Georgia State University Byrdine F. Lewis School of Nursing and Health Professions BSN PhD or Doctor of Philosophy Programs APPLICATION PACKET

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1 Application Deadlines: Georgia State University Byrdine F. Lewis School of Nursing and Health Professions BSN PhD or Doctor of Philosophy Programs APPLICATION PACKET BSN PHD Program February 1 Doctor of Philosophy Program/Ph.D. February 1 These deadlines are the dates for all applications, materials and test scores to be in the Office of Academic Assistance. This is NOT a post marked deadline. Please allow sufficient time for the delivery of your packet. For admission to the BSN PhD or Doctor of Philosophy Program, the Byrdine F. Lewis School of Nursing will utilize a self managed application process. This means that it is your responsibility to prepare and/or collect all credentials, including sealed transcripts and letters of recommendations, and mail them in one packet to the Office of Academic Assistance. Included in this information are: 1. Application Instructions 2. Application Checklist 3. Application Forms Before submitting your completed application packet, please review the contents of your packet to ensure all applications and supporting documents are included. Please use one of the addresses below when submitting your application packet. Delivery Options: Mailing Address (through the U.S. Postal Service) Courier (UPS, FedEx, DHL, etc) Office of Academic Assistance School of Nursing & Health Professions Georgia State University P.O. Box 3995 Atlanta, GA Office of Academic Assistance BFL School of Nursing & Health Professions Georgia State University 140 Decatur Street, Suite 811 Atlanta, GA For Questions Regarding the Application Process, Contact: Denisa Reed 404/ Page 1

2 APPLICATION INSTRUCTIONS To help expedite the admissions process, it is important for you to read these Applications Instructions carefully In addition to the Application for Graduate Study and the Residency Information Form, the following items should be collected by you and included in the packet mailed to the Office of Academic Assistance. Two sealed transcripts from each college or university ever attended Transcripts are required regardless of length of stay or if the grades are listed on another school s transcript. This also includes Hospital Schools of Nursing. NOTE: If you are currently enrolled or have previously attended Georgia State University, one sealed transcript from each school, except Georgia State s, must be sent. NOTE: You will collect and submit all unopened transcripts in your application packet. Three letters of recommendation From individuals knowledgeable of your academic or professional abilities. If you have been out of school less than five (5) years, one letter should be an academic recommendation. The recommender s contact information (telephone number and address) should be included in the letter. Each letter remains unopened with the recommender s signature across the seal. Resume/Curriculum Vitae Include education, work experience, professional development, professional and/or community activities, and research and publications. The Georgia R.N. License number should be included on the resume. Statement of Purpose/Goals and Area of Research Interest This should be a paper that (briefly) describes the applicant s doctoral education and career goals. It should also include an area of the applicant s research interest. And, if there is a faculty member in the SNHP/SON with whom you might be able to develop a common research interest, please describe briefly how this would be congruent with your own research interests. Faculty profiles can be found at this website: Writing Sample A two page Position Paper on a current social or health issue. Application Fee. A $50.00 check or money order (in U.S. currency) should be made payable to Georgia State University. This fee is nonrefundable. The following items are needed but not submitted in the application packet you mail to the Office of Academic Assistance. Page 2

3 Graduate Record Exam Scores The GRE score should be sent directly to GSU from the Educational Testing Service (ETS). Scores cannot be more than five years old from the desired semester of entry. We recommend that you take the GRE with enough lead time to ensure the scores are reported prior to the application deadline. The correct institution code for GSU is A department code is not used. If you have an official copy of your GRE scores, please send a photocopy with your application packet. While a photocopy is not acceptable for admission and we must still receive official scores from ETS, a photocopy can help expedite the processing of your application. Visit the GRE website at or call GRE CALL for information and registration. Certificate of Immunization This is required for accepted applicants who have never attended Georgia State University. If admitted, you must submit this form to Georgia State University Health Services prior to registration. The form can be printed from Verification of Lawful Presence Additional information regarding this requirement and a list of acceptable documents can be found at the Undergraduate Admissions link: Additional requirements include the following: 1. BSN Ph.D a. Bachelor s Degree in Nursing from an accredited nursing program 2. Doctor of Philosophy/ Ph.D a. Masters of Science Degree in Nursing from an accredited nursing program 3. Licensure/Certification. All applicants (including international applicants) must hold a license in Georgia as a registered nurse (R.N. license) prior to acceptance to the BSN PhD or Ph.D program. The R.N. License number should be listed on the resume. 4. Interview with faculty in the School of Nursing. Page 3

