ArizonaStateUniversity

College of Nursing Health Innovation

Application Instruction

Packet

Updated 5/31/11

College of Nursing Health Innovation

500 North 3rd Street, Mail Code 3020

Phoenix, Arizona 85004-0698

Application Instructions:

ADMISSION PROCEDURE

Please be aware that because of the changes in the health care system, certain nursing rolesare in great demand and admission is highly competitive. Therefore,completed applications (includingtranscripts, letters of recommendation, all required paperwork) must be received no later than the posted deadline for priority review. Applications that are late will be reviewed only if there is space available after the admission process (interviews and review) has been completed. Late applications that are not reviewed will not be processed for the next application cycle; those applicants will need to reapply for the following admission term.

1.Apply to the ASUGraduateCollege:

  • See web site:
  • An official transcriptfrom each institution attended must be sent directly to the Graduate College Admissions Office (see address below)
  • GRE (Graduate Record Examination) - Analytical Writing Score from the General Test– request that scores be sent electronically to ASU. See web site: (Note: post-Masters students are not required to provide a GRE score; recommended [not required] for Nursing Education degree/certificate program if needed to enhance academic record.)

Send transcripts to:

Arizona State University

Graduate College, Interdisciplinary Bldg, B-Wing, Room 170

P.O. Box 871003

Tempe, Arizona 85287-1003

2.Apply to your desired degree program by completing the supplemental section of the Graduate College’s application, and download the Required Application Forms Packet from the link within this section of the application.

  • Upload a current, detailed resume or curriculum vitae
  • Upload your Statement of Purpose, per the below instructions:

Prepare a statement reflecting your goals and purposes for pursuing graduate study. For admission purposes, goals will be judged for clarity and congruity with graduate education, congruity with selected role in the degree/certificate and congruity with past and current work experience. Please limit to no more than 500 words. Include the following in your statement:

Relationship of your identified area of study, your career goals, and specific outcomes you want to accomplish from graduate study

Relationship between your career goals and past and current clinical experience including work experience or future plans to work in rural areas and/or with medically underserved populations.

Ideas for your Applied Project in your planned area of clinical expertise.

  • Upload materials on creative/research activities in which you have participated.

3.Submit Self-Evaluation Form (in this packet) and other requested materials

Please complete and submit your self evaluation form and other materials to:

Arizona State University

College of Nursing Health Innovation

Graduate Admissions Advisor

500 North 3rd Street, Mail Code 3020

Phoenix, Arizona 85004-0698

4.Advisement/Information

Applicants who wish to discuss the application process, or explore career choices and graduate program options, cancontact the Graduate Academic Advisor at (602) 496-0703.

5.Interview

Applicants are required to have an interview with a faculty representative from the area in which the student plans to study. Only applicants with complete application files will be scheduled for an interview with College of Nursing Health Innovation faculty.

TUITION AND FEES

The current University Tuition and Fees Schedulesare published on the ASU Web site at:

and fees are subject to annual review and possible change upon approval by the Arizona Board of Regents. Additional fees may be attached to practice courses.

FINANCIAL ASSISTANCE

Financial Assistance for graduate study is available in the form of scholarships, traineeships, assistantships and loans. Scholarships, some traineeships and assistantships are awarded to full-time students with regular admission status and satisfactory academic standing. Students are advised to consult the Graduate College Bulletin, Arizona State University Office of Student Financial Assistance, or the College of Nursing Health Innovation website for additional information.

Please visitour website at for additional information

and links to University resources.

SELF EVALUATION FORM

Applicant’s Name (to be completed by applicant)Address (to be completed by applicant)

Applying to: Master of Science in Nursing Degree __ Nurse Educator __Community & Public Health

Certificate Programs:

Community and Public Health Certificate Nurse Educator Certificate

Indicate your preference for program of study: Full time  Part time

DIRECTIONS TO THE APPLICANT: Please complete all three pages of this form, sign at the end, and mail to the address indicated. Early receipt of the evaluation will be advantageous.
Place an “X” through the box that best reflects your assessment of yourself on each of the attributes listed below.

