application bachelor of science in nursing • BSN Application

Transcription

ap plicatio n
bachelor of sci ence i n n u rsi ng
BSN Application • 1
Undergraduate Application Procedures
Nell Hodgson Woodruff School of Nursing
Emory University
Applicants to the Nell Hodgson Woodruff School of Nursing at Emory University are considered for admission on an individual basis. The
Admission Committee will not review an applicant’s file until all materials have been received by the Office of Admission and Student Services. The
Committee’s decision to offer or deny an applicant admission to a program, or to request additional information before making a final decision,
is based on the applicant’s complete record. Final acceptance into an academic program in the School of Nursing is contingent upon satisfactory
completion of all prerequisite coursework. A final transcript must be submitted prior to enrollment.
Applicants are encouraged to submit self-managed applications: collecting all required materials, including sealed official transcripts and sealed
letters of recommendation, and submitting them in a single envelope will expedite the processing and review of an applicant’s file. Applicants
may contact the Office of Admission and Student Services at any time during the application process with questions or concerns. They may also
view the status of their applications by accessing OPUS (www.opus.emory.edu), which is the Emory online student information system. Instructions on how to use this system will be sent to each applicant once the application form and fee have been received.
APPLICATIONS
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Applicants are encouraged to submit the application form, fee, essay, resume, and recommendations online at www.nursing.emory.edu using
the online application.
APPLICATION DEADLINES
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The priority deadline for admission and scholarships to the BSN, BSN Second Degree, and BSN-MSN Segue option is January 15. Accelerated
BSN/MSN is December 1.
Applications completed after December 1 or January 15 will be reviewed on a space-available basis only.
APPLICATION PROCEDURES
All BSN applicants must submit:
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A complete School of Nursing undergraduate application form. The Office of Admission and Student Services can acknowledge receipt of
other materials once this form has been received.
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A $50 application fee in the form of a check or money order made payable to Emory University. This fee is nonrefundable and does not apply
toward registration fees. The application fee is only waived for those applicants who are currently attending Emory or Oxford College, or are
current employees of Emory University or Emory Healthcare.
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Three letters of recommendation, two of which must be academic: one from a physical science instructor, and another from an instructor in
any academic area. The third letter may be academic or a personal/professional letter from anyone other than a family member or friend. Applicants who have been out of school for more than two years may submit one academic recommendation from a physical science instructor
and two personal/professional recommendations from anyone other than a family member or friend. Academic recommendations from a high
school instructor will not satisfy this requirement.
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A statement of purpose describing personal and professional reasons for selecting nursing as a career. The statement of purpose is an important part of the application process. The Admission Committee members read it for content, grammar, and spelling. It should reflect the
applicant’s own writing ability and interest in nursing. Additional information on the statement of purpose can be found on page 5 of the
application form. BSN-MSN Segue and Accelerated BSN/MSN applicants must also answer question #7 on page 5 of the application form.
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Resume including work experience, community service, leadership roles, and research opportunities.
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A completed prerequisite information form (see page 7 of the application form).
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Official transcripts from each college or university attended, regardless of whether or not a degree was conferred. Transcripts received become
the property of the School of Nursing and can neither be given to the applicant nor transferred to another institution. The Office of Admission
and Student Services must receive transcripts in a sealed envelope bearing the registrar’s official seal.
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Pending approval official TEAS scores will be required.
BSN-MSN SEGUE AND ACCELERATED BSN/MSN APPLICANTS:
In addition to the requirements listed above, applicants to the Segue or Accelerated option also must do the following.
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Must
submit official scores on the Graduate Record Examination (GRE) or Miller Analogies Test (MAT) that are no more than five years old.
The GRE institutional code for Emory University is 5187, and the department code for the School of Nursing is 0610.
Undergo an interview conducted in the fall or spring semester of the senior year of the BSN program, prior to the transition into the
MSN program the following fall.
