SCHOOL OF NURSING GRADUATE ADMISSIONS SUPPLEMENTAL APPLICATION

SCHOOL OF NURSING GRADUATE ADMISSIONS SUPPLEMENTAL APPLICATION Shenandoah University does not discriminate on the basis of sex, race, color, religion, national or ethnic origin, age, physical or mental disability or sexual orientation. 1-800-432-2266 540-665-4581 Fax: 540-665-4627 sugradapp@su.edu www.su.edu

SCHOOL OF NURSING, GRADUATE APPLICATION CHECKLIST A complete graduate application to the School of Nursing consists of the following: Completed Graduate Application for Admission, with a $30 non-refundable application fee. Official, unopened transcripts from all institutions of higher education previously attended where credit was earned. Official, unopened Test of English as a Foreign Language (TOEFL) scores for all applicants from outside the United States and whose first language is not English, SU code is 5613. Completed School of Nursing Supplemental Application Materials: Three completed recommendation forms: o o o o o At least one and no more than two from a former dean, faculty member, or advisor familiar with the applicant's academic performance. At least one and no more than two from a current or former supervisor familiar with applicant's clinical practice. Two of the three recommendations should be from persons with graduate degrees. The recommendations must not be from friends, family or acquaintances. Individuals asked to provide a recommendation must complete the form included in this packet, and: Place it in a sealed envelope, signed across the seal and return it to the applicant to be mailed with the application packet, OR Scan and e-mail the form directly to sugradapp@su.edu from a verifiable e-mail address. Completed documentation of Clinical Hours Form documenting one year RN nursing work experience (2080 hours) for all MSN and DNP applicants, and: o o For those applying to the Psychiatric Mental Health Certificate, documentation of number of clinical hours in psychiatric mental health program, OR For those applying to the DNP post graduate completion certificate, documentation of number of clinical hours in nurse practitioner program. Current professional resume. Copy of current nursing license. Completed required essay(s). Completed application materials must be returned to: Office of Graduate Admissions 1460 University Drive Winchester, VA 22601 Only completed application files will be considered for admission. It is the applicant s responsibility to confirm that all application materials have been received by the Office of Admissions by the appropriate due date. Upon receipt of a completed application the School of Nursing MSN Curriculum Committee will invite potential qualified candidates for a personal interview. Applicants approved for admission to Shenandoah University will receive official notification via postal mail by the Office of Graduate Admissions. Applicants must submit written confirmation of their intention to accept the offer along with a nonrefundable tuition deposit within 15 days of receiving notification. This written confirmation and tuition deposit will reserve placement in the upcoming class. Financial Aid - You are encouraged to complete the Free Application for Federal Student Aid (FAFSA). The FAFSA is updated every year by the U.S. Department of Education and is available for the upcoming academic year after January 1. The FAFSA is completed annually on-line at: www.fafsa.ed.gov. The FAFSA is used to determine eligibility for aid such as grants, awards, loans and scholarships. The Virginia Tuition Assistance Grant Program (VTAG) is a state-funded, non-need-based grant available to graduate students who are Virginia residents and enrolled in a graduate health program for at least 9 credit hours per semester. This application must be completed by July 31. Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 2 of 19

ADMISSION CRITERIA TO MASTERS PROGRAMS Admission to the Master of Science program in Nurse-Midwifery, Family Nurse Practitioner, Psychiatric Mental Health Nurse Practitioner, and Health Systems Management is competitive. Individuals seeking admission into the MSN program must meet the following requirements: Be a licensed Registered Nurse. Applicants not licensed in Virginia must apply and receive reciprocity. Students must also hold RN licensure in all states where they participate in student clinical. BCLS for Healthcare Provider by the American Heart Association only, that includes infant, child, adult and AED. Have up to date health records including current immunizations, including flu vaccine and evidence of a health insurance policy. (Required by Shenandoah University and the School of Nursing.) Earned a baccalaureate degree in nursing from a NLNAC or a CCNE accredited program. If degree is not from a NLNAC or a CCNE accredited program the applicant will be evaluated on an individual basis. Earned a minimum undergraduate cumulative grade point average (GPA) of 3.0 on a 4.0 scale. Successfully completed baccalaureate level nursing courses in physical assessment, introductory statistics, and community nursing with a grade of C or better. Students who cannot document a separate physical assessment or community nursing course will be required to pass a standardized comprehensive examination at their own expense. Have a minimum of 2,080 hours or one year (or equivalent) of relevant RN clinical experience prior to enrolling in the specialty courses for all except Health Systems Management. Specialty courses usually begin in the second year of study. Students may take graduate core courses while completing this requirement. Students requesting consideration of course equivalency must do so in writing to the School of Nursing Graduate Curriculum Committee and provide rationale for the request. Be able to meet the Technical Performance Standards for Nursing identified by the School of Nursing. Refer to the current academic course catalog for further guidelines on admission requirements related to the graduate nursing specialties. Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 3 of 19

