Dear Applicant, Sincerely, Marilyn Swan, PhD, RN Pre-Licensure Program Coordinator

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Dear Applicant, Thank you for your interest and application to our Pre-Licensure Program. Please read carefully and follow all of the instructions on the subsequent pages to submit your program application, complete the HESI Admission Assessment Exam and the group interview. Admission will be considered upon completion of the entire application process. The deadline for submitting the program application is 4:00pm on Friday, September 14, 2018. Upon receiving admission, students will begin the Pre-Licensure Program coursework spring semester 2019, and should expect to complete the degree in 4 semesters. Sincerely, Marilyn Swan, PhD, RN Pre-Licensure Program Coordinator Plan of Study for Students Admitted to the Pre-Licensure Program Spring 2019 Spring 2019 NURS 333 Professional Nursing (3) NURS 334 Physiologic Integrity I (4) NURS 335 Family & Societal Nursing Inquiry (3) NURS 336 Assessment and Nursing Procedures (5) Fall 2019 NURS 363 Critical Inquiry in Nursing (2) NURS 364 Physiologic Integrity II (5) NURS 365 Nursing Care of Families in Transition I (7) NURS 366 Quality, Safety & Informatics in Nursing Practice (2) Spring 2020 NURS 433 Community Oriented Nursing Inquiry (4) NURS 434 Physiologic Integrity III (4) NURS 435 Nursing Care of Families in Transition II (3) NURS 436 Psychosocial Integrity (4) Fall 2020 NURS 463 Nursing, Leadership and management (3) NURS 464 Physiologic Integrity IV (4) NURS 465 Nursing Care of Families in Crisis (2) NURS 466 Professional Role Integration (4) Projected Graduation Date: December, 2020

Pre-Licensure Program Application Instructions and Procedures Please read all instructions carefully. Application Instructions and Procedures 1. The applicant is responsible for being informed of the School of Nursing s Application Criteria, Pre-requisite coursework, Admission Procedures and Ranking. These requirements are listed in the Minnesota State University, Mankato Undergraduate Catalog and the School of Nursing website. 2. Each applicant is responsible for including all of the required information when submitting the application for full admission consideration. All official transcripts from previous institutions must be transferred, evaluated by MSU s Registrar s Office, and notated on the Degree Audit Report (DARS) before submitting application. 3. Each applicant must submit the Pre-Licensure Program application with an attached Degree Audit Report (DARS) to a Nursing Advisor, by the application deadline. Applications must be submitted during a walk-in (preferred) or scheduled appointment. Distant student applicants may schedule a telephone appointment with a Nursing Advisor. The program application and required documents must be mailed to the School of Nursing prior to the scheduled phone appointment, and must be completed by the application deadline. Phone appointments can be made by contacting the School of Nursing Advising Office: 507-389-6022 Spring 2019 Program Application Deadline: Friday, September 14, 2018 4. Each applicant must complete the HESI Admission Assessment Exam for admission to the School of Nursing. Each applicant is allowed 2 testing attempts each semester. An applicant s highest exam score will be used towards the admission process. HESI Date for First Testing Attempt: HESI Date for Second Testing Attempt: Saturday, September 15: 11:00am-3:30pm Saturday, October 13: 11:00am-3:30pm 5. The cost of the HESI examination is the responsibility of the applicant and must be paid for each testing attempt.

6. To ensure payment, applicants must complete the HESI Admission Assessment Exam Cost Sheet (enclosed) and pay the $38 fee to the Cashiers Office. The CONFIRMATION OF PAYMENT must be returned to the School of Nursing Advising Office. Distant student applicants may mail the Cost Sheet and fee to the Cashier s Office-128 Wigley Administration Center. a. Once the CONFIRMATION OF PAYMENT is returned to the School of Nursing Advising Office, students will receive an email within 24 hours instructing them to electronically register for the exam. b. CONFIRMATION OF PAYMENT must be received by the School of Nursing Advising Office 48 hours prior to the scheduled exam date. c. Students must be registered for the HESI exam 48 hours prior to the scheduled testing date. d. No refunds are available. e. Additional information regarding HESI policies, accommodations and preparation are available on the School of Nursing website and in the Pre-Nursing Student Handbook. 7. Each applicant must participate in an on-campus group interview. a) Group interviews may hold up to 5 student applicants and may last up to 30 minutes. b) After the application deadline, student applicants will be contacted via email with interview information including available dates, times and signing-up. Interviews will take place during the month of October. c) Students will receive a list of sample interview questions after signing up. 8. Full admission to the Pre-Licensure Program requires students to fulfill the following requirements, prior to program start date: a) Completion of required Support Pre-requisites with a minimum C grade. b) Approval to work with patients without supervision from the Minnesota Department of Health Background check.