It is each applicant’s responsibility to allow ample time for application materials to be compiled and sent through the mail and to make certain
that all materials arrive or are postmarked by the priority deadline for admission and scholarship consideration. The Nell Hodgson Woodruff
School of Nursing cannot assume responsibility for delays that occur before the materials are received by the Office of Admission and Student
Services. The Office of Admission and Student Services will send the only official notification of the admission decision to the applicant.
Application Checklist
Complete in full the School of Nursing application form.
Submit the $50 (U.S. dollars) application fee.
Submit resume. Additional information regarding resume can
be found on page 5.
Submit a statement of purpose. Additional information
regarding the statement of purpose can be found on page 5
of the application form.
Submit official transcript from the registrar of each
college or university attended, whether a degree was earned
or not.
Submit three letters of recommendation. Additional information regarding the letters of recomendation can be found on
page 4 of the application form.
Complete in full the prerequisite information section listed
on page 7 of the application form.
TEAS scores (pending fall 2011 approval)
Request official scores on the Graduate Record Examination
(institution code: 5187; departmental code: 0610) or Miller
Analogies Test be sent to the School of Nursing (for BSNMSN Segue and Accelerated BSN/MSN applicants only).
International Applicants Only
Request official scores on the Test of English as a Foreign
Language (TOEFL) be sent to institution code 5187 (Emory
University). This requirement is for non-native speakers of
English only. Scores cannot be more than two years old.
Request an official WES credentials evaluation be sent to the
School of Nursing. This requirement is for applicants submitting international transcripts only and does not apply to
coursework taken by U.S. Study Abroad students.
Submit a photocopy of green card or other paperwork indicating current immigration status.
Undergraduate Application
PERSONAL INFORMATION–Please type or print
Name
Last NameFirst NameMiddle NamePreferred NameSSN
Address ____________________________________________________________________________________________________________
Street AddressApt #CityStateZip Code
Home Phone Number __________________________________
Fax Number ________________________________________
Cellular Phone Number ________________________________
Email Address _______________________________________
Business Phone Number________________________________
Birth Date __________________________________________
Month
Day
Year
Other Name (s) under Which Documents Might Be Received
Place of Birth_______________________________________Country of Citizenship _____________________________________________
City State
Citizenship Status:
U.S. Citizen
Nonimmigrant alien (Visa type _______)
Refugee
Asylee
(Attach a copy of both sides of your I-94 or alien registration card.)
Permanent resident alien
Other______________ (please explain)
Will you be requesting a visa?
Yes (If yes, which type?) ______________________________
No
Do you currently hold a visa?
Yes (If yes, which type?) ______________________________
No
Is English your first language?
Yes
No (If no, what language?)
Language of College instruction (if not English) _________________________________________________________________________
TOEFL score: Date Taken/Will be taking ______________/ ___________/ _____________ Score
Internet-based test
(TOEFL score only needed if English is not your first language.)
STATISTICAL INFORMATION
The following information is voluntary and refusal to provide it will not result in any adverse treatment. It will be kept confidential and
will be used only in accordance with Title VI of Civil Rights Act of 1964.
Marital Status:
Single
Married
Divorced
Gender:
Male
Female
Ethnicity: Are you Hispanic/Latino?
Yes
No If yes, please describe your background __________________________
____________________________________________________________________________________________________________________
American Indian/Alaska Native
Asian
Native Hawaiian/Other Pacific Islander
Black
Not Specified/Unknown
White Other ____________________________
Religious Preference
PROGRAM INFORMATION
Expected Entry Term: Fall 20____ Summer 20____ (Accelerated BSN/MSN only)
I have previously applied to the School of Nursing:
Intended Degree Program:
Yes (semester ______ year _____)
No
Bachelor of Science in Nursing
Bachelor of Science in Nursing for Second Degree Students
BSN-MSN Segue Option (please indicate desired MSN specialty option below)
BSN/MSN Accelerated Option (please indicate desired MSN specialty option below)
Please check desired BSN Specialty area (BSN-MSN Segue and Accelerated BSN/MSN Only):
Adult/Gerontology Nurse Practitioner
Nurse-Midwifery
Family Nurse Practitioner
Pediatric Nurse Practitioner – Primary Care
Family Nurse Midwife
Women’s Health Nurse Practitioner
Master of Science/Master of Public Health
Women’s Health/Adult Health Nurse Practitioner*
(Please select MSN specialty)
*Pending fall 2011 approval, this program may be discontinued.
