DNP Program Application

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1 DNP Program Application Step 1 Complete the DNP Program Application and submit required items indicated on the enclosed Checklist. Send a packet containing all items together, including official transcripts and sealed letters of recommendation. We will forward your transcripts to Admissions and Records. Step 2 Complete the California State University Graduate Application online: You need to select CSU Fullerton as the campus to which you are applying. Select the Doctor of Nursing Practice Program from the list. YOUR APPLICATION FILE WILL BE CONSIDERED COMPLETE ONCE ALL OF THE ABOVE REQUIRED MATERIALS ARE SUBMITTED Only completed files will be reviewed. All application materials must be on file by January 15, DNP Applicant Writing Assessment Selected candidates will be invited to attend a computer-based writing assessment. Several dates will be offered at the CSU Fullerton campus in January, If you are invited to attend this assessment, you will be notified in early January. You must be invited to sit for this assessment. Those without an invitation will not be admitted. DNP Applicant Interviews Applicants who pass the writing assessment will be scheduled for interviews. Incomplete files will not be scheduled for interview. Interviews will be scheduled in February at all three consortium campus. Specific dates and locations will be provided to selected applicants. Fees and Tuition Fees are subject to change. Current information about CSUF fees and tuition can be found on the university Student Financial Services website: Accreditation The Southern California CSU DNP Consortium is accredited by the Commission on Collegiate Nursing Education (CCNE). Additionally, each member school of the Southern California CSU DNP Consortium is accredited by the Western Association of Schools and Colleges (WASC) and each of their existing nursing programs is accredited by CCNE.

2 Doctor of Nursing Practice Program Application PERSONAL INFORMATION Name App Date Applying For Fall 16 Address Home Phone ( ) City State Zip Work Phone ( ) address California Registered Nurse License Number: Active duty member or veteran of the U.S. armed forces? Yes, Active Yes, Veteran No EDUCATIONAL BACKGROUND (List all institutions since high school) School Name Dates Attended Diploma or Degree Received Date Awarded Do you have a Master of Science Degree with a major in Nursing? Yes No If no, what is your master s degree major? Which specialty certification(s) do you hold? (check all that apply and identify specialty if applicable) Direct Care Track Nurse Anesthesia Nurse-Midwifery Nurse Practitioner: Clinical Nurse Specialist: Other: Indirect Care Track Nurse Leadership/Management/Administration Community/Public Health Nurse Educator Other: If in process, indicate expected completion date: RECOMMENDATIONS Name Title Organization How did you first hear about our program?

3 Doctor of Nursing Practice Program Application Pre-Requisite Worksheet (Required for Direct Care Applicants Only) PERSONAL INFORMATION Name App Date Applying For Fall 16 Identify each of the following pre-requisite courses on your transcripts and provide the required information: School Name: List the name of the institution where you completed the specific pre-requisite course. Course Title: List the course title as it appears on the transcript. Term: List the term in which the course was completed. (ex: Spring 2011) Units: List the number of units as reflected on the transcript. S/Q: Specify if the course was offered as semester or quarter units. Enter S for semester or Q for quarter. Grade: List the grade received for the course as it appears on the transcript. ADVANCED PHYSICAL / HEALTH ASSESSMENT ADVANCED PATHOPHYSIOLOGY ADVANCED PHARMACOLOGY

4 To be completed by Applicant Doctor of Nursing Practice Recommendation Form I,, am applying to the Doctor of Nursing Practice program. (Name of Applicant) APPLICANTS WAIVER OF ACCESS STATEMENT: I understand this letter of evaluation and any other disclosures by the individual / organization listed below is to be received and maintained in confidence by the DNP Program for admission consideration. I hereby expressly waive any and all rights I might have of access to this evaluation under the Family Education Rights and Privacy Act of 1974, the California Information Practices Act of 1977, and any/or all other laws, regulations or policies. I understand that the rights I am waiving include, but are not limited to, the right to inspect and review this letter, the right to have copy of this letter made for my use, and the right to request an amendment of this letter. To be completed by Evaluator This applicant is interested in admission to our DNP program. We appreciate your confidential evaluation: Excellent Above Below Poor Not Known Knowledge of Nursing Demonstrates Advanced Practice Knowledge and Skills Potential for Interdisciplinary Collaboration Potential to Conduct Research Ability to Express Self Verbally Ability to Express Self in Writing Ability to Relate to Others Leadership Ability Please indicate the strength of your overall endorsement of this applicant: Highly Recommend Recommend Recommend with Reservations Do Not Recommend PLEASE ATTACH A LETTER outlining your knowledge of the applicant and your candid assessment of his/her ability to succeed in doctoral level education, which requires independence and initiative throughout a two-year demanding curriculum. Evaluator Name Organization Position Signature Phone Date Please return the completed Recommendation Form and letter to the applicant in a sealed envelope *OR* directly to from your work account. These forms and letters are confidential; the applicant should not be sent a copy.

5 Doctor of Nursing Practice Application Checklist Please submit the following between October 1, 2015 and January 15, 2016: School of Nursing Application (1 page) If direct care applicant, Pre-Requisite Worksheet (1 page) Statement of Purpose: Please type a brief statement (no more than 500 words) describing your reason(s) for pursuing the Doctor of Nursing Practice. Indicate your specialty in which you will continue preparation (i.e., FNP, CRNA, CNS, nurse leader, etc.). (3) DNP Recommendation Forms with letters. These forms and letters are confidential; the applicant is not to have access to them. Option 1: Letter and form can be signed and submitted in sealed envelopes to the applicant and forwarded with the packet. Option 2: Letter and form can be signed and sent via directly to Recommenders must from their WORK address and the applicant should NOT be cc ed. Resume or CV: Your current employment should be in an area appropriate to your anticipated DNP Program track (indirect care or direct care). If your current employment is not appropriate to your (current or anticipated) nationally certified role, please attach a letter outlining your plan to obtain appropriate employment (can be an unpaid position) or your plan to attain appropriate national certification prior to beginning the program. If this requirement is not clear, please contact for clarification. Copy of your National Certification as an Advanced Practice Nurse or in another nursing specialty. National Certification is required for direct care applicants and recommended for indirect care applicants. Official documentation of nursing practicum hours attained during your master s degree or post-master s certificate program One (1) set of official, un-opened transcripts from each institution you have ever attended SUBMIT ALL ABOVE ITEMS IN ONE PACKET TO: CSU, Fullerton School of Nursing, DNP Program 800 North State College Blvd. Fullerton, CA You must do the following between October 1, 2015 and January 15, 2016: Complete the CSU Graduate Application for Admission on-line at (Select CSU Fullerton as the campus to which you are applying. Then, select the Doctor of Nursing Practice.) If you are selected as a student for the program, additional materials including background check and health clearance will need to be submitted. Instructions will be given upon admission.

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