4 For Applicants with International Education Credentials Additional Information can be found at this website: International credential evaluation An applicant who has completed all or part of his/her education outside the United States is required to have his/her foreign credentials evaluated by an independent evaluation service. We accept evaluations of foreign credentials from the companies below. For more information, please link to the company s website: Josef Silny & Associates Educational Credential Evaluators, Inc. World Education Services https://www.ece.org/ The evaluation should include: Grade Point Average Equivalent Course by Course listing A Copy of the Transcript used in the Evaluation Please allow sufficient time to have your credentials evaluated to assure that the evaluating service has enough time to send their evaluation to the Office of Academic Assistance by the application deadline. On average, it takes 4 weeks from the time the evaluation agency receives your materials until we receive the evaluation. Official TOEFL scores (for applicants whose native language is not English). If available, please include a copy of your TOEFL score in your application packet. Scores cannot be more than 2 years old from the desired term of entry. The TOEFL is waived if the applicant holds an academic degree from a United States accredited college or university. TOEFL information can be found at Applicants living in the Atlanta area may take the Georgia State Test of English Proficiency (GSTEP) in the place of the TOEFL. GSTEP information is found at: Foreign Student Financial Statement (for international applicants seeking a student visa). For more information, please contact the Office of International Student & Scholar Services: Page 4

5 Application Deadlines: Admissions Packet Checklist BSN PHD Program February 1 Doctor of Philosophy Program/Ph.D. February 1 This deadline is the date for all applications, materials and test scores to be in the Office of Academic Assistance. This is NOT a post marked deadline. The following items should be submitted in one packet: Check Off ITEM Application for Graduate Study Residency Information Form Transcripts from all colleges and universities attended in sealed envelopes Three Letters of Recommendation Resume/Curriculum Vitae Statement of Purpose/Goals and Area of Research Interest Writing Sample $50.00 Application Fee (check or money order) made payable to Georgia State University Certificate of Immunization (not required for admission, may be submitted after acceptance) Verification of Lawful Presence (not required for admission, may be submitted after acceptance) Please refer to the beginning of this document for delivery options. You may also hand deliver your application packet to: Room 811; Urban Life Center; 140 Decatur Street, Atlanta For Questions Regarding the Application Process, Contact: Denisa Reed 404/ Page 5

6 Name Please type and print completed application. Social Security Number (if available) Byrdine F. Lewis School of Nursing Application Application_Forms BS-PHD or Doctor of Philosophy Program Last (family name) First Middle Former name(s) used at previous colleges, if any address List an active address as this will be the primary mode of communication. Present mailing address Number/Street City State ZIP Nation If applicable, address good until Present telephone numbers Permanent mailing address (if different from above) Home Work (if available) Cell Number/Street City State ZIP Nation Permanent telephone number (if different from above) GSU is required to report data on gender and ethnic groups to certain federal and state agencies, as the data relates to civil rights compliance. The provision of this information by applicants is not mandatory. Gender: Race/Ethnic Group: Birth date Month Day Year Country of Birth Program for which you are applying: Doctoral Program Nursing BSN-Ph.D. Program (must hold BSN degree) Doctor of Philosophy Program/Ph.D. (must hold a MSN Degree) Semester/Year for which you are applying: Fall (August) Page 6