EDUCATIONAL BACKGROUND
List in chronological order all colleges or universities that you have attended including all schools you are currently attending, regardless of
dates or academic performance or if the credit appears on another institutions transcript. List additional schools on a separate page.
College Name Location Attendance From: mm/yy —To: mm/yy
Degree Granted Date Received
or Expected
or Expected
TEST SCORES (BSN-MSN Segue and Accelerated BSN/MSN ONLY)
Please provide the following information regarding your GRE or MAT test scores. Official Scores are required to complete the application
GRE
Date Taken/Scheduled to Take
Verbal Score Quantitative Score
Analytic Score
MAT
Raw Score
Percentage for Major
Percentage for Group
TEAS
Raw Score
Percentage National
Percentage for Program
LETTERS OF RECOMMENDATION
Please list three persons from whom you will request letters of recommendation. Of the three letters of recommendation, two must be academic:
one from a physical science instructor, and another from an instructor in any academic area. The third letter may be academic or a personal/professional letter from anyone other than a family member or friend. Applicants who have been out of school for more than two years may submit
one academic from a physical science instructor and two personal/professional recommendations from anyone other than a family member or
friend. Academic recommendations from a high school instructor will not satisfy this requirement.
Name
Title
Phone Number
E-mail Address
Academic or Personal/Professional
1. __________________________________________________________________________________________________________________
2. __________________________________________________________________________________________________________________
3. __________________________________________________________________________________________________________________
STATEMENT OF PURPOSE
Please submit a typewritten double-spaced essay, not to exceed two pages in length, addressing the points listed below. Your response will be
regarded as confidential and you are encouraged to elaborate in each area thoroughly and openly. The essay is an important part of the application process. The Admission Committee members read it for content, grammar and spelling. It should reflect your own writing ability and
interest in nursing.
I ATTEST THAT EVERYTHING IN THIS STATEMENT OF PURPOSE IS TRUE AND WRITTEN BY ME.
Please Sign ________________________________________________________________
1.
2.
3.
4.
5.
6.
7.
Your concept of nursing and your reason for choosing nursing as a profession
Your reasons for choosing Emory’s School of Nursing and your perceptions and expectations of the nursing program
Specific goals after graduation and ideas of how you can contribute to improving our society and the nursing profession
Personal experiences and activities that have influenced you in any way and have made you the type of person you are now
Leadership positions you have held and your own participation in community service activities/projects
Any additional comments or observations that you feel would influence your candidacy
BSN-MSN Segue and Accelerated BSN/MSN applicants ONLY: Address your interest in graduate nursing education and your interest
in a particular specialty
RESUME
1. EMPLOYMENT HISTORY
Please list any positions held since you began working, beginning with the most recent. Attach additional pages as needed.
2. PUBLICATIONS
Please give evidence of any original work or investigation (thesis, article, published and unpublished research). List each item with title,
date, and place of publication.
3. ACTIVITIES AND HONORS
Please list your collegiate or community activities and designate any leadership positions that you have had as well as any honors that
you have received.
