Please complete and return to: School of Nursing, Northern Michigan University, 1401 Presque Isle, Marquette, MI

Transcription

1 Northern Michigan University School of Nursing Application for Admission: BSN Fast Track Deadline for applying for admission into the BSN Fast Track February 1 for Fall admission Please complete and return to: School of Nursing, Northern Michigan University, 1401 Presque Isle, Marquette, MI Name: Other Names: NMU ID #: Date of birth: Male Female Mailing address: Zip Current phone: address: Permanent address: Zip Permanent phone (if different from current phone #): Eligibility requirements for the BSN Fast Track: Admitted to Northern Michigan University Achieved a minimum cumulative grade point average of 3.0 Have completed with a minimum of a C-; or be concurrently enrolled for all the following prerequisite courses: BI 201, BI 202, CH 109 (or CH107/108 or 111/112), PY 100, SO 101, HN 301A & B, BI 203 Have completed or be in the process of completing all of the n-nursing graduation requirements prior to admission Office Use Only Apply by due date Division I requirements met: Division II requirements met: Division III requirements met: Division IV requirements met: Division V requirements met: Division VI requirements met: Liberal Studies: 40 credits World Culture met: 300/400 Level L.S. met: PE requirement met: BI 201 Grade BI 202 Grade CH 107/111 Grade CH 108/112 Grade or CH109 PY 100 Grade SO 101 Grade BI 203 Microbiology complete HN 301 Nutrition complete Admit Fast Track Admit BSN Waiting List Hold for TCE Not Admit Transfer GPA NMU GPA (min 12 credits)

2 Application Directions: Required Prerequisites: Please indicate when you completed all of the n-nursing courses on the table on the attached page. Application Attachments: Please attach the following to this application: A copy of your NMU student transcript. Include current semester of classes & GPA. Ufficial transcripts for all colleges or universities you have attended. A copy of your NMU Transfer Credit Evaluation (TCE) if you have transferred credit from ather college or university. (Obtained from the Registrar s Office; takes several weeks.) PB students Registrar Office completes evaluation of prerequisite courses only All required prerequisite courses should be highlighted on transcripts & TCE. I wish to be admitted as: (May check more than one) Please check if applicable: an entering first semester BSN Fast Track student a re-entry student. Specify semester reentered: I am a transfer student; specify institution(s): I have ather Degree, specify: I have previously applied for admission to the NMU nursing program; When? Please answer the following questions: 1. Are you currently enrolled at Northern Michigan University? 2. If t currently enrolled, have you been informed by letter of your acceptance to Northern Michigan University? 3. Have you completed a minimum of 12 credits at NMU? If, is your NMU GPA > 3.0? If, is your Transfer GPA > 3.0? 4. Have you completed or are currently enrolled for all of the following prerequisite courses: BI 201, BI 202, CH 109 (or CH107/108), PY 100, SO 101? 5. To date, have you earned a minimum of a C- for all of the prerequisite courses:bi 201, BI 202, CH 109 (orch107/108 or CH111/112), PY 100, SO 101,HN301 A&B, BI Have you completed or are currently enrolled to complete all of the n-nursing graduation requirements? 7. Would like your application to be considered for the Traditional BSN Track should you t be accepted to the BSN Fast Track? Applicants will be ranked by the Nursing Department Admissions Committee. Students will be tified by mail by the time of registration (mid semester) regarding their admission status. The faculty reserves the right to select the applicants who shall be admitted and that action by the Admissions Committee of the School of Nursing is provisional, pending receipt of evidence that all pre-nursing requirements have been met. The Admission Committee will t review your application if you are t admitted to NMU or any part of the application is incomplete. This includes missing transcripts & TCE. Students, who are t admitted, must reapply to be considered for future admission. I have met the eligibility requirements for the Traditional BSN Track. Signature Date

