Concordia COLLEGE Department of Nursing

Concordia COLLEGE Department of Nursing Dear Accelerated Nursing Program Applicant, Thank you for your interest in the accelerated nursing major at. As Chair of the Department of Nursing, I want to congratulate you on your decision to return to school to follow your vocational calling to become a nurse. As you consider application to the accelerated nursing program at, there are a few steps in the process that I want to highlight for you. The first step of the application process is to confirm how you are going to pay for the program. Some applicants determine that they are unable to meet the tuition requirements after being accepted or admitted to the program. It is important that you confirm how you are going to pay for the program before you apply to the major. If you have any questions regarding the cost of the program, please contact the Business Office at at 218-299-3150. Another important step in the application process is to ensure that all official transcripts from every college/university you have attended since high school are sent directly to the Concordia College Department of Nursing, as noted on the application. The final important step is for you to confirm that all pieces of your application have been received in the Department of Nursing. Incomplete applications are not reviewed for admission. Applicants are encouraged to contact the Nursing Department Office Manager, Kristi Jarolimek, to assure that all materials are submitted by the deadline. Her contact information is: kjaroli1@cord.edu or 218-299-3879. Please do not hesitate to contact the Department of Nursing if you have questions regarding submission of your application. Sincerely, Polly K Kloster Pollly Polly K. Kloster, PhD, RN, FCN Chair and Associate Professor Department of Nursing 901 8 th St S, (218) 299-3879 www.concordiacollege.edu

Instructions for Application to the Accelerated Nursing Major at ~ Beginning Summer 2015 Applicants are encouraged to review the FAQ resource on the nursing program web page. Official transcripts must be submitted from all schools attended after high school (including if applicable). The baccalaureate degree must be completed prior to the application deadline of May 15. Two references are required. (Only two references are accepted.) The Reference Forms provided with the on-line application materials are to be used. References from relatives and family friends WILL NOT be accepted. Individuals who are asked to provide a reference must be able to evaluate the applicant on the criteria listed on the form and are to submit the completed references directly to the Department of Nursing. A one-page resume is required. Applicants are encouraged to be professional on their resumes. An impromptu word-processed essay is to be completed after the application & resume have been submitted to the Nursing Department, prior to May 15, 2015. Applicants must schedule a time to complete the essay by contacting our Office Assistant, Kristi Jarolimek, at 218-299-3879 or kjaroli1@cord.edu. The completed essay is submitted on-line. Applicants who require special accommodation to word process this essay should communicate these concerns when scheduling the appointment. All application materials must be received in the nursing department (or be postmarked) by May 15, 2015. It is the applicant s responsibility to verify that the nursing department has received all application materials by the deadline. Incomplete applications WILL NOT be considered after the deadline. (Application materials are not retained for reapplication in subsequent years.) An interview may also be requested by the Admissions Committee. If so, the applicant will be contacted after the application deadline. The following checklist may be helpful in completing the application. 1. Note the following required materials are to be mailed directly to the nursing department (NOT to the Admissions Department) in one envelope by the applicant. Completed Accelerated Nursing Major application (found on our web site NOT the standard admissions application). Please sign all indicated applicant signature areas on this application. One-page resume Non-refundable application fee of $35.00. Make check payable to: Department of Nursing. The fee is applied toward summer course fees for students who are admitted to the major. 2. The following required materials are to be sent directly to the nursing department (NOT to the Admissions Department). These materials are not to be sent by the applicant. Official transcripts from all schools attended after high school including baccalaureate degree granting institution [sent by the institutions] Two references completed by the evaluators [sent by the evaluators] 3. Schedule the word-processed essay through the Nursing Department Office Assistant Send the completed application to: Nursing Department G:\Admissions-Accelerated Track\APPLICATION\AcceleratedNursing Application Letter, Instructions, Reference Forms, Guidelines.

Application to the Accelerated Nursing Major 2015 The Application Deadline is May 15 to begin coursework July 13. Name Last First Middle Former name, if applicable Current Mailing Address Street City State Zip Phone Number (cell or home) Permanent Address Street City State Zip Phone Number (cell or home) E-Mail Address Colleges/Universities attended: List all colleges/universities/vocational institutions you have attended in order of most recent attendance. Please have official transcript(s) sent directly to the Nursing Department. Name of Institution and Location Dates Attended Reason for Leaving or Degree Received Have you ever attended or been admitted to another program of nursing at a hospital, college or university? Yes/No If yes, please indicate the name and address of the program and your reason for leaving. References: All applicants are requested to supply two confidential references (relatives and family friends are not accepted). References should be from an employer, supervisor, clergy, counselor, or college professor. Name Position Address Telephone 1. 2. Please sign your name and date to indicate you understand the references are confidential and you waive access to the information. Applicant s Signature Date

