CHECKLIST. January 1 For Summer Admission September 1 For Spring Admission April 1 For Fall Admission

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1 ND/DNP Admission Procedures Use this application if you have a MS in nursing from a NLN or CCNE accredited institution and a ND degree from the College of Nursing. CHECKLIST University of Colorado Denver (UCD) for Admission Non-refundable application fee of $65 is payable online. Please click here to pay your application fee. Letters of recommendation - 4 Official transcripts from the institutions where the MS and ND degrees were received. This includes the official transcript from College of Nursing (CON) Registrar s Office. Official transcripts must be sent directly from the Registrar s Office of the issuing institution to the CON Office of Student Affairs and Diversity. To request transcripts for credits completed at the CON, call Official transcripts are also needed if you completed course work after the MS and ND degrees. Copy of RN License and advanced practice specialty certification Proof of NLN or CCNE accreditation for the MS degree if it was received at an institution other than at the CON Current Curriculum Vitae (CV) On-site or telephone interview required TOEFL test required of all applicants whose primary language is not English. This also applies to US citizens and permanent residents. The test results for US citizens and permanent residents will not be used to determine admission. The results will be used after admission to determine if additional English language assistance is needed. For more information, go to Once admitted, you must register for a portfolio class. You will receive more information in your admit letter. The applicant will be notified of admission status by mail. Please contact the Office of Student Affairs and Diversity for changes in name, address, telephone number or address. All materials should be sent to: Office of Student Affairs & Diversity University of Colorado Denver, College of Nursing C E 19 th Ave Aurora, CO Phone: Internet: DEADLINES All application materials must be received by the deadline dates. It is the responsibility of the applicant to ensure that materials arrive by the deadline. January 1 For Summer Admission September 1 For Spring Admission April 1 For Fall Admission 10/2009

2 Section A APPLICATION FOR ADMISSION DOCTOR OF NURSING PRACTICE Please indicate year & semester for which you are applying Year Fall Spring Summer SSN # MS in nursing specialty Type or clearly print all information. Answer all questions completely. Full legal name (Do not use nicknames) Last First Middle Other name(s) which may appear on your records Address to which admissions information should be sent. (Please notify us immediately of changes) No. & Street or P.O. Box City County State Zip Code Birth date Telephone ( ) ( ) Male Female month/day/year home work Permanent address if different from above ( ) No. & Street or P.O. Box City State Zip Code Telephone Address: Emergency contact: ( ) Name Telephone Address CITIZENSHIP: (Attach photocopy of visa or permanent resident card, if applicable.) US Citizen/Permanent Resident Non US Citizen Country of Citizenship If non US Citizen: Visa Type Passport Number Expiration Date If you are a former CU student, name under which were last registered Campus Location Term and Year If you are a male born after December 31, 1959, are you registered with the Selective Service? Yes No Military service: Yes No Active Duty dates from (mo/yr) / To / 10/2009 2

3 Optional Questions: The following information is voluntary and is used for statistical purposes: Ethnic Origin: American Indian or Alaskan Native, enrolled member of tribe or nation Asian or Pacific Islander American Indian or Alaskan Native, non-enrolled member of tribe or nation White, Non-Hispanic African-American, Black, Non-Hispanic Hispanic, Chicano, Mexican American, Latino Other, Foreign I do not wish to provide this information If American Indian or Alaskan Native, indicate the name of the tribe or nation: If Multiracial, indicate other ethnic or racial terms that further or better describe your ethnic background: Has either one of your parents earned a baccalaureate (4-year) degree? Yes No Is your primary language English? Yes No If no indicate language Are you from a rural county or state? Yes No If yes indicate county or state List the colleges and universities where you received your ND and MS in nursing degrees. Also include institutions if course work was taken after the MS and ND degrees. DATES ATTENDED Name of Institution CITY STATE ZIP Degree Earned DATE IMPORTANT: YOU MUST ANSWER ALL QUESTIONS BELOW AND SIGN THE APPLICATION. 1. Have you ever been convicted of a felony or misdemeanor other than traffic violations? Yes No (If yes, attach a detailed explanation, including the type of conviction, the sentence imposed and if/when the sentence was completed.) 2. Have you ever been placed on probation, or been suspended/expelled from any Yes No post-secondary institution for other than academic reasons? If yes, you must include an explanation with this application. Failure to do so will delay processing of your application. I hereby certify that to the best of my knowledge the information furnished in this application is true and complete. I understand that if found to be otherwise, it is sufficient cause for rejection or dismissal. Applicant s Signature Date 10/2009 3