3 NMU Department of Nursing Student Application Information Form Core Performance Standards Potential BSN Students: Please read the following statements carefully before signing. Nursing is an occupation which involves daily contact with individuals and requires ability to perform a wide variety of activities. Some individuals might t be suited to perform the activities of a registered nurse. Many hospitals require physical examination, laboratory testing and x-rays prior to hiring an individual to rule out pre-existing conditions which could cause problems in performing the expected duties. If you have any condition which might impair your ability to perform the activities required of a registered nurse, you might wish to reconsider applying for admission to the nursing major. Indicated below are core performance standards for admission and progression in the BSN program. CORE PERFORMANCE Communication Mobility Motor Skills Hearing Visual Tactile STANDARD Communication 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 ability sufficient to monitor and assess health needs. Visual ability sufficient for observation and assessment necessary in nursing care. Tactile ability sufficient for physical assessment and performance of skilled nursing activities. Adapted from MAIN Dimensions: February 1993, Vol. 4 Issue 2 EXAMPLES OF NECESSARY ACTIVITIES (t all inclusive) Explain treatment procedures, initiate health teaching, document and interpret nursing actions and client responses. Move around in client rooms, work spaces and treatment areas, administer cardio-pulmonary procedures. Calibrate and use equipment, position clients, administer medications orally and parenterally Hears monitor alarms, emergency signals, auscultatory sounds, cries for help. Observes client responses; recognizes subtle physical changes. Performs palpation, functions of physical examination and/or those activities related to therapeutic nursing interventions, e.g. insertion of a catheter or starting and IV. OTHER CONSIDERATIONS 1. Criminal background checks (CBC) are required of all students admitted to any of the nursing programs. This requirement is a result of state legislation (Michigan Public Acts 26, 27, 28 and 29 of 2006) that mandates criminal background checks be completed by health care providers working in or for health care institutions. Students in the clinical programs are subject to this legislation, therefore a criminal background check is a condition for participation in the clinical component of nursing programs. Northern Michigan University has contracted with Certified Background.com and will only accept criminal background checks performed by this company. 2. Admission to the BSN Program involves a significant time commitment. Students should

4 expect to spend hours per week on course related work on campus and in clinical placements. Students are required to be in clinic at 6:30 a.m. for some clinics and on occasion may also be assigned afteron or evening clinics. Transportation to clinic sites is the responsibility of the student. 3. Registered nurses are exposed to a variety of substances within the work environment and other work sites such as occasional fluctuations in temperature and electro-magnetic radiations. Exposure to blood and other body tissue and fluids, dust, electrical hazards, loud or unpleasant ises and occasional high humidity or wetness are the rm. The Department of Nursing does t review individual cases as to medical and/or legal suitability. However, we do wish to have prospective students informed of performance standards prior to making an investment of time and money in the program. ======================================================================== PLEASE RETURN THIS PORTION WITH YOUR APPLICATION I believe I have fulfilled the requirements for admission as set forth by the School of Nursing. I understand incomplete applications will t be reviewed or considered. I understand that if I am t selected for admission, I will need to go through the application process again to be considered for admission. I understand the faculty reserves the right to select the applicants who shall be admitted and that action by the Admissions Committee of the School of Nursing is provisional, pending receipt of evidence that all pre-nursing requirements have been met. I understand the previously described Core Performance Standards. I understand I need to complete a criminal background check by a university designated firm, prior to admission. Printed Name: Signature: Date: NOTE: This form must accompany application form and transcript. Return to the Department Secretary later than October 1 for winter semester admission and later than February 1 for fall semester admission. Please complete the following information: Used only for program report. 1. Indicate citizenship: U. S. Other, specify 2. Indicate location of home: Upper Peninsula Lower Peninsula Out of State 3. Indicate racial/ethnic background: Caucasian/White Multiracial, Specify African-American Asian-American Hispanic/Lati Native American

