ACCELERATED UNDERGRADUATE NURSING OPTION APPLICATION CHECKLIST FOR CLINICAL ADMISSION REQUIREMENTS. Applicant must be admitted to UWO

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ACCELERATED UNDERGRADUATE NURSING OPTION APPLICATION CHECKLIST FOR CLINICAL ADMISSION REQUIREMENTS Applicant must be admitted to UWO Mail application to: Undergraduate Nursing Program/Admission Application/Accelerated Option College of Nursing University of Wisconsin Oshkosh 800 Algoma Blvd, CF-112, Oshkosh, WI 54901-8660 OR Deliver application to: Undergraduate Nursing Program office Clow Faculty Room 112 UW Oshkosh Hours 7:45 am-4:30 pm Monday-Friday Rolling Admissions: Admission decisions occur every other month once all application and admission criteria have been met. Check the appropriate option or options: A. Submit my application for admission to any cohort (February, May, or October) B. Submit my application for admission to a PREFERRED cohort (Select One) February May October Applicant Information: Name: UWO email Cell Phone: Personal email: Alternate Phone Student ID: Address: City State Zip

ADDITIONAL INFORMATION NEEDED: Gender Have you ever served in the Military? Yes No Have you ever applied to the Accelerated Program? Yes No When? Have you: 1. Received admission to the University of Wisconsin Oshkosh? Yes No 2. Had your unofficial transcripts evaluated by the on-line pre-nursing advisor? 3. Completed the prerequisite courses by the time of the application? 4. Had no less than a "C" in each of the prerequisite courses? 5. Had no more than two of the prerequisite courses repeated? 6. Completed four of the six science prerequisites by the application deadline? (two months prior to the start of the cohort) 7. Completed your bachelor's degree? 8. Completed your CNA certification and have license? 9. Ordered your Castle Branch Background Check? 10. Completed the TEAS test? The community in which I will reside while I complete the Accelerated Online Bachelor's to BSN Option: In the event clinical placements are not available in your geographical location, you are required to provide other locations(s) you could reside during the Accel Option: The city/area in which I intend to seek employment as a nurse upon graduation: The Admissions Committee expects that, if admitted, you will complete the option in the community you are identifying on this application. It is your responsibility to notify the committee if residence changes.

REQUIREMENTS: 1. POLICIES: Read the information regarding admission to UW Oshkosh College of Nursing 2. BACKGROUND DISCLOSURE FORMS AND CHECKS: Complete forms according to directions, sign, and attach to the written application. Background Information Disclosure Form ALL applicants Required Certified Background Check (Castle Branch) to be completed with application process (fee paid by student). 3. Transfer Disclosure Form Requirement for all institutions attended. 4. Resume 5. CERTIFIED NURSING ASSISTANT (CNA) CRITERION Attach a copy of your CURRENT CNA certificate to the application or a print out from the your state s Nurse Aide Registry verifying licensure is current with expiration date that is good through application process. 6. PRE-ENTRANCE NURSING EXAM: TEAS TEST 7. GPA CALCULATION FORM: Attach completed GPA Calculation Form and submit unofficial transcripts (if you have not done so) to the Pre-Nursing Advisor ona@uwosh.edu 8. ADMISSION INTERVIEWS: After application process is complete, you will be notified if you have been selected for an interview and it will be scheduled with you. 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:

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 below 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 end of the semester you are applying in.) 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 Do you have a degree 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.

INSTRUCTIONS FOR PAGES 4-8: 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. 1. 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?

II. Health Related Experience Nursing Assistant Status [attach a copy of your certification] 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 Years PT or FT Reference: (Name/Phone Number) D. Briefly describe any other caregiver or life experiences not covered in your work history or resume.

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.

V. Optional Information Letters of Recommendation may be attached or mailed directly to address provided for application process. It is applicants responsibility to directly confirm with your reference whether it has been completed. Our office cannot disclose this information. Please tell us anything else you think we need to know about you and consider in the admission process: