[ETSU] Fall RN to BSN

ETSU COLLEGE OF NURSING Fall RN to BSN APPLICATION

APPLICATION FOR THE BACHELOR OF SCIENCE IN NURSING MAJOR

APPLICATIONS CAN BE SUBMITTED February 1st, 2013 THRU June 1st, 2013

Current High School Students are not Eligible to apply

NOTE: To complete the application, scroll down and click Next. In order to complete this application you will need the following items and have met the criteria for consideration.

Documents you will need:

Transfer Students must have official copies of college/university transcripts on file with the ETSU Office of Admissions.
Copy of current semester enrollment
RN's will need to provide a copy of their license

Criteria to Apply:

Students should apply to the University as Pre-Nursing, Transfer students.
In order to be considered, you must be admitted into East Tennessee State University in the term for which you are applying for admittance into the College of Nursing. If you need to apply for admittance to East Tennessee State University, please follow this link: ETSU Application

Please make sure that you meet all of the Criteria for Admittance to the College of Nursing before completing the application. You can review the criteria by following this link: College of Nursing Admittance Requirements

( NOTE: To properly view and submit the application, you must use either Google Chrome or Mozilla Firefox as your browser. Click either link to download your preferred browser.)

Contact Kathy Hawks with any technical issues regarding application submission at 423-439-4591.

ETSU College of Nursing RN-BSN Application

Application for the Bachelor of Science in Nursing Major
Note: Please notify Office of Student Services of changes in personal information.

Applicant

Full Name *

First Name *

Initial

Last Name *

ETSU Student ID:

University Application Verification

I submitted my application for enrollment at East Tennessee State University.

University Application Status *

(NOTE: Your application to the College of Nursing will not be processed until you have been accepted into ETSU for the term in which you are applying for admittance to the College of Nursing. Please contact the admissions office to change the term for which you are applying if necessary.)

Program Selection

Choose the Program(s) you wish to apply for: *

Fall RN to BSN

Associate RN Degree Status? *

If you are currently enrolled in an Associates RN Degree Program, please complete the following:

Which Institution?

Anticipated Date of Completion of Associate RN Program:

Month

Day

Year

RN Licensure Verification

Are You Currently a Licensed RN? *

(IF YES: Current, licensed RN's must provide their license number, state of licensure, and a copy of their license. You must upload a copy of your license within the File Uploader section below. Your application cannot be considered until we receive a copy of your license.)

License #:

State of Licensure:

Currently Employed? *

Current Employer:

Applicant Mailing Address

Mailing Address *

Street Adress *

City *

State *

Zip *

Country *

Permanent Address

Permanent Address *

Street Adress *

City *

State *

Zip *

County *

Country *

Phone Numbers

Home/Local *

Work

Cell

Pager

Email

Email *

Educational Background

High School

High School *

Address *

Street Adress *

City *

State *

Zip *

From

Month *

Day

Year *

Month *

Day

Year *

Current College

Address

Street Adress

City

State

Zip

From

Month

Day

Year

Month

Day

Year

Degree

Major

Nursing School

Address

Street Adress

City

State

Zip

From

Month

Day

Year

Month

Day

Year

Degree

Major

Other College

Address

Street Adress

City

State

Zip

From

Month

Day

Year

Month

Day

Year

Degree

Major

Other College

Address

Street Adress

City

State

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From

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Degree

Major

File Uploader

Transfer students must have official copies of all college / university transcripts on file with the ETSU Office of Admissions. Transfer students must attach a copy of their current semester schedule.

Attach Support Documents:

APPLICANT UNDERSTANDS AND AGREES

IMPORTANT CERTIFICATION: I understand the policies outlined above and I hereby certify that I have read and understand the application and selection process on the CON application. I certify all statements in this application are correct and complete. Failure to submit correct and complete information shall be considered to be utterance of a false oath on an official document and may result in the immediate dismissal of the student without refund of fees, as determined by a review of a judicial board. By submitting this form, applicant verifies that the information given is correct and complete.

Acknowledge: *

First Name *

Last Name *

Core Performance Standards

The performance standards are used to assist students in determining whether accommodations or modifications are necessary and provide and objective measure upon which informed decisions can be based about whether students can meet requirements.

Critical thinking ability sufficient for clinical judgment.
Interpersonal abilities sufficient to interact with individuals, families, and groups from a variety of social, emotional, cultural, and intelligent backgrounds.
Communications abilities sufficient for interaction with others in verbal and written form.
Physical abilities sufficient to move from room to room and maneuver in small spaces.
Gross and fine motor abilities sufficient to provide safe and effective nursing care.
Auditory abilities sufficient to monitor and assess health needs.
Visual ability sufficient for observation and assessment necessary in nursing care.
Tactical ability sufficient for physical assessment

If an otherwise qualified student believes that he or she cannot meet one or more of the standards without accommodation or modifications, the nursing program will determine, on an individual basis, whether or not the necessary modifications can be made reasonably. The following process will be used:

Before admission to the nursing major, all students will have information regarding Core Performance Standards.
A student with disabilities who believes that he or she may need assistance in meeting the Core Performance Standards should contact Disabilities Services at ETSU, Upper Level, D.P. Culp Center, or call 423-439-8364.

I have read and understand the College of Nursing Core Performance Standards listed above and by submitting this form, applicant verifies that the information given is correct and complete.

APPLICANTS SIGNATURE

I hereby represent, warrant, and affirm under penalty of perjury that all information in this application is true and correct to the best of my knowledge and belief. I understand that if at any time in the future I plead guilty or no contest to or am convicted of an offense under 18 United States Code Section 1033 or a criminal felony as defined therein that I am required to notify by certified mail all insurance companies with whom I am appointed and the department of insurance in each of those states.

Applicant Signature (Name): *

First Name *

Last Name *

Application Date *

Month *

Day *

Year *

Captcha *

Please enter the text you see in the image above.

ETSU College of Nursing RN-BSN Application

Applicant

University Application Verification

Program Selection

RN Licensure Verification

Applicant Mailing Address

Permanent Address

Phone Numbers

Email

Educational Background

High School

Current College

Nursing School

Other College

Other College

File Uploader

APPLICANT UNDERSTANDS AND AGREES

Core Performance Standards

APPLICANTS SIGNATURE

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