5 NON-NURSING GRADUATION REQUIREMENTS PREREQUISITES FOR BSN FAST TRACK PLEASE COMPLETE; INDICATE IF CURRENTLY ENROLLED OR PLANNED FOR SPRING OR SUMMER Semester Course Semester Year Grade Institution Requirements met Credits (office use only) Liberal Studies (36-40 credits) * Liberal Studies Course taken at 300/400 level * Liberal Studies Course meeting the World Culture requirement Division I Composition I (6-8) (3-4) (4) EN 111: College Composition (3-4) EN 211: College Composition II (3-4) Division II: Humanities (6-8) Electives: (3-4) Electives: (3-4) Division III: Natural Sciences (6-8) CH 109 or (4) Minimum C- CH 107 or 111 Chemistry and (3-4) Minimum C- CH 108 or 112, Chemistry (3-4) Minimum C- Division IV: Social Sciences (6-8) SO 101: Intro to Sociology (3-4) Minimum C- Elective: (3-4) Division V: Formal Studies (3-4) Elective: (3-4) Division VI: Fine/Performing Arts (3-4) Elective: (3-4) Required Courses Lib Studies course at 300/400 level (3-4) Lib Studies world culture (4) Physical Education (2) HP 200 Physical Well Being (1) HP Elective (1) Other Required Courses (26) PY 100 General Psychology (4) Minimum C- BI 201: Human Anatomy (3) Minimum C- BI 202: Human Physiology (5) Minimum C- BI 203: Medical Microbiology (5) Minimum C- HN 301A: Nutrition for Health Prof (2) HN301B: Nutrition for Health Prof (2) General Electives (5) Minimum C- Minimum C- Attach transcript and/or Transfer Credit Evaluation to the application. Highlight all listed courses on transcripts & TCE. NMU GPA TRANSFER GPA INSTITUTION

6 LPN to BSN Students Additional Application Directions: LPN to BSN students who are applying for the BSN Fast Track, must complete this page. Application Attachments: In addition to previous directions, please attach the following to this application: A copy of your LPN license: The license must be unencumbered and have restriction and/or sanctions. A letter verifying employment within the last 5 years. (if LPN > 5 years.) I am a registered LPN; specify State: License # If you are t accepted to the BSN Fast Track, would like your application to be considered for any of the following? (May check more than one) an entering first semester Traditional BSN student an entering first semester LPN to BSN t interested in ather Track PREREQUISITES FOR THE LPN TO BSN TRACK: PLEASE COMPLETE; INDICATE IF CURRENTLY ENROLLED OR PLANNED FOR SPRING OR SUMMER Semester Course Semester Year Grade Institution Requirements met Credits (office use only) Minimum C NU212 Pharmacology (2) Highlight listed course on transcripts & Transfer Credit Evaluation (TCE) LPN EMPLOYMENT HISTORY PLEASE COMPLETE; INDICATE IF CURRENTLY EMPLOYED Employer & Supervisor Dates Address & Phone Requirements met (office use only) Office Use Only LPN License License < 5yrs Working in past 5 years NU 212 Pharmacology Admit Fast Track-LPN Admit LPN to BSN Admit BSN Waiting List

7 Checklist for Nursing Application Please attach the following to your application: An ufficial copy of your NMU transcript. Include current semester of classes and gpa. Ufficial transcripts from all colleges and universities you have attended. A copy of your NMU Transfer Credit Evaluation (TCE) if you have transferred credit from ather college or university (obtained from the Registrar s Office and takes several weeks).