4 All applicants must pay an application fee of $65 which is non-refundable. This fee is payable online. Please click here to pay your application fee. Applicants will be notified by mail when application is received. To avoid delay in notification, please contact the Office of Student Affairs & Diversity immediately with any changes in name, address, phone number or . All materials should be sent to: Office of Student Affairs & Diversity University of Colorado Denver, College of Nursing C E 19 th Ave Aurora, CO Phone: NOTE: All curriculum and fees are subject to change without notice. A computer, meeting the College of Nursing standards, is required of all students while enrolled in this program Section B Letters of Recommendation List the names and addresses of the four references you have asked to submit a Request for Recommendation on your behalf. Be sure to select people who are in a position to comment competently on your probability of success in the DNP program (Forms included in application packet). At least one recommendation must be academic. 1. Phone ( ) Name 2. Phone ( ) Name 3. Phone ( ) Name 4. Phone ( ) Section C Copy of RN License and current specialty certification, if applicable Section D Current Curriculum Vitae (CV) 10/2009 4

5 Section E After being admitted to the DNP program, you will be contacted by the DNP office regarding submission of your portfolio. Instructions for Portfolio Preparation (for applicants with a MS degree in nursing from a NLN or CCNE accredited institution and the ND degree from the College of Nursing)) 1. Assemble evidence of formal coursework that demonstrates attainment of specific DNP competencies (see a-h below). 2. Assemble evidence of informal or non-degree or elective courses, including continuing education, that demonstrates attainment of specific DNP competencies. 3. Assemble evidence of work-related competencies, including projects, policies, educational materials, reports, or other products that demonstrates working knowledge and incorporation of the competencies into one s nursing practice. 4. Complete the Summary Chart of Competency Evidence to Accompany Portfolio (located on the following page) 5. Submit the Portfolio of evidence and accompanying summary chart for faculty review. DNP Portfolio and Competencies The purpose of the portfolio is to determine specific DNP competencies that have been met through education and experience, and identify those competencies that have yet to be met through degree-specific coursework. The portfolio should contain transcripts from nursing education courses, as well as other evidence, that address the extent of current nursing competencies in each of the essential DNP content areas. Please organize the portfolio according to the competencies a-h below. You will be contacted by the DNP office after formal admission to the program regarding when to submit your portfolio. It is recommended that you work on the portfolio and have it ready for submission by the first day of class. For more information on the competencies, please go to the following web site: Competencies for Portfolio: a. Scientific Underpinnings for Practice b. Organizational and Systems Leadership for Quality Improvement and Systems Thinking c. Clinical Scholarship and Analytical Methods for Evidence-Based Practice d. Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care e. Health Care Policy for Advocacy in Health Care f. Inter-professional Collaboration for Improving Patient and Population Health Outcomes g. Clinical Prevention and Population Health for Improving the Nation s Health h. Advanced Nursing Practice Total Credits needed to complete DNP will vary depending on portfolio review 10/2009 5

6 Summary Chart of Competency Evidence to Accompany Portfolio Competencies Scientific Underpinnings for Practice Evidence of Competency Attainment Please list the evidence you are providing for each competency, and code each piece of evidence as follows: A = Academic coursework C = Continuing Education E = Experiential or Work-related Organizational and Systems Leadership for Quality Improvement and Systems Thinking Clinical Scholarship and Analytic Methodologies for Evidence-Based Practice Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care Health Care Policy for Advocacy in Health Care Inter-professional Collaboration for Improving Patient and Population Health Outcomes Clinical Prevention and Population Health for Improving the Nation s Health Advance Nursing Practice Portfolio Format Requirement: No more than 175 pages Accreditations and Memberships The University of Colorado is recognized by all major accrediting agencies and is fully accredited by the North Central Association of Colleges and Schools. The College of Nursing is accredited by the National League for Nursing and the Commission on Collegiate Nursing Education. The College of Nursing maintains the following memberships: American Academy of Nursing, American Association of Colleges of Nursing, American Nurses Association, Colorado Nurses Association, National League for Nursing and Sigma Theta Tau. The University of Colorado is committed to Diversity and Equality in Education and Employment. *Curriculum subject to change without notification 10/2009 6