7 How did you learn about this degree program? _ List all Colleges/Universities you have attended: (List most recent first) OAA Office Use Only Name of College/University Location From: Mo/Yr To: Mo/Yr Degree Program Major or Concentration Degree Awarded Name/Date Date you took or intend to take the appropriate exam: GRE MAT Date you requested or intend to request scores to be sent to GSU: GRE MAT GMAT GMAT Have you previously applied to Georgia State University? _ No Yes: Which year and term? Employment History: OAA Office Use Only Organization City, State, Country Occupation Title Full-time or Part-time Years Employed Other Information: Have you ever been convicted of a crime other than a minor traffic violation? If yes, explain in 100 words or less: Are you currently charged with or have been found guilty of any violation of a federal, state, or municipal law, regulation or ordinance other than minor traffic violations, including offenses for which any type of first offender status has been granted? If yes, explain in 100 words or less: Have you ever entered a plea of guilty, no contest, nolo contender, or Alford plea, or have otherwise accepted responsibility for the commission of a crime? If yes, please explain in 100 words or less: Page 7

8 Do you currently have disciplinary or academic misconduct or academic misconduct charges pending against you from another college or university? If yes, please explain in 100 words or less: Have you ever been disciplined, suspended, or expelled for conduct code violations from a postsecondary educational institution? If yes, please explain in 100 words or less: Are you on academic probation, suspension, exclusion, or any other type of academic warning at any previously attended institution? If yes, please explain in 100 words or less: Have you received any type of discharge from military service other than an honorable discharge? If yes, please explain in 100 words or less: Emergency Contact Information: Name Last (family name) First Relationship Emergency Phone Number INTERNATIONAL APPLICANT INFORMATION Applicants whose native language is not English or who have not earned a degree from a U.S. institution. Primary language: Language used in college instruction: Date you took or intend to take the Test of English as a Foreign Language (TOEFL): Date you requested or intend to request scores to be sent to GSU: Page 8

9 Non-U.S. Citizens Only (whether in this country or applying from abroad): Type of Visa requested (Select one) Other F-1 F-2 J-1 J-2 H-1 H-2 B-1 B-2 Refugee Asylee Is this visa currently held? Yes No If you are a Permanent Resident Alien, please provide your alien number and date the card was issued: I understand that any material false statement made knowingly and willfully by me on this application, or any documents attached hereto may, in accordance with O.C.G.A , which provides that upon conviction, a person who knowingly commits the offense of false swearing shall be punished by a fine of not more than $1000 or by imprisonment for not less than one nor more than five years, or both, subject me to prosecution in a court of law. Additionally, I further understand that any such false statement may subject me to immediate dismissal from the institution. Further, I certify that, to the best of my knowledge, the information submitted on this application is true and complete. IMPORTANT: THIS FORM MUST BE SIGNED. I certify that the information provided on this application and any attached documents is true and accurate to the best of my knowledge and understand that omissions or falsifications may result in withdrawal of a decision to accept me or in disciplinary action. I understand that I must request and provide official transcripts to the Byrdine F. Lewis School of Nursing and Health Professions from all appropriate colleges or universities attended (except GSU) before I may be considered for admission. I further understand that I may be required to furnish additional information or take additional tests to be considered for admission. SIGNATURE OF APPLICANT DATE Georgia State University, a unit of the University System of Georgia, is an equal opportunity educational institution and an equal opportunity/affi rmative action employer. The University is open to people of all races and actively seeks to promote racial integration. Page 9

10 LAWFUL PRESENCE REQUIREMENT The Board of Regents of the University System of Georgia requires that any student applying to Georgia State University must provide verification of their lawful presence in the United States before their admission to the university can be finalized. This requirement is detailed in the following Board of Regents policies: Policy Admission of Persons Not Lawfully Present in the United States Policy Verification of Lawful Presence While not required at the time of application, providing one of the following documents may expedite your verification process. Please submit a black and white copy of one of the items listed below with your application. Please note, only U.S. Citizens and Permanent Residents should submit documentation. Please submit a copy of one of the following documents: Current U.S. Passport Current GA Driver s License issued by the State of Georgia after January 1, 2008 Current GA ID Card issued by the State of Georgia after January 1, 2008 U.S. Certificate of Naturalization U.S. Certificate of Citizenship U.S. Certificate of Birth Abroad Permanent Resident Card Page 10

