Alicia Huckstadt, PhD, APRN, FNP BC, GNP BC, FAANP DNP Graduate Director & Professor AH/am



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May 19, 2015 Dear Prospective Post masters DNP Student: Thank you for your interest in the Doctor of Nursing Practice (DNP) degree program at Wichita State University (WSU). We invite you to apply for the spring 2016 class by completing the following two phases: 1. Apply to the WSU Graduate School and submit two copies of official transcripts for all colleges/universities attended. You can apply online at http://webs.wichita.edu/gradsch or by mail or in person. Complete this application prior to the October 15, 2015 deadline. 2. Complete the School of Nursing application and mail your completed application back to us by October 15, 2015. Prerequisites to the DNP program include a graduate level statistics course approved by the Graduate Nursing Program and taken within the last six years. Courses in the DNP curriculum are sequenced and all courses are not offered every semester, so you are advised to work closely with your DNP faculty adviser. To complete the School of Nursing application fill out all of the attached forms including the DNP Application Checklist, sign the application, request your references, and send your completed School of Nursing application to the following address: School of Nursing Graduate Program, Wichita State University, 1845 Fairmount, Wichita, Kansas 67260 0041. Admission priority will be given to applicants who have met all criteria. Please contact the Graduate Nursing Program for questions about the application. We look forward to receiving your completed application. Sincerely, Alicia Huckstadt, PhD, APRN, FNP BC, GNP BC, FAANP DNP Graduate Director & Professor AH/am Enclosures

Graduate Program DNP Application Checklist for Spring 2016 Post-Masters Entry Prior to admission consideration, accepted students must meet the DNP admission criteria. Application Procedure Applications with all supporting documents must be submitted by October 15, 2015 for Spring 2016 semester admission. Late applications will not be reviewed until all timely applicants have been processed and will be reviewed only if space is available. Send all materials to: Wichita State University Graduate Nursing Program 1845 N. Fairmount Campus Box 41 Wichita, KS 67260-0041 For All Applicants: Place a checkmark in front of your completed items prior to submission of your application materials: 1. Meets Admission Requirements for the MSN (BSN from nationally accredited nursing program; GPA of 3.25 in last 60 hours, 3.0 in undergraduate nursing courses, 3.0 in selected science courses; coverage of professional liability insurance at specified level; computer literacy; meets technical standards) 2. Prerequisite Graduate level Statistics course within the last 6 years (minimum 3 credit hours) 3. Admission to Wichita State University Graduate School 4. Application for the DNP Complete all areas of the form including: Current registered nurse license (if not Kansas, must have Kansas license prior to admission) Program Interest & Requested Focus/Specialization Goals/Essay - A maximum of 1000 word essay Resume or Curriculum Vitae 5. References Complete top section and provide forms to your three references Interview: In some cases, applicants may be notified to the date and time of an interview. Interviews are evaluated and provide information to the Admissions Committee.

Action on Admission: The Admissions Committee will select the best qualified applicants for the DNP program based on a composite assessment of: Academic performance on all coursework taken, with particular emphasis on the sciences (because of their relationship to assessing analytical problem-solving abilities), relevance to selected DNP focus, patterns of course withdrawals and course repeats, and the nature of course selections. Applicant-supplied information and statements on the application forms and essay. Responses from References. If necessary, a personal interview with representatives of the Admission Committee. Writing and verbal communication skills. Completeness of application forms. Admissions will be granted to the most highly qualified applicants. The next most highly qualified applicants will have their names placed on a waiting list. Some students may not be admitted. They will be referred to appropriate advising offices for assistance. 05/2015