7 REQUEST FOR RECOMMENDATION UNIVERSITY OF COLORADO DENVER COLLEGE OF NURSING I. The applicant should complete Section I. Give one form to each recommender. Last (family) First name Middle or Maiden name is applying for admission to the DNP (Doctorate of Nursing Practice) program at the University of Colorado Denver College of Nursing and has listed you as a reference on his/her application. To the applicant: Under the Family Educational Rights and Privacy Act of 1974 students who are accepted and who matriculate into the school/college program for which they applied are given the right to inspect their records, including their letters of recommendation, unless they have waived their right of review. You have the option of (a) signing the following waiver; or (b) declining to do so. A. I expressly waive any rights I might have to access this letter of recommendation under the Family Educational Rights and Privacy Act of Signature: B. I do not agree to the waiver above. Signature: II. To the recommender: Before you agree to submit a recommendation, please review the reference to the Federal law entitled the Family Educational Rights and Privacy Act of 1974 as presented above in our instructions To the applicant. A. Comparative Evaluation Compared with students you have known please rank the applicant on the scales below: 1. Scholarly achievement 2. Creative achievement 3. Potential for leadership in field 4. Ability to handle stress 5. Ability to work with others 6. Perseverance in pursuing goals 7. Ability to exchange ideas 8. Written expression 10/2009 7

8 NOTE: The educational level of the representative group with whom the applicant is compared to: College Seniors College Graduates First Year Graduate Students Intermediate Year Graduate Students Terminal Year Graduate Students Other (Specify) B. Narrative Evaluation We solicit your candid evaluation of the applicant s preparation for study, range of abilities and accomplishments, and creative and intellectual promise. In the space below please summarize your opinion of (a) the quality of the applicant s academic or creative achievements, (b) the applicant s scholarly or creative potential and promise for advanced and original work, (c) those aspects of the applicant s special skills and experience as demonstrated in an art, vocation, or profession. We would appreciate knowing the extent of your contact with the applicant and any special opportunities you may have had to observe him/her. (Attach additional sheets if necessary.) How long have you known applicant? In what capacity? Recommender s Signature: Name printed or typed: Address: Title: PLEASE RETURN THIS FORM TO: Office of Student Affairs & Diversity, University of Colorado Denver, College of Nursing, C288-6, E 19 th Ave, Aurora, CO /2009 8

9 REQUEST FOR RECOMMENDATION UNIVERSITY OF COLORADO DENVER COLLEGE OF NURSING I. The applicant should complete Section I. Give one form to each recommender. Last (family) First name Middle or Maiden name is applying for admission to the DNP (Doctorate of Nursing Practice) program at the University of Colorado Denver College of Nursing and has listed you as a reference on his/her application. To the applicant: Under the Family Educational Rights and Privacy Act of 1974 students who are accepted and who matriculate into the school/college program for which they applied are given the right to inspect their records, including their letters of recommendation, unless they have waived their right of review. You have the option of (a) signing the following waiver; or (b) declining to do so. A. I expressly waive any rights I might have to access this letter of recommendation under the Family Educational Rights and Privacy Act of Signature: B. I do not agree to the waiver above. Signature: II. To the recommender: Before you agree to submit a recommendation, please review the reference to the Federal law entitled the Family Educational Rights and Privacy Act of 1974 as presented above in our instructions To the applicant. A. Comparative Evaluation Compared with students you have known please rank the applicant on the scales below: 1. Scholarly achievement 2. Creative achievement 3. Potential for leadership in field 4. Ability to handle stress 5. Ability to work with others 6. Perseverance in pursuing goals 7. Ability to exchange ideas 8. Written expression 10/2009 9

10 NOTE: The educational level of the representative group with whom the applicant is compared to: College Seniors College Graduates First Year Graduate Students Intermediate Year Graduate Students Terminal Year Graduate Students Other (Specify) B. Narrative Evaluation We solicit your candid evaluation of the applicant s preparation for study, range of abilities and accomplishments, and creative and intellectual promise. In the space below please summarize your opinion of (a) the quality of the applicant s academic or creative achievements, (b) the applicant s scholarly or creative potential and promise for advanced and original work, (c) those aspects of the applicant s special skills and experience as demonstrated in an art, vocation, or profession. We would appreciate knowing the extent of your contact with the applicant and any special opportunities you may have had to observe him/her. (Attach additional sheets if necessary.) How long have you known applicant? In what capacity? Recommender s Signature: Name printed or typed: Address: Title: PLEASE RETURN THIS FORM TO: Office of Student Affairs & Diversity, University of Colorado Denver, College of Nursing, C288-6, E 19 th Ave, Aurora, CO /