FAMILY INFORMATION
Father
Living
Deceased
Name___________________________________________________
State of Residence ___________________________________________
Address______________________________________________________________________________________________________________
Street AddressApt#CityStateZip
Occupation_______________________________________________
Employer__________________________________________________
College(s) attended and highest degree earned______________________________________________________________________________
______________________________________________________________________________________________________________________
Mother
Living
Deceased
Name___________________________________________________
State of Residence___________________________________________
Address______________________________________________________________________________________________________________
Occupation_______________________________________________ Employer___________________________________________________
College(s) attended and highest degree earned ______________________________________________________________________________
______________________________________________________________________________________________________________________
Spouse, Guardian, or Life Partner
Name
State of Residence
Address
Occupation____________________________________________Employer____________________________________________________
College(s) attended and highest degree earned
Please list the names, relationship to you and years of attendance of any family members who have been students at Emory University.
NameRelationship to YouYear(s) of Attendance
CONTACT INFORMATION
Who or what influenced your decision to apply to the Nell Hodgson Woodruff School of Nursing at Emory University?
To what other nursing schools are you applying?
To the best of my knowledge, the information furnished in this application is complete, true and correct, and the statement of purpose
is written by me. I understand that falsification or purposeful misrepresentation of my qualifications may result in the denial of my admission application. I agree that if admitted to the Nell Hodgson Woodruff School of Nursing at Emory University, I will, during such
time as I may be enrolled as a student, abide by all the rules, regulations, practices and policies of Emory University as they may be at
the time of my admission or as they may be changed during my continuance as a student. I further agree to pay any fines or assessments
that may be made against me for violation of campus traffic or safety rules, including parking, and for such charges to be added to my
tuition and rent statements from Emory University.
Signature ______________________________________________________ Date ________________________
Emory University does not discriminate in admissions, educational program or employment on the basis of race, color, religion, sex, sexual orientation,
national origin, age, disability or veteran/Reserve/National Guard status and prohibits such discrimination by its students, faculty and staff. Students,
faculty and staff are assured of participation in University programs and in the use of facilities without such discrimination. The University also complies
with all applicable federal and Georgia statutes and regulations prohibiting unlawful discrimination. All members of the student body, faculty and staff
are expected to assist in making this policy valid in fact. Inquiries and complaints should be directed to the Equal Opportunity Programs Office, Emory
University, Administration Building, Atlanta, Georgia 30322-0520.
PREREQUISITE INFORMATION
All applicants must complete the section below, indicating the completion of their prerequisite work as appropriate for their intended
degree. All prerequisite coursework must be completed before entering the nursing program at the Nell Hodgson Woodruff School of
Nursing. All courses are subject to evaluation by the Office of Admission and Student Services.
Please note the following before filling out the form:
• Only the first 7 prerequisite courses are required for applicants to the BSN Second Degree, BSN-MSN Segue, or Accelerated
BSN/MSN option.*
• Human Anatomy and Physiology I and II, Microbiology and their respective labs must have been taken within seven years prior
to application.
• Humanities electives may include courses such as English, art, music or theatre appreciation, foreign languages, religion, philosophy or history.
• No general elective credit is given for pathophysiology, pharmacology, nursing, physical education, and courses such as applied
art, music, or theater.
• Credit will only be granted for courses where a grade of “C” or better was earned.
Please
list the courses you have taken to satisfy the following prerequisite courses:
Subject: Science and Math Courses
Course Number and Title Check box
if NOT taken Semester Taken
(To be taken)
# of
Credits Grade
General Chemistry I* (optional lab)
Organic Chemistry* (optional lab)
Introductory Statistics* Human Anatomy and Physiology I (with lab)*
Human Anatomy and Physiology II (with lab)*
Microbiology (with lab)*
Subject: Social Science Courses Human Growth and Development*
Introductory Psychology
Introductory Sociology or Anthropology History, Politics, or Economics Subject: Humanities Courses English Composition
Humanities I
Humanities II Humanities III Subject: General Electives (Additional courses to bring total to 60 semester or 90 quarter hours)
Elective I
Elective II
Elective III Elective IV Elective V BSN Application • 7
Applicant Recommendation Form
Emory University
TO BE COMPLETED BY THE APPLICANT
Please complete this section and forward this form to your recommender.