Coursework/GPA: Cumulative GPA I certify that my cumulative college Grade Point Average (GPA) is > 2.5 (.0 scale) at the time of application to the nursing major. Applicant s Signature Date The following prerequisite courses for the nursing major must be at least three (3) credits and must be completed with letter grades of C- or better (not taken as pass/fail). For each course listed, indicate date completed, in progress, or planned date of completion. All prerequisite coursework must be completed by June 1, 2015. Transcripts for coursework not completed by the May 15 application deadline must be received in the nursing department by June 15, 2015. General/Introductory Psychology General Sociology *Human Anatomy & Physiology (must include all body systems) *Microbiology *One semester of Chemistry (Introductory Chemistry or higher level) Mathematics (College Algebra, statistics, or higher level Math) *Designates coursework that must include a laboratory component Essential Qualifications: The curriculum leading to a baccalaureate major in nursing from this program requires that students engage in diverse, complex, and specific experiences essential to the acquisition and practice of nursing skills and functions. Possession of certain abilities is necessary to ensure the health and safety of patients and oneself. These abilities are needed for successful admission and progression by candidates in the nursing program. They relate to motor skills, sensory abilities, communication, cognitive processes, behavioral and emotional health, and professional conduct. The Essential Qualifications of Candidates for Undergraduate Admission and Progression document is included with these application materials. To enter or continue in the nursing program, the applicant/student must be able to perform all of the essential qualifications (either with or without accommodation) to ensure personal safety and the safety of clients. The nursing program will make reasonable accommodations, but is not required to make modifications that would alter the nature of the requirements of the nursing program or present an undue burden to the nursing program. (Review the essential qualifications document). I certify that I have read and understand the Essential Qualifications document. I am able to perform all abilities, with or without reasonable accommodation, as set forth in the Department Essential Qualifications document. Applicant s Signature Date Departmental Requirements: Applicants admitted to the accelerated nursing major will be notified of established requirements to be completed for progression in the program. The requirements include: 1. Completion of all prerequisite course work prior to June 1, 2015, with the established cumulative GPA of 2.5 and all prerequisite coursework completed with letter grades of C- or better, as previously noted. 2. Annual Criminal Background Checks (If the review disqualifies a student from providing care, the circumstances will be individually evaluated.) 3. Semester fees in addition to Concordia tuition to cover necessary program requirements and standardized testing.. Submission of a physical exam and health record, including annual screening for tuberculosis. 5. Acquisition of professional liability/malpractice insurance (1 million each claim/3 million aggregate). 6. Proof of CPR Certification at the health care professional level. This must include single and two person rescuer, infant, child and adult. (On-line courses without in-person demonstration test are not accepted.) I certify that I have read and understand that I must complete these departmental requirements if I am admitted to the Nursing Program. Applicant s Signature Date

Information Regarding Future Licensure by Boards of Nursing: In order to insure safety for clients and to avoid denial of a license by a state board of nursing, it is important that you are aware of the following: 1. Substance abuse and certain physical or mental conditions can be a cause for denial of a license to practice nursing. 2. Certain criminal conduct or offenses can be a cause for denial of a license to practice nursing. 3. Clinical agencies reserve the right to deny students access to clinical experiences based on findings revealed in the criminal background check. If you need further information, please contact the program chair or a state board of nursing representative. The following questions are similar to those that appear on an application for professional nursing licensure. Affirmative answers to these questions do not exclude you from review for admission. Your circumstances will be individually evaluated. Yes No 1. Have you ever been convicted of a crime other than a minor traffic offense, or been involuntarily confined based on harm to self or others? Yes No 2. Have you ever been disciplined for cheating or any other offense at any college? Yes No 3. Have you ever had a nurse aide registry listing marked for abuse, neglect or misappropriation of property? (If yes, please describe on a separate sheet the offense(s), circumstances, and any disciplinary action taken against you. This information will be reviewed by the Department of Nursing s Admissions and Academic Progression Committee.) I certify that all information given on this application and supporting documentation is correct and complete. I understand any omission, misinformation, or misrepresentation may void my admission or result in dismissal or revocation of the completion of the nursing major based upon this admission. Applicant s Signature Date I understand that submission of this application and admission to does not guarantee admission to the major. Applicant s Signature Date It is the policy of to provide equal opportunity for all qualified persons in its educational programs and activities. The college is in full compliance with the laws of the United States and all applicable regulations. The college does not discriminate on the basis of race, creed, color, national origin, age, sex or physical handicap in the educational programs that it operates. 2012, Moorhead, Minnesota