11 REQUEST FOR RECOMMENDATION UNIVERSITY OF COLORADO DENVER COLLEGE OF NURSING I. The applicant should complete Section I. Give one form to each recommender. Last (family) First name Middle or Maiden name is applying for admission to the DNP (Doctorate of Nursing Practice) program at the University of Colorado Denver College of Nursing and has listed you as a reference on his/her application. To the applicant: Under the Family Educational Rights and Privacy Act of 1974 students who are accepted and who matriculate into the school/college program for which they applied are given the right to inspect their records, including their letters of recommendation, unless they have waived their right of review. You have the option of (a) signing the following waiver; or (b) declining to do so. A. I expressly waive any rights I might have to access this letter of recommendation under the Family Educational Rights and Privacy Act of Signature: B. I do not agree to the waiver above. Signature: II. To the recommender: Before you agree to submit a recommendation, please review the reference to the Federal law entitled the Family Educational Rights and Privacy Act of 1974 as presented above in our instructions To the applicant. A. Comparative Evaluation Compared with students you have known please rank the applicant on the scales below: 1. Scholarly achievement 2. Creative achievement 3. Potential for leadership in field 4. Ability to handle stress 5. Ability to work with others 6. Perseverance in pursuing goals 7. Ability to exchange ideas 8. Written expression 10/

12 NOTE: The educational level of the representative group with whom the applicant is compared to: College Seniors College Graduates First Year Graduate Students Intermediate Year Graduate Students Terminal Year Graduate Students Other (Specify) B. Narrative Evaluation We solicit your candid evaluation of the applicant s preparation for study, range of abilities and accomplishments, and creative and intellectual promise. In the space below please summarize your opinion of (a) the quality of the applicant s academic or creative achievements, (b) the applicant s scholarly or creative potential and promise for advanced and original work, (c) those aspects of the applicant s special skills and experience as demonstrated in an art, vocation, or profession. We would appreciate knowing the extent of your contact with the applicant and any special opportunities you may have had to observe him/her. (Attach additional sheets if necessary.) How long have you known applicant? In what capacity? Recommender s Signature: Name printed or typed: Address: Title: PLEASE RETURN THIS FORM TO: Office of Student Affairs & Diversity, University of Colorado Denver, College of Nursing, C288-6, E 19 th Ave, Aurora, CO /

13 REQUEST FOR RECOMMENDATION UNIVERSITY OF COLORADO DENVER COLLEGE OF NURSING I. The applicant should complete Section I. Give one form to each recommender. Last (family) First name Middle or Maiden name is applying for admission to the DNP (Doctorate of Nursing Practice) program at the University of Colorado Denver College of Nursing and has listed you as a reference on his/her application. To the applicant: Under the Family Educational Rights and Privacy Act of 1974 students who are accepted and who matriculate into the school/college program for which they applied are given the right to inspect their records, including their letters of recommendation, unless they have waived their right of review. You have the option of (a) signing the following waiver; or (b) declining to do so. A. I expressly waive any rights I might have to access this letter of recommendation under the Family Educational Rights and Privacy Act of Signature: B. I do not agree to the waiver above. Signature: II. To the recommender: Before you agree to submit a recommendation, please review the reference to the Federal law entitled the Family Educational Rights and Privacy Act of 1974 as presented above in our instructions To the applicant. A. Comparative Evaluation Compared with students you have known please rank the applicant on the scales below: 1. Scholarly achievement 2. Creative achievement 3. Potential for leadership in field 4. Ability to handle stress 5. Ability to work with others 6. Perseverance in pursuing goals 7. Ability to exchange ideas 8. Written expression 10/

14 NOTE: The educational level of the representative group with whom the applicant is compared to: College Seniors College Graduates First Year Graduate Students Intermediate Year Graduate Students Terminal Year Graduate Students Other (Specify) B. Narrative Evaluation We solicit your candid evaluation of the applicant s preparation for study, range of abilities and accomplishments, and creative and intellectual promise. In the space below please summarize your opinion of (a) the quality of the applicant s academic or creative achievements, (b) the applicant s scholarly or creative potential and promise for advanced and original work, (c) those aspects of the applicant s special skills and experience as demonstrated in an art, vocation, or profession. We would appreciate knowing the extent of your contact with the applicant and any special opportunities you may have had to observe him/her. (Attach additional sheets if necessary.) How long have you known applicant? In what capacity? Recommender s Signature: Name printed or typed: Address: Title: PLEASE RETURN THIS FORM TO: Office of Student Affairs & Diversity, University of Colorado Denver, College of Nursing, C288-6, E 19 th Ave, Aurora, CO /

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