Trinity Washington University School of Nursing and Health Professions Nursing Program Application Packet Checklist Spring Semester, 2013

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1 Trinity Washington University School of Nursing and Health Professions Nursing Program Application Packet Checklist Spring Semester, 2013 Please make an appointment to meet with your academic advisor to apply to the nursing program. The application process and this application packet will need to be completed with your advisor by 4:00 PM on Tuesday, October 9 th, It is the applicant s responsibility to ensure that all required documents listed below are contained within the packet. The applicant should also include documentation of having passed the TEAS. Please make a copy of the completed packet for your records. Incomplete packets will not be processed. Packets will be delivered to the front office of the Nursing Program building by the academic advisor in a sealed envelope. Packets delivered by the applicant will not be accepted. Important Dates: Tuesday, October 9 th, 2012, 4:00 PM Deadline for completing your application with your advisor Thursday, November 1, Welcome session for new nursing students Monday, November 5, 2012 First day of registration for Spring Semester, 2013 classes Let Us Know More About You Attach a one page type-written essay on the following topic: Discuss why you are interested in studying nursing at Trinity Washington University and how your interest in nursing relates to your future goals. Explain how your experiences or ideas shaped your decision to pursue a career in nursing. Describe how you feel your education at Trinity Washington University may assist you in making a contribution to the nursing profession in the future.

2 Advisors Please Check Completed Signed Trinity Nursing Program Application Transcripts from all institutions where prerequisite and general education courses have been taken Official Report of TEAS Score Results Essay Completed Academic Advising Checklist Student Name Student Signature Date Advisor Name Advisor Signature Date

3 Trinity Washington University School of Nursing and Health Professions Nursing Program Application Spring, 2013 Student Information Last Name First Name Middle Initial Street Address City State ZIP CODE Telephone: (Home) (Cell) Personal address: Trinity Address: Trinity Student ID # Program Information Program applying to: Pre-Licensure BSN Program Expected Semester of Entry into the Nursing Program: Have you previously applied to this nursing program? (Yes or No) (If yes, when?) (Semester/Year)

4 Trinity Washington University School of Nursing and Health Professions Nursing Program Acknowledgement Form 1. I understand that once accepted into the Trinity Washington University Nursing Program, I must, within 45 days, have the following and provide proper documentation in my student records: A. A physical examination by a licensed health care professional, using the Trinity Washington University Health Screening Form. This form must be submitted to the Nursing Program Office in the provider s sealed, return address envelope, with the provider s signature across the seal of the envelope. The Trinity Health Form can be downloaded from the Trinity website. The physical exam must be completed annually while enrolled in the nursing program. B. Tuberculosis (TB) skin test with follow up chest x-ray (if skin test is positive). Your chest x-ray must have been taken within two years in order to be current. NOTE: A new TB skin test must be completed annually and the chest x-ray (if required) must be repeated every two years while enrolled in the nursing program. C. Immunizations: Immunization records must be completed by a licensed health care professional, using the Trinity Washington University Health Screening Form. This form must be submitted to the Nursing Program Office in the provider s sealed, return address envelope, with the provider s signature across the seal of the envelope. i. Tetanus/Diphtheria (TD Booster) within ten years ii. MMR Two vaccines or a positive titer iii. Varicella (Chicken pox) Two vaccines or a positive titer iv. Hepatitis B Series of 3 vaccines given over a six-month period. All 3 vaccines must be completed before student participates in the clinical portion of the program. v. Seasonal Influenza Proof of updated annual vaccine D. Proof of current major medical health insurance E. Current Cardiopulmonary Resuscitation (CPR) certification (American Heart Association - CPR for the Health Care Provider) 2. I understand that the nursing program s clinical requirements may change and I am expected to check my Trinity s daily throughout the whole year for programmatic updates. 3. I understand that I will need to get an updated annual flu vaccine, an updated annual TB test (or chest x-ray every two years), an updated annual physical exam, and keep my CPR card current.

5 4. I understand that if my physical exam, TB skin test, or CPR card are due to expire while I am taking a clinical course, I may be required to update them prior to being allowed to begin the clinical course. 5. I understand that I will be required to take a certified drug test through at my expense and that the results need to be in my student records by 45 days after acceptance into the Nursing Program. I may be denied access to clinical placement sites by the agencies based on the results of my drug test. 6. I understand that right after being accepted into the Nursing Program, I will be required to utilize to submit to a Nationwide Federal Background Check with FBI fingerprinting, criminal search, sex offender index, and a resident history search, at my expense. The results need to be in my records within 45 days of acceptance into the nursing program. I understand that I may be denied access to clinical placement sites by the agencies based on the results of my background check. 7. I understand that, once accepted into the nursing program, I must go to to set up an account for my background check. I also will need to set up a Magnus Health Portal account at that same website. Then, after submitting my health documents to the Nursing Program front office, these documents will be filed in my health records folder and also uploaded to the Magnus Health Portal for safe-keeping. 8. I understand that I will be required to purchase a uniform and laboratory coat with the school logo embroidered on the uniform and coat at Fenton s Uniforms in Silver Spring, Maryland, and that the uniform will be required for my hospital clinical held during my first semester in the nursing program. 9. I understand that I will be unable to register for a nursing clinical course until all of the above required documents are submitted and I have received a permission letter of completion from the nursing office to submit to my nursing program advisor. 10. I understand that I must have a cumulative GPA of at least 2.5 to be accepted into and remain as a student in the Nursing Program. If my GPA drops below a 2.5, I cannot register for courses to begin the nursing program and will need to reapply to the program after raising my GPA. 11. I understand that I must earn a C or better in all nursing prerequisite courses in order to be admitted into the nursing program. If I earn less than a C in a prerequisite nursing course, I cannot begin taking courses in the nursing program and will need to repeat the course, earn a C or better, and reapply to the nursing program. Note: Nursing classes, clinical days, and lab hours vary. As a result, your schedule may change each semester. Nursing classes and hospital clinicals are held during daytime hours, in the evening, as well as during the weekend (Saturday and Sunday), so you may have to adjust your work schedule. Due to

6 hospital and community nursing clinical schedules, the Nursing Program cannot guarantee that you will be able to take all of your classes in the evenings and on weekends. It is recommended that you register for courses as early as possible in order to get into the nursing courses you would like to take. The nursing program is a year-round program with courses also offered in the summer. I have read and understand the admission criteria for the Nursing Program at Trinity Washington University. I understand that it is my responsibility to meet all program and application criteria. I verify that all statements on this application are complete and true. I understand that falsification of any information may lead to disqualification or dismissal from the program. Applicant Signature Date

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