STUDENT APPLICATION CHECKLIST Complete the School of Nursing s Pre-Licensure Program Application (Last two sheets) Attach a Degree Audit Report (DARS) to the application. A Nursing DARS can be obtained at the Campus Hub or printed from E-Services. On the DARS, highlight ALL Core AND Support pre-requisites. A student may repeat a Core prerequisite only once for the purpose of improving a grade of a C+ or lower. If applicable, attach a copy of any test scores, if using as a substitute for a Core pre-requisite. If applicable, attach a copy of any documentation approving course appeals, substitutions or waivers. Submit the Pre-Licensure Program Application at a walk-in (preferred) or scheduled appointment with a nursing advisor. Check available walk-in times below, or call for scheduling assistance: 507-389-6022 The paper application must be submitted by 4:00pm on Friday, September 14, 2018. Application Walk-in Times (WH 360): Monday, August 27 9:00-4:00pm Tuesday, August 28 1:00-4:00pm Wednesday, August 29 9:00-12:00pm Friday, August 31 1:00-4:00pm Wednesday, September 5 9:00-12:00pm Friday, September 7 9:00-4:00pm Monday, September 10 9:00-4:00pm Wednesday, September 12 9:00-12:00pm Pay for the HESI Exam by completing the HESI Admission Assessment Exam Cost Sheet (enclosed) Return the CONFIRMATION OF PAYMENT to School of Nursing Office. Electronically register for the HESI Exam upon receiving the email notification. Schedule a time to complete the group interview upon receiving the email notification. ADMISSION INFORMATION: Admission notifications will be emailed to all applicants on Wednesday, October 24, 2018. Notifications will be emailed to the address listed on the application. Be diligent in checking your email. Admitted applicants are asked to reserve Thursday, November 1, 2018 from 4:00-5:30pm for a mandatory advising and orientation session in Armstrong Hall, room 0039.

HESI Admission Assessment Exam Cost Sheet Complete the top and bottom half of form. Name: Tech ID #: Fall 2018 Testing (please circle which attempt) FIRST Attempt Testing or SECOND Attempt Testing $38.00 HESI Exam Fee COST CENTER: 210431 9799 Pay to: Cashiers Office 128 Wigley Administration Center Mankato, MN 56001 CONFIRMATION OF PAYMENT Return this half to School of Nursing Office in Wissink Hall 360 Must be marked paid by Cashiers Office Name: Tech ID #: Fall 2018 Testing (please circle which attempt) FIRST Attempt Testing or SECOND Attempt Testing $38.00 HESI Exam Fee *Once this portion is submitted to the School of Nursing Office, students will receive a follow-up email within 24 hrs to electronically register for the HESI exam.

MINNESOTA STATE UNIVERSITY, MANKATO School of Nursing Application for Admission Spring 2019 Semester Pre-Licensure Nursing Program Please print neatly and legibly in ink: Date Submitted: Section I Student Information Name Last First Middle Social Security # Tech ID # Birth Date: Permanent Address: Local Address: Street City State Zip Street City State Zip Permanent Phone #: ( ) Present Phone #: ( ) Cell Phone# ( ) MavMAIL email address: Section II Name of High School Attended: Education Year of Graduation Post High School Education (other than MNSU) Dates of Dates of Include name of institution along with city and state Area of Study Attendance Degrees Earned Have you previously applied to the Basic Nursing Program: YES or NO Section III Background Information Your responses to questions 1-8 are necessary to meet agency regulations for public safety and to be in compliance with Minnesota Board of Nursing Licensure requirements. Please provide an explanation for every YES answer and attach to this application. 1. Have you ever violated a state or federal law or rule relating to the practice of nursing? Yeso Noo 2. Have you ever violated a state or federal law or rule relating to narcotics or controlled Yeso Noo substances, or other similar regulations? 3. Have you ever been convicted, entered a plea of guilty, nolo contendere, or no contest, Yeso Noo for any felony, gross misdemeanor or misdemeanor offense? 4. In the last five years, have you ever misused or abused alcohol, other drugs or Yeso Noo chemicals or been considered chemically dependent? 5. In the last five years, have you been fired from a nursing-related job? Yeso Noo 6. Are you under investigation or are you the subject of any pending or past disciplinary action by Yeso Noo a nurse licensing agency or have you been refused a nursing license by a state or country? 7. Do you have any physical or mental disability, illness or disease (such as visual or auditory Yeso Noo impairments, mobility impairments, mental or physical conditions, and learning disabilities) that may impair your ability to practice nursing or be potentially harmful to the public. If yes, please attach a statement explaining how this has been resolved or managed to allow you to safely practice nursing. 8. Have you ever received notification from the Minnesota Department of Human Services or the Yeso Noo United States Department of Health and Human Services, Office of the Inspector General that you have been disqualified from providing direct care or excluded from participation in Medicare or Medicaid? Have you ever been suspended from any college or university? Yeso Noo If you answer yes to this question, please complete a release of information form (available in the School of Nursing office) and submit it with your application packet. 6/1/2018

Name: MINNESOTA STATE UNIVERSITY, MANKATO School of Nursing Academic Information - Pre-Licensure Program Last First Middle Core and Support Pre-requisites Applicants Educational Information IF Taken Elsewhere Letter MSU Course Title MSU Sem MSU Grade Course Credits Please Specify College/University Credit Amount Earned * Human Anatomy BIOL 220 4 * Principles of Human Physiology BIOL 330 4 * Chemistry of Life Processes II CHEM 111 5 * Composition ENG 101 4 * Cultural Geography GEOG 103 3 * Human Development KSP 235 3 * Courage, Caring and Teambuilding NURS 101W 3 * Elementary Statistics STAT 154 3 or 4 ~ Microbiology BIOL 270 4 ~ Nutrition for Healthcare Professional FCS 242 3 ~ Psychology PSYC 101 4 ~ Pathophysiology for Healthcare Professionals NURS 282 3 ~ Pharmacology for Healthcare Professionals NURS 284 3 ~ Relationship-based Care in Nursing Practice NURS 286 3 * Core Pre-requisites - must be completed prior to application (C or better) Core pre-reqs may only be repeated one time each, and only to improve a grade of a C+ or lower. ~ Support Pre-requisites - must be completed prior to beginning the nursing major fall 2018 (C or better) For Office Use Only: Cumulative GPA (2.8 minimum required): Jun-18