Application Checklist

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1 School of Health Sciences RN to BS Degree Program Application Checklist In order to complete your application, the following items must be received by the RN to BS Office prior to the program s published deadline. RN to BS Application (see page 2) Recommendation Letters Professional (2) (see pages 6 and 8) Submit two professional recommendations, one of which must be from a recent supervisor, instructor, or faculty person who is able to address your current potential to be successful in the. Personal Statement (see page 10) Official Transcript(s) Submit official transcripts from all colleges and universities that you attended, including any graduate study or degrees. International Students: Submit all transcripts in English and provide a course-by-course credential evaluation for all international institutions attended. The translation agency must be approved by SPU. Diplomas are also required for degrees earned outside the United States. Resume Unencumbered Washington State RN License Verification The RN to BS Office will confirm your RN license. Application Fee: $50 International students must complete the supplementary application form found at and provide the required supplementary information. Please have all transcripts, recommendations, and forms sent to: rd Avenue West, Suite 106 Contact Information: Phone: Fax: spu.edu/rnb

2 Engaging the culture, changing the world RN to BS Application Note: The provides education for registered nurses to achieve a bachelor of science degree in nursing. If you are not a registered nurse, submit the basic undergraduate application available from the School of Health Sciences website: spu.edu/nursing Application Information To present an accurate picture of your academic and personal qualifications, please respond clearly and completely to the questions in this section. As you work through your application, please note the following items. Review the Application Checklist. A complete application file consists of: your RN to BS application, two professional recommendations, application fee, official transcripts, personal statement, resume, and other items as required. All materials required before decision. All required materials must be submitted to the RN to BS office before an admission decision will be made. Quarter Applying for: Autumn (deadline July 15) Winter (deadline October 15) Spring (deadline January 15) Summer (deadline April 1) Are you a registered nurse in Washington state? Yes No Are you a registered nurse in another state? Yes No If yes, please indicate which state: Are you a registered nurse in the military? Yes No How did you hear about the at SPU? Information Session Co-worker or Colleague Your Employer Internet Search SPU Website Other Have you ever applied for admission to SPU? Yes No Have you previously attended SPU? Yes No If yes, when did you last attend? Has a family member previously attended SPU? Yes No (mm/yyyy) If yes, relationship? Years of attendance? Are you employed by SPU? Yes No (yyyy/yyyy) Are you related to an SPU employee? Yes No If yes, to whom? spu.edu/rnb

3 Personal Information 1. Name Prefix First Middle Last Preferred Name Former Last Name 2. Permanent Address Number and Street City State Zip Code Country 3. Contact Information Home Phone ( ) Cell Phone ( ) Work Phone ( ) Address 4. Date of Birth (mm/dd/yyyy) 5. Please list all the languages in which you are proficient, including English. Use the check boxes to indicate your level of proficiency. Speak Read Write First language Spoken at home Language 1: English Language 2: Language 3: 6. Are you a U.S. Citizen? Yes No If yes, please supply your social security number. 7. Country of Citizenship (if other than the United States) 8. Are you a resident alien? Yes No If yes, please indicate resident alien number. The following question is required if you are not a U.S. citizen. Those who are not citizens or permanent residents of the United States must provide supplementary application materials, including an official confidential statement of financial support covering each year of intended enrollment. (See link in SPU Undergraduate Catalog: ) 9. Please select Visa type B1 Visitor for Business B2 Visitor for Pleasure E1 Treaty Trader E2 Treaty Investor F1 Student F2 Dependent of F1 H1B Temporary Worker in a Specialty Occupation H4 Dependent of H1, H2, or H3 J1 Exchange Visitor J2 Dependent of J1 Permanent Resident R1 Religious Worker R2 Dependent of R1 TD Dependent of TN TN Canadian/Mexican Citizen Work (NAFTA) The following questions (10 16) are optional. 10. Marital Status Single Married Divorced Widowed 11. Gender Male Female 12. What racial background(s) do you most identify with? African American/African/Black Alaska Native With Tribal Affiliation American Indian With Tribal Affiliation Asian, Including Indian Subcontinent Hispanic or Spanish Native Hawaiian/Other Pacific Islander Non-U.S. Citizen White/Non-Hispanic Unknown 13. Do you have a disability as defined under the Americans with Disabilities Act? Yes No 14. Are you a military veteran? Yes No If yes, what is your separation date? (mm/dd/yyyy) 15. What is your church/religious affiliation? 16. Do you plan to apply for financial aid? Yes No spu.edu/rnb

4 Educational Background 1. Please list all colleges and universities that you have attended. Name of College Years Attended Major Degrees Earned Year Name of College Years Attended Major Degrees Earned Year Name of College Years Attended Major Degrees Earned Year Name of College Years Attended Major Degrees Earned Year Name of College Years Attended Major Degrees Earned Year Note: Official transcripts from all colleges and universities that you attended are required for admission to Seattle Pacific University. Request that your official transcripts be sent to: 3307 Third Avenue West, Suite 106 spu.edu/rnb

5 Employment History Please list your two most recent places of employment (list most recent first). 1. Company/Institution Address Number and Street City State Zip Code Country Job Titles or Duties From (mm/yyyy) To (mm/yyyy) 2. Company/Institution Address Number and Street City State Zip Code Country Job Titles or Duties From (mm/yyyy) To (mm/yyyy) Resume Note: Applicants to the are asked to provide a current resume with their applications. your resume to or mail it to: rd Avenue West, Suite 106 Contact Information: Phone: Fax: Agreement and Required Signature I certify that all information submitted in the admission process including the application, the personal essay, any supplements, and any other supporting materials is my own work, factually true, and honestly presented, and that these documents will become the property of the institutions to which I am applying and will not be returned to me. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation, expulsion, or revocation of course credit, grades, and degree, should the information I have certified be false. Signature Date Print Name Nondiscrimination Policy does not discriminate on the basis of race, color, national origin, sex, age, or disability in policies and practices, as required by applicable laws and regulations. As a religious educational institution, SPU is permitted and reserves the right to prefer employees or prospective students on the basis of religion. For the full Nondiscrimination Policy visit spu.edu/hr. spu.edu/rnb