8 LIBERAL STUDIES PROGRAM * World Cultures Course + Prerequisite(s) necessary # Satisfies Lab Requirement Updated: 9 January 2008** Does t satisfy the upper-division requirement Div I Communication EN College Composition I (4) EN 211A+... Writing and Literature (4) EN 211B+... Narrative & Descriptive Writing (4) EN 211D+... Technical and Report Writing (4) EN 211E+... Critical Thinking and Writing (4) (x) Number of Credit Hours EN Good Books (4) EN Mythology (4) EN Introduction to Shakespeare (4) EN Survey of British Literature I (4) EN Survey of British Literature (4) EN Literature and the Bible (4) EN World Literature in English (4) EN 311Z+*... World Literature in English (4) EN 314+*... Trad Oral Lit: Nat Am Cultures (4) EN 316+*... Nat Am Novels and Poetry (4) EN 317+*... Nat Am Dr, Non-F & S Stories (4) EN Am Lit I: Columbus to the Am Rev (4) EN Am Lit II: Emergent Nat Voices (4) EN Am Lit III: Realism & Naturalism (4) EN Am Lit IV: Modern Voices ( ) (4) EN Diverse Traditions in Am Lit (4) EN 375Z+*...Diverse Traditions in Am Lit (4) EN 376Z+*... Am Lit V: Cont Voices (1970-present) (4) FR Intro to French Civ and Culture (4) FR Cult & Artistic Heritage of Europe (4) GR Intro to German Civ and Culture (3) HN Cultural Food Patterns (4) HS History of Western Civ to 1600 (4) HS History of Western Civ since 1600 (4) HS 234*... Indigeus People-Latin America (4) HS 251*... Latin American Civilization (4) HS 252*... Arab-Islamic History (4) HS 254*... Intro to the History of Africa (4) HS 256*... Approaching China (4) HS The American Woman (4) HS Mirities in American History (4) HS Imperialism (4) HS African American History (4) HS History of the Americas (4) HS 362+*... History of Mexico (4) LB Orig-West Values: Greeks & Bible (4) LB 295H... Spec Topics in LS: Humanities (4) LG World Stud - Lit in Translation (4) LG 317Z+*... World Stud - Lit in Translation (4) NAS 204*... Native American Experience (4) PL Intro to Philosophy (4) PL Fundamentals of Ethical Theory (4) PL Issues in Business Ethics (2) PL Issues in Computer Ethics (2) PL Issues in the History of Ethics (2) PL Issues in Legal Ethics (2) PL Issues in Medical Ethics (2) PL Topics in Theoretical Ethics (2) PL Issues Involving the Human Geme (2) PL History of Ancient & Medieval Phil (4) PL History of Modern Philosophy (4) PL 270*...World Religions (4) PL Philosophy of Religion (4) PL Social and Political Philosophy (4) PL Existentialism (4) PS History of Political Theory (4) PS Women and US Politics (4) PS Modern Political Thought (4) SN 312+*... Introduction to Spanish America (4) SN 314+*... Contemporary Latin Am Culture (4) SP Oral Interpretation of Literature (4) SP Communication Criticism (4) TE Humanity and Techlogy (4) Div II Humanities