Reference Form for the Nursing Major 1. Name of Applicant NOTE: The person whose name appears above has applied for admission to the Nursing Program. It would be helpful to the nursing department admissions committee if you would give us an assessment of the applicant as called for below. If you are not able to evaluate the applicant on the qualities listed, please notify the applicant. The information you provide will be confidential and the applicant has waived his/her right to access this evaluation. 2. How long have you known the candidate and in what capacity? 3. Please rate the applicant on each of the 10 criteria. Mark your responses with an X. Exceptional Average Needs Improvement Unable to Assess Integrity/Honesty Initiative/Motivation Maturity Ability to work with others Communication skills Empathy/caring Judgment Ability to make decisions Dependability Critical thinking OVERALL RATING. If you have additional comments you believe may be of value to the admissions committee, please include them below. (If more space is needed, continue on the back. Name Title Address Telephone ( ) Date Area Code This evaluation must be received in the Nursing Department no later than May 15, 2015. SEND COMPLETED REFERENCE FORM TO: Nursing Department Phone: (218) 299-3879 FAX: (218) 299-309 It is the policy of to provide equal opportunity for all qualified persons in its educational programs and activities. The college is in full compliance with the laws of the United States and all applicable regulations. The college does not discriminate on the basis of race, creed, color, national origin, age, sex or physical handicap in the educational programs that it operates. 8 2011, Moorhead, Minnesota Rev. 10/2013 G:\Admissions-Accelerated Track\ADMISSIONS\AcceleratedNursing Instructions-Application-Ref Forms-Guidelines

Reference Form for the Nursing Major 1. Name of Applicant NOTE: The person whose name appears above has applied for admission to the Nursing Program. It would be helpful to the nursing department admissions committee if you would give us an assessment of the applicant as called for below. If you are not able to evaluate the applicant on the qualities listed, please notify the applicant. The information you provide will be confidential and the applicant has waived his/her right to access this evaluation. 2. How long have you known the candidate and in what capacity? 3. Please rate the applicant on each of the 10 criteria. Mark your responses with an X. Exceptional Average Needs Improvement Unable to Assess Integrity/Honesty Initiative/Motivation Maturity Ability to work with others Communication skills Empathy/caring Judgment Ability to make decisions Dependability Critical thinking OVERALL RATING. If you have additional comments you believe may be of value to the admissions committee, please include them below. (If more space is needed, continue on the back. Name Title Address Telephone ( ) Date Area Code This evaluation must be received in the Nursing Department no later than May 15, 2015. SEND COMPLETED REFERENCE FORM TO: Nursing Department Phone: (218) 299-3879 FAX: (218) 299-309 It is the policy of to provide equal opportunity for all qualified persons in its educational programs and activities. The college is in full compliance with the laws of the United States and all applicable regulations. The college does not discriminate on the basis of race, creed, color, national origin, age, sex or physical handicap in the educational programs that it operates. 8 2011, Moorhead, Minnesota Rev. 10/2013 G:\Admissions-Accelerated Track\ADMISSIONS\Accelerated Nursing Instructions-Ref Forms-Guidelines

Accelerated Nursing Program Guidelines Psychology General Sociology Human Anatomy and Physiology, including a lab Microbiology, including a lab Chemistry, including a lab College Algebra, Statistics or higher math Prerequisite Requirements Application Requirements Earned baccalaureate degree in a non-nursing major from an accredited institution of higher learning in the U.S. GPA of > on a.0 scale on all post high school work All prerequisite coursework must be completed with passing letter grades of C- or better (not taken as pass/fail) Submission of original transcripts from all post high school institutions of higher learning Completion of application form Submission of $35.00 non-refundable application fee Submission of 2 references (see reference forms provided with the application materials) Submission of a one-page resume Completion of word-processed essay First Semester (May Course) Credit Load NURS 351 (Nursing Concepts) NURS 31 (Client Concepts) NURS 361 (Health Assessment) NURS 02 (Mental Health Nursing) FND 321 (Nutrition) NURS 32 (Adult Health Nursing I) NURS 352 (Family Nursing I) NURS 20 (Nursing Research) NURS 30 (Nursing Management) CHEM 30 (Pharmacology) Second Semester (Fall) Third Semester (Spring) Fourth Semester (Summer) NURS 362 (Family Nursing II) or NUR 01 (Community Health Nursing as summer study abroad) NURS 0 (Adult Health Nursing III) Fifth/Final Semester (Fall) NURS 362 (Family Nursing II) or NURS 01 (Community Health Nursing) NURS 03 (Adult Health Nursing II) NURS 23 (Roles and Issues Capstone) Program Completion in December Credit Load Credit Load 2 2 2 Credit Load Rev. /2015 ontact Information: Nursing Department: Admissions: 1-800-699-9897; 218-299-300 Office: 1-218-299-3879 Financial Aid: 218-299-3010 Fax: 1-218-299-309 Registrar: 218-229-3250 G:\Admissions-Accelerated Track\ADMISSIONS\Accelerated Nursing Instructions-Application-Ref Forms-Guidelines