS FOR PAGES 5-9: If any of your responses from this point forward do not fit within space provided you may place See attached in that section and attach appropriate document(s). I. Personal Statement Complete your answer to the following questions. Please make sure to address each part of the question in your response. Why do you want to be a professional nurse? What gifts/talents will you bring to the profession? Why did you choose to apply to the University of Wisconsin Oshkosh Accelerated Online Bachelor's to BSN Option? Page 5

6 II. Health Related Experience A. My Nursing Assistant status is: Certified Nursing Assistant with experience (Please complete TABLE 1 below) Certified Nursing Assistant without experience B. State where Nursing Assistant course taken: If other than Wisconsin, attach list of required skills with class and clinical hours indicated. TABLE 1 Employer/Location Years of work Part/Full Time Reference: (Name/Phone Number) OTHER CREDENTIALS C. Do you have a credential or license in another health field (EMT, LPN, etc.)? Yes No If Yes, complete TABLE 2 below and attach copy of credential. TABLE 2 Type of credential/ license Employer/Location Year received Part/Full Time Reference: (Name/Phone Number) D. Briefly describe any other caregiver or life experiences not covered in your work history or resume. Page 6

7 III. Activities Reflecting a Service Orientation [volunteerwork] Briefly describe any former or current volunteer work in the community (local, hometown, or campus) over the past five years. IV. Experience with Diversity Describe your experience working with diverse groups or individuals: Diverse people may include individuals of a specific age group such as elderly or children, ethnic groups, developmentally disabled, etc. Activities may appear in this section and also in Part III if appropriate. Page 7

8 V. Optional Information Please tell us anything else you think we need to know about you and to consider in the admission process: Page 8