Please complete the following information, obtain references, and submit for review: 1. PERSONAL INFORMATION Name & previous name(s) Address (permanent): Address (mailing): Contact Phone: Email: WSU ID Citizenship (if not US, country of origin) Are you licensed as a registered nurse? Yes No If yes, what state? (A copy of your valid State of Kansas nursing license is required prior to admission) 2. PROGRAM INTEREST Place a checkmark in the program for which you are intending to apply and fill in the blanks for when you want to enter the DNP program: Post-masters Entry Applying to Enter Year & Semester 3. REQUESTED FOCUS (SPECIALIZATION) Place a checkmark for the one focus you are applying: INDIVIDUAL/FAMILY FOCUS: Acute Care NP Family NP Psychiatric/Mental Health NP Adult CNS Complete the following information: 4. Previous Colleges/Universities Institution Location Dates of Attendance Mo & Year Degree Awarded (Expected) 5. List the last 5 years of your REGISTERED NURSE & ARNP (if any) Employment Agency Address (include City, ST Zip) Dates of Employment, Position, Supervisor 6. CURRENT RESUME OR CURRICULUM VITAE Attach a copy

7. THREE CURRENT PROFESSIONAL REFERENCES Obtain references using the reference forms provided. Complete Section A of the reference forms and mail to each of your three selected references listed below: Two colleagues (ARNP or Physician) or supervisors from your advanced nursing practice who can address your professional competency and leadership, and One from a graduate nursing academic advisor or graduate nursing faculty member who can address your academic achievement and potential or ability to function in the advanced practice role. 8. GOALS/ESSAY Your essay will be evaluated on content and writing abilities. If admitted, this essay will also be used to help tailor the learning experience toward the individual s area of interest. Attach the following: A maximum of 1000 words in the form of a typed essay which addresses your: Reasons for pursuing the DNP including your professional goals and how the program will enhance your future roles/activities as an advanced practice nurse, Focused area of interest in pursuing DNP (e.g., practice area of interest in which you may be interested in developing the final project), and Most difficult issues that you anticipate while in the DNP program and your plans to handle them. 9. CERTIFICATION/EXPERIENCE-For Post-masters entry to Individual/Family Focus Current national certification in specialization and relevant experience as an advanced practice nurse not listed in item #5. Attach your documentation including copies of current certification and APRN designation with a listing of relevant experience including dates and the supervisor s name and contact information. Applicants not meeting this criterion may be considered on an individual basis. 10. APPLICANT AGREEMENT & SIGNATURE/DATE I certify that the information recorded on this application is true and correct. Applicant Signature Date Following receipt of application materials, an interview may be required. Selected applicants will be notified of the date, time, and location for the interview. Interviews are evaluated and provide information to the Admission Committee. Accepted students must meet the admission criteria for the DNP program (GPAs, prerequisites), and be admitted to Wichita State University Graduate School. Mission and Vision Statement The School of Nursing mission is to improve the health of the community (public good) by inspiring change in health care (cultural/economic driver) through innovation and excellence in nursing education, scholarship, practice, and service (essential educational driver). Vision: INSPIRE INNOVATE EXCEL Notice of Nondiscrimination Wichita State University does not discriminate in its programs and activities on the basis of race, religion, color, national origin, gender, age, sexual orientation, marital status, political affiliation, status as a veteran, genetic information or disability. The following person has been designated to handle inquiries regarding nondiscrimination policies: Executive Director, Office of Equal Employment Opportunity, Wichita State University, 1845 Fairmount, Wichita KS 67260-0138; telephone (316) 978-3186. 05/2015

Recommendation Form Doctor of Nursing Practice (D.N.P.) Program Section A: To be completed by the applicant: Applicant Name (please print) The Family Education Rights and Privacy Act of 1974 and its amendments guarantee students access to their educational records. Students may, however, waive their right of access to recommendations. The choice of the applicant regarding this recommendation is to be indicated below. Failure to sign will constitute acceptance of limited access. I do waive I do not waive my right to inspect the contents of the following recommendation Signed Date Section B: To be completed by the person serving as a reference. Please check the small box preceding your response to each of the following attributes: ATTRIBUTES (4) Outstanding CURRENT NURSING KNOWLEDGE CREATIVITY/ INNOVATION ACCOUNTABILITY WRITTEN COMMUNICATION SKILLS ORAL COMMUNICATION SKILLS Recognized by peers for expertise Generates new ideas; grasps new information easily, great intellectual curiosity Thoroughly accountable for own actions Outstanding in the written expression of ideas Very articulate; outstanding command of language (3) Above Average Stays current Contributes to development of new ideas; grasps new information. In general accepts responsibility for own actions Expresses ideas logically and succinctly in writing most of the time Articulates ideas clearly and logically (2) Satisfactory Familiar with most general information Supports the development of new ideas; deals adequately with information. Gives excuses for own actions Uses correct grammar and punctuation but has trouble with logical order Articulates fairly well but order of ideas is not always logical (1) Below Average Possesses limited current information Maintains status quo; requires assistance with new information Projects blame on others as reason for own actions Has some trouble with logical order, grammar/ punctuation Weak in oral skills including command of language Unable To Judge