ADMISSION CRITERIA TO POST-BACCALAUREATE DOCTOR OF NURSING PRACTICE Admission to the Post-BSN Doctorate of Nursing Practice in Family Nurse Practitioner and Psychiatric Mental Health Nurse Practitioner is competitive. Individuals seeking admission into the DNP program must meet the following requirements: Be a licensed Registered Nurse. Applicants not licensed in Virginia must apply and receive reciprocity. Students must also hold RN licensure in all states where they participate in student clinical. BCLS for Healthcare Provider by the American Heart Association only, that includes infant, child, adult and AED. Have up to date health records including current immunizations, including flu vaccine and evidence of a health insurance policy. (Required by Shenandoah University and the School of Nursing.) Earned a baccalaureate degree in nursing from a NLNAC or a CCNE accredited program. If degree is not from a NLNAC or a CCNE accredited program the applicant will be evaluated on an individual basis. Earned a minimum undergraduate cumulative grade point average (GPA) of 3.0 on a 4.0 scale. Successfully completed baccalaureate level nursing courses in physical assessment, introductory statistics, and community nursing with a grade of C or better. Students who cannot document a separate physical assessment or community nursing course will be required to pass a standardized comprehensive examination at their own expense. Have a minimum of 2,080 hours or one year (or equivalent) of relevant RN clinical experience prior to enrolling in the specialty courses. These courses usually begin in the second year of study. Students may take the core courses while completing this requirement. Students requesting consideration of equivalency must do so in writing to the School of Nursing Graduate Curriculum Committee and provide rationale for the request. Be able to meet the Technical Performance Standards for Nursing identified by the School of Nursing. Refer to the current academic course catalog for further guidelines on admission requirements related to the graduate nursing specialties. Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 4 of 19

ADMISSION CRITERIA TO POST-GRADUATE DOCTOR OF NURSING PRACTICE & POST-GRADUATE CERTIFICATES Admission to the Post-Graduate Doctorate of Nursing Practice or the Post-Graduate s Certificate in Psychiatric Mental Health Nurse Practitioner, Family Nurse Practitioner, and Nurse-Midwifery is competitive. Individuals seeking admission into the graduate program must meet the following requirements: Be a licensed Registered Nurse. Applicants not licensed in Virginia must apply and receive reciprocity. Students must also hold RN licensure in all states where they participate in student clinical. For those applying to the DNP, be certified as an FNP by either the ANCC or AANP or PMHNP certificate from ANCC, or CNM certificate from AMCB. Have a minimum of 2,080 hours or one year (or equivalent) of relevant RN clinical experience prior to enrolling in the specialty courses (for DNP, Nurse-Midwifery and Nurse Practitioner applicants only). The School of Nursing Graduate Admissions Committee determines equivalency. Students requesting consideration of equivalency must do so in writing and provide rationale for the request. Applicants to the Psychiatric Mental Health Nurse Practitioner Certificate must document a minimum of 320 clinical hours in their PMH course work. Students having less than 320 hours will need to take additional clinical hours in their program at SU. Applicants to the post NP master s DNP must document a minimum of 690 clinical hours in their NP course work. Students having less than 690 hours will need to take additional clinical hours in their program at SU. Earned a Master of Science degree in nursing from a CCNE accredited program. If degree is not from a CCNE accredited program the applicant will be evaluated on an individual basis. Earned a minimum graduate cumulative Grade Point Average (GPA) of 3.0 on a 4.0 scale. Applicants to the post MSN NP DNP must show transcripts of the following prerequisite graduate level course work with a grade of B or better: Advanced Pharmacology and Therapeutics (equivalent of N550). Applicants to the FNP and PMHNP Certificate must include at least 30 hours of clinical practice associated with the course (equivalent to NP570). Advanced Concepts in Physiology and Pathophysiology (equivalent of N560). Advanced Heath Promotion and Assessment Across the Life-span (equivalent of N580). Applicants to the Family Nurse Practitioner Certificate must include at least 120 hours of clinical practice and lab associated with the course (equivalent to NP580 & N580 lab). Applicants to the PMHNP and NMW certificate must include at least 60 hours of clinical practice and lab associated with the course (equivalent to N580). In addition, for those applying to the DNP: o o Applied and Interactive Genetics (equivalent to N583). Emergency preparedness and disaster nursing (equivalent to N515). Be able to meet the Technical Performance Standards for Nursing identified by the School of Nursing. BCLS for Healthcare Provider by the American Heart Association only that includes infant, child, adult and AED Have up to date health records including current immunizations, including flu vaccine and evidence of a health insurance policy. (Required by Shenandoah University and the School of Nursing.) Refer to the current academic course catalog for further guidelines on admission requirements related to the graduate nursing specialties. Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 5 of 19

SUPPLEMENTAL APPLICATION Submit your supplemental application materials directly to sugradapp@su.edu. Applicant Full Name: Applying to: Fall 20 Spring 20 Summer 20 Doctor of Nursing Practice (DNP): Post Baccalaureate to DNP Family Nurse Practitioner (FNP) Psychiatric Mental Health Nurse Practitioner (PMHM) Post Master s to DNP Master of Science in Nursing (MSN); applicant currently holds BSN Family Nurse Practitioner (FNP) Nurse-Midwifery (NMW) Psychiatric Mental Health Nurse Practitioner (PMHMP) Health Systems Management (HSM) Post Graduate Nursing Certificate; applicant currently holds MSN Family Nurse Practitioner (FNP) Nurse-Midwifery (NMW) Psychiatric Mental Health Nurse Practitioner (PMHMP) Nursing Education (Advance Practice graduates only required prerequisites for entry) Post Baccalaureate Nursing Certificate Health Informatics RN-MSN (Select specialty track) PMHMP FNP NMW HSN MSN/MBA REQUIRED Essay Question(s) and Professional Resume Submit your essay(s) responses and your professional resume directly to sugradapp@su.edu. 1. Critical thinking skills are an essential aspect of leadership in nursing. Describe a specific example of a conflict you have experienced in your professional role in which you utilized critical thinking skills to resolve the issue. Why do you see this as an effective use of critical thinking? (essay format, 2-3 doublespaced pages in length) 2. If you are applying to the DNP program, please describe a specific area of clinical practice research interest, and how this will impact your advanced practice role. (statement up to 500 words) Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 6 of 19

Certifications Registered Nurse License (s) (State and Number) State Expiration Date Number State NP/NMW/CNS License State Specialty Expiration Date Number Advance Practice Certification Type ANCC /AANP/AMCBNMW Expiration Date Number CPR and AED for Health Care Provider (American Heart Association only required) Certifying Organization Expiration Date Prerequisites Indicate when and where you have taken or plan to take these baccalaureate level courses. Course Academic Institution Course title Completion Date Grade Community Nursing with Clinical Introductory Statistics Physical Assessment (4 credits) Post Graduate Certificate and DNP Applicants only Graduate Level Course Academic Institution Course title Completion Date Grade Pathophysiology Pharmacology Advanced Health Assessment Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 7 of 19

Honors and Awards Are you a member of Sigma Theta Tau International Honor Society of Nursing? Yes No If yes, which chapter? Please list academic, community or employment honors and/or awards you have received. Honor/Award Name of Award Date Recommendations List the contact information for the people who will be submitting recommendations on your behalf. Recommendations should address the applicant s academic and professional abilities in the intended field of study and preparation for graduate study. Name Title/Institution Address Telephone Employment Information (List most recent first): Employer Position/Title Dates Service Committee Work List the professional, community and volunteer organization in which you have been active Organization Your role in the project Dates Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 8 of 19

Professional Organizational Membership List the professional, community and volunteer organization in which you have been active Organization Offices Held Dates Publications and Presentations (if applicable) List titles Publications Dates Teaching Experience, if applicable (begin with most recent): Lecture or Presentation Audience and Location Dates Please indicate what influenced you most to apply to the Shenandoah University School of Nursing: Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 9 of 19

School of Nursing Graduate Application Recommendation Form Instructions to the Applicant: Three recommendations must be completed. At least one, and no more than two, from a nursing faculty member who was one of your educators, and at least one and no more than two from a nursing supervisor who was/is your direct supervisor. Please use your full name as it would appear on your Social Security Card or Passport. General Information Applicant Name: Previous Applicant? YES / NO Address: Date of Birth: / / Evaluator: Name: Address: Title: Degree: Type of reference (check one): Educator Supervisor The Family Education Rights and Privacy Act of 1974 permits you to review letters of recommendation. You may waive this right in order to allow your recommender to submit a confidential letter on your behalf. You must complete the following statement indicating whether you do or do not waive this right. I hereby waive do not waive the right to review this letter. Applicant s Signature: Date: Instructions to the Evaluator: Please give a candid evaluation of the applicant s potential for successfully completing the Graduate program by responding to the following required questions. Please complete promptly and return this recommendation form to the applicant in a sealed and signed envelope. We thank you for your time and effort. 1. How long have you known the applicant and in what capacity? Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 10 of 19

2. What do you consider to be the applicant s major strengths and accomplishments as they pertain to suitability for the advanced practice role and success in graduate program? 3. What do you consider to be the applicant s weaknesses? 4. Please rate the applicant on the following categories with reference to potential for success as an advanced practice nurse. Outstanding (Top 2%) Excellent (Top 10%) Good (Top 25%) Average (25%-75%) Below Avg. (Under 25%) N/A Application of Knowledge Spoken English Communication Skills Clinical Skills, Oral & Written Emotional Maturity Judgment and Decision Making Ability Dependability Integrity Awareness of Need for Assistance or Supervision Productivity Effectiveness Interaction with Clients, Peers, Subordinates, & Supervisors Overall Assessment for Graduate Study 5. Please comment on the ratings you assigned above and provide any further comments about the applicant s record, potential, or personal qualities that may be helpful to the Admissions Committee. 6. Please check ONE as appropriate: I recommend this applicant strongly I recommend this applicant I recommend this applicant, but with reservation Evaluator s Signature: Date: RETURN COMPLETED FORM to the applicant in a sealed envelope, signed across the seal; OR, scan and e-mail this form directly to sugradapp@su.edu from a professional and verifiable e-mail address. Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 11 of 19

School of Nursing Graduate Application Recommendation Form Instructions to the Applicant: Three recommendations must be completed. At least one, and no more than two, from a nursing faculty member who was one of your educators, and at least one and no more than two from a nursing supervisor who was/is your direct supervisor. Please use your full name as it would appear on your Social Security Card or Passport. General Information Applicant Name: Previous Applicant? YES / NO Address: Date of Birth: / / Evaluator: Name: Address: Title: Degree: Type of reference (check one): Educator Supervisor The Family Education Rights and Privacy Act of 1974 permits you to review letters of recommendation. You may waive this right in order to allow your recommender to submit a confidential letter on your behalf. You must complete the following statement indicating whether you do or do not waive this right. I hereby waive do not waive the right to review this letter. Applicant s Signature: Date: Instructions to the Evaluator: Please give a candid evaluation of the applicant s potential for successfully completing the Graduate program by responding to the following required questions. Please complete promptly and return this recommendation form to the applicant in a sealed and signed envelope. We thank you for your time and effort. 1. How long have you known the applicant and in what capacity? Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 12 of 19

2. What do you consider to be the applicant s major strengths and accomplishments as they pertain to suitability for the advanced practice role and success in graduate program? 3. What do you consider to be the applicant s weaknesses? 4. Please rate the applicant on the following categories with reference to potential for success as an advanced practice nurse. Outstanding (Top 2%) Excellent (Top 10%) Good (Top 25%) Average (25%-75%) Below Avg. (Under 25%) N/A Application of Knowledge Spoken English Communication Skills Clinical Skills, Oral & Written Emotional Maturity Judgment and Decision Making Ability Dependability Integrity Awareness of Need for Assistance or Supervision Productivity Effectiveness Interaction with Clients, Peers, Subordinates, & Supervisors Overall Assessment for Graduate Study 5. Please comment on the ratings you assigned above and provide any further comments about the applicant s record, potential, or personal qualities that may be helpful to the Admissions Committee. 6. Please check ONE as appropriate: I recommend this applicant strongly I recommend this applicant I recommend this applicant, but with reservation Evaluator s Signature: Date: RETURN COMPLETED FORM to the applicant in a sealed envelope, signed across the seal; OR, scan and e-mail this form directly to sugradapp@su.edu from a professional and verifiable e-mail address. Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 13 of 19

School of Nursing Graduate Application Recommendation Form Instructions to the Applicant: Three recommendations must be completed. At least one, and no more than two, from a nursing faculty member who was one of your educators, and at least one and no more than two from a nursing supervisor who was/is your direct supervisor. Please use your full name as it would appear on your Social Security Card or Passport. General Information Applicant Name: Previous Applicant? YES / NO Address: Date of Birth: / / Evaluator: Name: Address: Title: Degree: Type of reference (check one): Educator Supervisor The Family Education Rights and Privacy Act of 1974 permits you to review letters of recommendation. You may waive this right in order to allow your recommender to submit a confidential letter on your behalf. You must complete the following statement indicating whether you do or do not waive this right. I hereby waive do not waive the right to review this letter. Applicant s Signature: Date: Instructions to the Evaluator: Please give a candid evaluation of the applicant s potential for successfully completing the Graduate program by responding to the following required questions. Please complete promptly and return this recommendation form to the applicant in a sealed and signed envelope. We thank you for your time and effort. 1. How long have you known the applicant and in what capacity? Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 14 of 19

2. What do you consider to be the applicant s major strengths and accomplishments as they pertain to suitability for the advanced practice role and success in graduate program? 3. What do you consider to be the applicant s weaknesses? 4. Please rate the applicant on the following categories with reference to potential for success as an advanced practice nurse. Outstanding (Top 2%) Excellent (Top 10%) Good (Top 25%) Average (25%-75%) Below Avg. (Under 25%) N/A Application of Knowledge Spoken English Communication Skills Clinical Skills, Oral & Written Emotional Maturity Judgment and Decision Making Ability Dependability Integrity Awareness of Need for Assistance or Supervision Productivity Effectiveness Interaction with Clients, Peers, Subordinates, & Supervisors Overall Assessment for Graduate Study 5. Please comment on the ratings you assigned above and provide any further comments about the applicant s record, potential, or personal qualities that may be helpful to the Admissions Committee. 6. Please check ONE as appropriate: I recommend this applicant strongly I recommend this applicant I recommend this applicant, but with reservation Evaluator s Signature: Date: RETURN COMPLETED FORM to the applicant in a sealed envelope, signed across the seal; OR, scan and e-mail this form directly to sugradapp@su.edu from a professional and verifiable e-mail address. Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 15 of 19

School of Nursing Graduate Application Documentation of Clinical Hours. (For all Graduate Nursing Applicants, except those specializing in Health Systems Management, Nursing Education, and Health Informatics.) Instructions: This form should be returned to the applicant for inclusion in the application. (If completed in more by one institution, please fill out a separate form for each institution. You may duplicate this form as needed.) General Information: Name: Previous Applicant? YES / NO Address: Date of Birth: / / Applicant s Signature: Total hours worked as a Registered Nurse in the last 5 years: (Include dates when position was held) Position(s) held: Type of Unit(s): Nursing Supervisor/Faculty Evaluator: Name: Address: Date: Title: Degree: I verify that the total hours worked as a Registered Nurse, as indicated on this page, are accurate. Authority s Signature: Date: Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 16 of 19

School of Nursing Graduate Application: Documentation of Psychiatric Program Clinical Hours. (For Psychiatric Mental Health Nurse Practitioner Certificate Applicants Only) Instructions: This form should be returned to the applicant for inclusion in the application. (If completed in more than one institution, please fill out a separate form for each institution. You may duplicate this form as needed.) General Information: Name: Previous Applicant? YES / NO Address: Date of Birth: / / Applicant s Signature: Date: Total clinical hours in PMH course work: PMH Institution: Date course work completed: Nursing Supervisor/Faculty Evaluator: Name: Address: Title: Degree: I verify that the total hours worked as a Registered Nurse, as indicated on this page, are accurate. Authority s Signature: Date: Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 17 of 19

School of Nursing Graduate Application: Documentation of Nurse Practitioner Program Clinical Hours (For DNP Applicants Only) Instructions: This form should be returned to the applicant for inclusion in the application. (If completed in more than one institution, please fill out a separate form for each institution. You may duplicate this form as needed.) General Information: Name: Previous Applicant? YES / NO Address: Date of Birth: / / Applicant s Signature: Date: Total clinical hours in NP course work: NP Institution: Date course work completed: Nursing Supervisor/Faculty Evaluator: Name: Address: Title: Degree: I verify that the total hours worked as a Registered Nurse, as indicated on this page, are accurate. Authority s Signature: Date: Admission Guidelines- Graduate Program Approved 9/96 Rev. 9/07, Rev 9/12, Rev 10/12, Rev 6/14 Page 18 of 19