11 RESIDENCY INFORMATION GRADUATE PROGRAMS BYRDINE F. LEWIS SCHOOL OF NURSING & HEALTH PROFESSIONS GEORGIA STATE UNIVERSITY This section must be completed by all applicants. Please print clearly. Name Address Last (family name) First Middle Number/Street U.S. Social Security Number Length of time at this address_ Years/Months City State Zip Code County Telephones: ( )_ ( ) _ Area Code Home Area Code Other Place of Birth Country of Citizenship City State Country If not U.S. Citizen, VisaType (Attach a copy of both sides of your Permanent Resident Alien Card, 1-94, or other visa paperwork.) For the purpose of establishing Georgia residency for tuition and fee payment, your legal residence is your permanent home. Not only must you live in Georgia but you must remain indefinitely. The durational requirement for Georgia residency under the Board of Regents regulation is 12 months immediately before the semester for which you intend to enroll. If you entered Georgia to attend an educational institution, the time in school is not normally counted toward the 12-month residency requirement. If you have any questions, please feel free to call 404/ or the university s residence auditor at I wish to be considered a Georgia resident for tuition and fee payment purposes: Yes (You must complete the resident information on the reverse side of this form.) No (You must complete the information below.) NON-GEORGIA RESIDENTS If you do not consider yourself to be a Georgia resident, please list your home state (if U.S.) or country and please sign here Date The Board of Regents offers waivers of the non-resident fees based on certain circumstances. Please indicate if you feel that you may qualify for a waiver of the nonresident fees based upon: employment as a full-time teacher (by you or a supporting parent) in the Georgia public school system full-time employment in the University System of Georgia (by you, a spouse or a supporting parent) employment as a career consular officer (by you, a spouse or a supporting parent) marriage to and dependence on a Georgia resident (for 12 months) dependence on a parent or guardian who has been a resident for 12 months military active duty in Georgia (by you, a spouse or a supporting parent); this includes commissioned officers in the Public Health Service stationed in Georgia on active duty GEORGIA RESIDENTS CONTINUE ON REVERSE SIDE Page 11

12 PAGE 2 NAME: GEORGIA RESIDENTS I have lived continuously in GA since month day year Please indicate all situations that apply in your case: (A) I am an independent person who has not been claimed as a dependent on anyone else s income tax return and provided more than 50% of my income/financial support and I have maintained legal residence in Georgia (including payment of Georgia taxes) for the 12 months prior to the semester for which I intend to enroll. (B) I am the child of a Georgia resident or the spouse of a Georgia resident who has maintained legal residence in Georgia for the 12 months prior to the semester for which I intend to enroll. (C) I have a legal guardian who has maintained legal residence in Georgia for the 12 months prior to the semester for which I intend to enroll. (D) I (or my parents) am in the U.S. military and the home of record is Georgia. The income taxes are filed with and paid to the State of Georgia. According to the U.S. Immigration and Naturalization Service. I am a Permanent Resident Alien or other legal alien granted indefinite stay and I also qualify for A B C D above (I will attach a copy of my visa paperwork: 1-20, 1-55, 1-51, passport, etc.) I currently reside in _County, GA. Please note: The following circumstances alone do not constitute sufficient evidence to effect classification as a resident under Regents policies but may assist in determining your residency. Do you: have a driver s license? If yes, in which state is it registered? own a motor vehicle? If yes, in which state is it registered? have a voter registration? If yes, in which state are you registered? have a checking or savings account? If yes, in which state is it registered? If you answered yes to any of the above and the state is not Georgia, please attach an explanation and return it with this form. If you did not graduate from a Georgia college or came to Georgia in the last two years, please tell us know why you came to Georgia and your plans for the future. List all employment for the past two years: Employer Location From Dates To Full-time Part-time (City and State) (month/year) (month/year) (Approx. # of hours per week) List all educational institutions attended during the past two years: Institution Location From Dates To Full-time Part-time (City and State) (month/year) (month/year) (Approx. # of hours per week) I, the undersigned, hereby affirm the authenticity of the information provided. I understand that any false or misleading information may result in denial of admission or expulsion from the university. I further understand that it may also cause me to be billed for the nonresident fees. Signature Date Page 12

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