9 UN Introduction to Gender Studies (4) Div III Natural Sciences/Mathematics AS 103+#... Observ & Sol System Astron (4) AS 104+#... Stell/Galactic Astron & Cosmo (4) BI 100#... Biological Sciences (4) BI 104#... Human Anatomy and Physiology (4) BI 111#... Introductory Biology: Principles (4) BI 112#... Introductory Biology: Diversity (4) BI 305+#... Ecology of the Northern Forest (3) CH 105+#... Chemical Principles (4) CH 107+#... Introductory Chemistry I (4) CH 108+#... Introductory Chemistry II (4) CH 111+#... General Chemistry I (5) CH 112+#... General Chemistry II (5) ENV Intro to Environmental Science (4) GC Physical Geography (4) GC 255#... Physical Geology (4) LB 295N... Spec Topics in LS: NS (4) MA Finite Mathematics (4) MA Coll Alg w/ Apps in Sci/Tech (4) MA Coll Alg for Calc Preparation (4) MA Trigometry (3) MA Precalculus (4) MA Calculus I (5) PH Einstein, Universe & Everything (3) PH 102#... Physics of Sound of Music (4) PH 201+#... College Physics I (5) PH 202+#... College Physics II (5) PH 220+#... Introductory Physics I (5) PH 221+#... Introductory Physics II (5) PY 100H+#... Hors Psych as NS (4) PY 100L#... Psych as NS with Lab (4) PY 100S... Psychology as NS (4) PY 204+#... Physiological Psychology (4) AN 100*... Intro to Socio-Cultural Anthro (4) AN 210*... People, Culture and Nature (4) AN 320+*... Native Peoples of N America (4) EC The American Ecomy (4) EC American Ecomic History (4) EC Cap sm, Socialism, & Democracy (4) ED The American School (3) GC 164*... Human Geography (4) GC 300+*... Reg Studies: World Cultures (4) GC Regional Studies (4) GC Population Geography (4) HL 322+*... International Health Issues (4) HS 104*... The 3 rd World in Hist Perspective (4) HS 105*... World History (4) HS The US to 1865 (4) HS The US since 1865 (4) HS 233*... Native American History (4) HS American Ecomic History (4) LB 295S... Spec Topics in LS: SS (4) NAS Politics of Indian Gambling (4) NAS Tribal Law and Government (4) PS Intro to Political Science (4) PS American Government (4) PS Nuclear War and Peace (4) PS 321+*... Politics in Islamic Nations (4) PS Politics of Am Foreign Policy (4) PY 100G... Psychology as a SS (4) SO Introductory Sociology (4) SO 101H+... Introductory Sociology Hors (4) SO Civil Life in Democratic Society (2) SO Social Problems (4) SO Marriage and the Family (4) SO Sports in American Society (2) SO Social Class, Power and Mobility (4) SO Social Change (4) SO Intro to Social Psychology (4) SO 372**... Mirity Groups (4) Div IV Social Sciences

10 CHN Elementary Chinese I (4) CIS Principles of CIS (4) CS Web Site Construction (4) CS Computer Science I (4) CS 120A+... Accelerated Computer Science I (4) CS Comp for the El School Teacher (4) FR Elementary French I (4) FR Elementary French II (4) FR Intermediate French I (4) FR Intermediate French II (4) FR Conv French and Phonetics (4) GR Elementary German I (4) GR Elementary German II (4) GR Intermediate German I (4) GR Intermediate German II (4) GR Conversational German (4) IS Intro to Windows, & I net (1) IS Beginning Word Processing (1) IS Beginning Spreadsheets (1) IS Beginning Database (1) IS Presentation/Multimedia Software (1) IS Computerized Sm Bus Accounting (1) IS Intermediate Spreadsheets (1) IS Advanced Database (1) IS Software Integration (1) IS Web Page Development (1) LAT Elementary Latin (4) LB 295F... Spec Topics in LS: FCS (2-4) MA Intro to Prob and Stats (4) NAS Elem Anishinabe Language I (4) NAS Elem Anishinabe Language II (4) POR Elementary Portuguese (4) POR Intermediate Portuguese (4) PL Introduction to Logic (4) PY Psychological Statistics (4) SN Elementary Spanish I (4) SN Elementary Spanish II (4) SN Intensive Introductory Spanish (6) SN Intermediate Spanish I (4) SN Intermediate Spanish II (4) SN Conversational Spanish (4) SO Methods of Social Research I (4) AD 200+*... Nat Am Art & Arch of the GL (4) AD Hist of Western Art & Arch (4) AD Why Am Looks This Way (4) AD 265*... Art & Arch of Japan (4) AD 300+*... Japan & West: Crossc s in A&A (4) AD th Century Art & Arch (4) AD History of Modern Craft and Design (4) BC 325+*... Comm & Performance in Africa (4) EN Introduction to Film (4) EN Theatre in Pers: Stratford Festival (4) LB 295A... Spec Topics in LS: VPA (2-4) MU Music in Society (4) MU Surv of Jazz: Origin to Present (4) MU 325+*... World Music (4) PE History of Dance (2) PE Theory of Dance (2) TH Introduction to Theatre (4) TH History of Theatre (4) TH Modern Drama (4) TH Theatre in Pers: Stratford Festival (4) Div V Formal Communications Studies Div VI Visual and Performing Arts