PRINT or TYPE
Applicant Name
Last
First
Middle
*Under the provision of the Family Educational Rights and Privacy Act of 1974, you may decide whether letters of recommendation
written at your request are to be held confidential or whether they are to be available for your personal inspection. Please check one of
the following statements and sign as indicated.
I expressly waive any rights I might have of access to this letter of recommendation under the Family Educational Rights and Privacy
Act of 1974, or any other law, regulation or policy.
I do not agree to the waiver above.
Signature______________________________________________________________________________ Date_______________________
TO BE COMPLETED BY INDIVIDUAL SUBMITTING RECOMMENDATION
The above named individual is seeking admission to the Nell Hodgson Woodruff School of Nursing at Emory University. Your thoughtfulness and care in furnishing the information requested are sincerely appreciated. Please feel free to complete the question areas or add
any additional thoughts and comments on your official letterhead.
PRINT or TYPE
Name___________________________________________________________________________________Title _______________________
Relationship toApplicant__________________________________Employer_____________________________________________________
Address
StreetCityStateZip Code
Work Phone Number _____________________________________________ Email _____________________________________________
General academic standing of applicant in relationship to other students of comparable age and status:
Upper 1%
Upper 10%
Upper 25%
Upper 50%
Unknown
Please include strengths and limitations of the applicant in each of the following areas:
Interpersonal attributes (relationship with peers and authority figures)
Communication skills (writing and speaking, poise, clarity, or presentation of ideas)
Intellectual ability (conceptualization, ability to transfer and utilize knowledge in problem solving)
Maturity and judgment (decision making, setting priorities, dependability)
Leadership ability or potential (organization, time management)
Personal attributes that may promote or inhibit professional study (integrity, stability, sociability)
Recommendations for RNs only. Please comment on this applicant’s clinical nursing ability, including decision making, clinical expertise,
innovation, and independence.
General comments: Please use the space below and/or additional pages to provide any qualifying or supporting recommendations that
you wish to make.
Overall Recommendation
Highly Recommend
Recommend
Recommend with reservation
Do not recommend
Signature _______________________________________________________________________ Date_______________________________
Please return in a signed and sealed envelope to:
NELL HODGSON WOODRUFF SCHOOL OF NURSING
Emory University
Office of Admission and Student Services
1520 Clifton Road Atlanta, Georgia 30322
404.727.7980 or 1.800.222.3879
Fax: 404.727.8509
www.nursing.emory.edu
email: [email protected]
Emory University does not discriminate in admissions, educational programs or employment on the basis of race, color, religion, sex, sexual orientation,
University, Administration Building, Atlanta, Georgia 30322-0520. Telephone: 404.727.6016 (V/TTY).
Emory University
PRINT or TYPE
Applicant Name
Last
First
Middle
Signature______________________________________________________________________________ Date _____________________
PRINT or TYPE
Name___________________________________________________________________________________Title _______________________
Relationship to Applicant__________________________________Employer_____________________________________________________
Address
Upper 1%
Upper 10%
Upper 25%
Upper 50%
Unknown
you wish to make.
Highly Recommend
Recommend
Do not recommend
Signature _______________________________________________________________________ Date_______________________________
Emory University
404.727.7980 or 1.800.222.3879
Fax: 404.727.8509
Emory University
PRINT or TYPE
Applicant Name
Last
First
Middle
Signature______________________________________________________________________________ Date_______________________
PRINT or TYPE
Name___________________________________________________________________________________Title _______________________
Relationship toApplicant__________________________________Employer_____________________________________________________
Address
Upper 1%
Upper 10%
Upper 25%
Upper 50%
Unknown
you wish to make.
Highly Recommend
Recommend
Do not recommend
Signature _______________________________________________________________________ Date_______________________________
Emory University
404.727.7980 or 1.800.222.3879
Fax: 404.727.8509

application bachelor of science in nursing • BSN Application

Transcription

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