ATTRIBUTES (4) Outstanding PERSEVERANCE ORGANIZATION LEADERSHIP DECISION MAKING ADAPTABILITY/ TOLERANCE RELIABILITY/ DEPENDABILITY Focused on goals; completes tasks; overcomes obstacles Prioritizes and accomplishes tasks independently Forceful leader; promotes top performance from others Excellent in considering consequences of decisions and taking appropriate action Highly flexible; can handle many varied assignments Consistently reliable; needs minimal or no supervision (3) Above Average Completes tasks with appropriate direction Organizes work and accomplishes tasks with minimal direction Influences and inspires others; gets job done well Generally competent in making decisions and taking action on them Usually learns new assignments with normal supervision Usually meets responsibilities carefully and correctly (2) Satisfactory Usually focused; completes most tasks; requires some directions Reorganizes efficient ways of accomplishing tasks with some direction Receives routine cooperation; gets job done satisfactorily Analyzes a situation correctly but has difficulty deciding on a course of action Average amount of guidance needed to learn variety of duties Usually can be depended upon, needs guidance on important matters (1) Below Average Not wellfocused; rarely completes tasks without direction Variable efficiency in managing tasks Frequent difficulty in obtaining cooperation; or getting job done Has difficulty analyzing problems and arriving at decisions Has some difficulty when shifted to new/different assignments Somewhat unreliable; requires occasional check on routine tasks Unable To Judge STRESS TOLERANCE OVERALL POTENTIAL FOR GRADUATE STUDY Works well under pressure; enjoys challenges and problems Highly likely to be successful in graduate studies Tolerates pressure; tolerates crises better than most Likely to be successful in graduate studies Has an average tolerance for crises; usually remains calm Has potential for success in graduate studies Occasionally goes to pieces under pressure; is jumpy and nervous Likely to have some difficulties in graduate studies

Comments: Section C: Identification information and signature of the person serving as a reference: Name Credentials Position Place of Employment Business Phone Length of time you have known the applicant: Capacity in which you have known the applicant: (Please check all that are applicable.) Personally As a professional colleague As a nursing student Only casually Other (please explain) Signature of reference Date Thank you for completing. PLEASE MAIL THE COMPLETED REFERENCE FORM TO: DNP -Graduate Nursing Program School of Nursing, Box 41 Wichita State University 1845 Fairmount Wichita, KS 67260-0041 (Telephone 316-978-5704) Prior to admission consideration, accepted students must meet the admission criteria to the graduate nursing program, the DNP admission criteria (including GPAs and prerequisites), and be admitted to Wichita State University Graduate School. Mission and Vision Statement The School of Nursing mission is to improve the health of the community (public good) by inspiring change in health care (cultural/economic driver) through innovation and excellence in nursing education, scholarship, practice, and service (essential educational driver). Vision: INSPIRE INNOVATE EXCEL Notice of Nondiscrimination Wichita State University does not discriminate in its programs and activities on the basis of race, religion, color, national origin, gender, age, sexual orientation, marital status, political affiliation, status as a veteran, genetic information or disability. The following person has been designated to handle inquiries regarding nondiscrimination policies: Executive Director, Office of Equal Employment Opportunity, Wichita State University, 1845 Fairmount, Wichita KS 67260-0138; telephone (316) 978-3186. 05/2015