6 School of Health Sciences RN to BS Degree Program Professional Recommendation To be completed by applicant: Note to Applicant: Two(2) Professional Recommendations are required as part of your application for admission to the at. The recommendations should be completed by people who know you in a professional setting (e.g., supervisor, teacher, preceptor), and who know you well enough to answer the questions below. These recommendations may not be completed by a relative or friend. Please type or print. Applicant s Name Date of Birth Address Number and Street City State Zip Code Please check if you wish to waive your right, under the Family Educational Rights and Privacy Act (FERPA) of 1974, to access this recommendation. To be completed by respondent: Note to Respondent: The above person is applying for admission to the at. We value your comments and ask that you provide a full and candid report so that fair consideration may be given to the applicant. The person has access to his/her file, which will include your recommendation (unless he/she has waived that right above). This provision is made in accordance with the Family Educational Rights and Privacy Act (FERPA) of Your recommendation and timely response are significant parts of the applicant's admission process; he/she cannot be considered for admission to the RN to BS program until this recommendation is received by staff. Please type or print. 1. How long have you known the applicant? 2. In what context have you known the applicant? 3. Please describe this applicant s talents and strengths that relate to the potential for success in the. spu.edu/rnb

7 4. Character and Personal Qualities How would you rate this applicant in the following areas? Outstanding (Top 10%) Good Average Below Average Leadership Ability to Accept Responsibility Organizational Ability Self-Confidence Concern for Others Integrity Competency in Spoken English Competency in Written English 5. I recommend this applicant for admission to the RN to BS Degree program: With Enthusiasm Strongly Fairly Strongly Without Enthusiasm Not Recommended Name Date Position Organization/Employer Address Number and Street City State Zip Code Phone ( ) SPU Alum Class of Signature Please to or return to: rd Avenue West, Suite 106 Contact Information: Phone: Fax: spu.edu/rnb

8 School of Health Sciences RN to BS Degree Program Professional Recommendation To be completed by applicant: Note to Applicant: Two(2) Professional Recommendations are required as part of your application for admission to the at. The recommendations should be completed by people who know you in a professional setting (e.g., supervisor, teacher, preceptor), and who know you well enough to answer the questions below. These recommendations may not be completed by a relative or friend. Please type or print. Applicant s Name Date of Birth Address Number and Street City State Zip Code Please check if you wish to waive your right, under the Family Educational Rights and Privacy Act (FERPA) of 1974, to access this recommendation. To be completed by respondent: Note to Respondent: The above person is applying for admission to the at. We value your comments and ask that you provide a full and candid report so that fair consideration may be given to the applicant. The person has access to his/her file, which will include your recommendation (unless he/she has waived that right above). This provision is made in accordance with the Family Educational Rights and Privacy Act (FREPA) of Your recommendation and timely response are significant parts of the applicant's admission process; he/she cannot be considered for admission to the RN to BS program until this recommendation is received by staff. Please type or print. 1. How long have you known the applicant? 2. In what context have you known the applicant? 3. Please describe this applicant s talents and strengths that relate to the potential for success in the. spu.edu/rnb

9 4. Character and Personal Qualities How would you rate this applicant in the following areas? Outstanding (Top 10%) Good Average Below Average Leadership Ability to Accept Responsibility Organizational Ability Self-Confidence Concern for Others Integrity Competency in Spoken English Competency in Written English 5. I recommend this applicant for admission to the RN to BS Degree program: With Enthusiasm Strongly Fairly Strongly Without Enthusiasm Not Recommended Name Date Position Organization/Employer Address Number and Street City State Zip Code Phone ( ) SPU Alum Class of Signature Please to or return to: rd Avenue West, Suite 106 Contact Information: Phone: Fax: spu.edu/rnb

10 School of Health Sciences RN to BS Degree Program Personal Statement Please respond to the mission statements below when writing your personal statement, which is required as part of the application for the. The quality of your essay is a consideration in the admission decision; however, the format of the essay varies from applicant to applicant. Please limit your essay to a total of 600 words and be specific in your answers to the questions. SPU Mission Statement seeks to be a premier Christian university fully committed to engaging the culture and changing the world by graduating people of competence and character, becoming people of wisdom, and modeling a grace-filled community. School of Health Sciences Mission Based on our commitment to Christian values, we seek to partner with the community to develop graduates who engage the culture, change the world, and: Serve all people with the highest level of professional care; Demonstrate competence in a diverse and changing environment; Act with wisdom, character, and caring; Demonstrate leadership in all aspects of nursing; and Promote optimum health of body, mind, and spirit. 1. What past education or work experiences have contributed to your interest in obtaining a bachelor s degree? Please elaborate. 2. What are your career goals in nursing and your reason for seeking a bachelor s degree in nursing? 3. How do your values complement the SHS Mission Statement? 4. Considering your nursing career, what was your most meaningful past nursing experience? Reflect on what was most gratifying and why. your personal statement to or mail it to: rd Avenue West, Suite 106 Contact Information: Phone: Fax: spu.edu/rnb

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