  1. CURRENT NURSING KNOWLEDGE

1 Outdated; scattered and irregular knowledge of nursing

2 Possesses limited current information

3 Familiar with most general information

4 Keeps abreast

5 Thorough systematic understanding of nursing

CANNOT JUDGE

  1. CREATIVITY

1 Fails to incorporate new information

2 Maintains status quo; requires assistance with new information

3 Supports the development of new ideas; deals adequately with information

4 Contributes to development of new ideas; grasps new information

5 Generates new ideas; grasps new information easily

CANNOT JUDGE

  1. INITIATIVE

1 Requires detailed instruction; dependent on others

2 Frequent supervision required; relies on others

3 Routine worker; requires supervision on new tasks

4 Resourceful; independent; paces self

5 A self-starter; seeks additional tasks

CANNOT JUDGE

  1. ACCURACY

1 Makes frequent avoidable errors

2 Work is inaccurate

3 Adequate level of accuracy; occasional errors

4 Seldom makes an error; careful

5 Always accurate; work shows great attention to detail

CANNOT JUDGE

  1. COMMUNICATION

1 Difficulty communicating ideas and intentions to others

2 Acceptable communication within nursing under normal circumstances

3 Communicates clearly within nursing under unusual circumstances

4 Communicates clearly to multiple audiences under unusual circumstances

5 Clearly expresses ideas even under stress; can translate communication of others (negotiator)

CANNOT JUDGE

  1. PERSEVERANCE

1 Changes objectives; unable to complete tasks without direction

2 Not well focused; rarely completes tasks without direction

3 Usually focused; completes most tasks; requires some direction

4 Focused; completes tasks with only appropriate direction

5 Focused on objectives; completes tasks; overcomes obstacles

CANNOT JUDGE

  1. ORGANIZATION

1 Unable to prioritize tasks; disorganized work habits

2 Variable efficiency in managing tasks

3 Reorganizes efficient ways of accomplishing tasks with some direction

4 Organizes work and accomplishes tasks with minimal direction

5 Prioritizes and accomplishes tasks independently

CANNOT JUDGE

  1. PRODUCTIVITY

1 Insufficient; needs prodding

2 Does only required minimum

3 Good, average output

4 Usually does more than required

5 Energetic; highly productive

CANNOT JUDGE

  1. LEADERSHIP

1 Does not understand how to get cooperation; poor discipline, too lax or severe

2 Frequent difficulty in obtaining cooperation; difficulty getting job done

3 Receives routine cooperation; gets satisfactory job done

4 Influences and inspires others; get job done well

5 Forceful leader; promotes top performance from others

CANNOT JUDGE

  1. JUDGMENT

1 Poor judgment; likely to make illogical decisions

2 Fair judgment under normal circumstances; sometimes acts before thinking

3 Judgment good on routine matters

4 Thinks clearly and positively under unusual circumstances

5 Logical; sound judgment

CANNOT JUDGE

  1. ADAPTABILITY

1 Has considerable difficulty in adjusting to any assignments

2 Has some difficulty when shifted to new/different assignments

3 Average amount of guidance needed to learn variety of duties

4 Usually learns new assignments with normal supervision

5 Highly flexible; can handle many varied assignments

CANNOT JUDGE

  1. STRESS TOLERANCE

1 Easily irritated; finds pressures intolerable

2 Occasionally goes to pieces under pressure; is “jumpy” and nervous

3 Has average tolerance for crises; usually remains calm

4 Tolerates pressures; tolerates crises better than most

5 Thrives under pressure; enjoys challenges and problems

CANNOT JUDGE

  1. DEPENDABILITY

1 Unreliable; needs detailed supervision and follow-up

2 Somewhat unreliable; requires occasional check on routine tasks

3 Usually can be depended on, but must be checked on important matters

4 Usually meets responsibilities carefully and correctly

5 Merits utmost confidence

CANNOT JUDGE

  1. OVERALL POTENTIAL FOR GRADUATE STUDY

1 Unlikely to be successful in graduate studies

2 Likely to have some difficulties in graduate studies

3 Has potential for success in graduate studies

4 Likely to be successful in graduate studies

5 Highly likely to be successful in graduate studies

CANNOT JUDGE

Additional comments:

If possible, please list the names, addresses, and phone numbers for five potential Clinical Sites / Preceptors in your area (this is especially important if you are outside the Phoenix area, or are an out-of-state applicant):

1.

2.

3.

4.

5.

Printed Name: Your Signature:

Date:

Reference forms received by the College of Nursing and Health Innovation are the property of Arizona State University. They are confidential and not shared with the applicant or persons other than the faculty on the ASU College of Nursing and Health Innovation Standards Committee or in an advisement position.

Please send completed reference form to:Graduate Admissions Advisor
College of Nursing HealthInnovation
Arizona State University
500 North 3rd Street, Mail Code 3020
Phoenix, AZ 85004-0698

ARIZONASTATEUNIVERSITY

COLLEGE OF NURSING AND HEALTH INNOVATION

GRADUATE PROGRAMS

Immunizations, Health and Fingerprint Information Required

Submit to: Graduate Academic Advisor-DNP, College of Nursing and Health Innovation, 500 N. 3rd Street, Phoenix, AZ 85004-0698 prior to the application deadline :

  • Proof of required two doses of MMR, Measles (Rubeola), Mumps, and Rubella vaccine (second MMR must be given after 12/31/79). If the student chooses not to have the second MMR, the student must have a titer that demonstrates immunity for Measles (Rubeola) and Rubella.

*Required of all students applying to ASU. Therefore, you must also submit MMR information separately to the ASU Health Services office; please download the form from the following website:

If this is not in place, you will be unable to register for classes. Students who have had organ transplants should notify the Graduate Program Office to request a permanent waiver.

  • Proof of completion of Hepatitis B vaccine (a series of three inoculations or titer)
  • Proof of Tetanus/Diphtheria (Td) immunization within the past 10 years.
  • Proof of Chicken Pox (Varicella) immunity by titer. If titer is negative, a series of two vaccinations (at least 8 weeks apart) is required.
  • Proof of a negative TB Skin Test that will be current at the beginning of the time of admission. Follow-up treatment is required if the TB Skin Test is positive. Documentation of BCG does not mean you do not have to meet this requirement. BCG does not give a true positive TB test and therefore does prevent you from being required to demonstrate a negative TB skin test or proof of treatment for latent TB infection. . Treatment must be initiated prior to enrollment in any clinical course. A TB Skin Test (or evidence of follow-up treatment) is required every 12 months while students are participating in clinical courses.
  • Copy of active RN license(andcopy of advanced practice license if applicable);copy ofcurrent CPR “Level C” Certification (Health Care Provider) that will not expire in the next 12 months.
  • Fingerprint Clearance Card (AZ residents.) (Xerox copy must be submitted; student responsible for retaining the original card and showing it to agencies upon request). “Restricted” fingerprint card requires a Petition submitted to the College of Nursing & Healthcare Innovation Standards Committee. See website: Out-of-state applicants: please submit similar verification of clearance of a fingerprint/background check.

The following items will need to be submitted to the College of Nursing and Health Innovation Graduate Program Office,upon admission to your program:

  • Proof of negative drug screen. Applicants will be notified by the Graduate Education and Advanced Practice Program Office about the procedure for the drug screen. Due to changes in contracts with clinical agencies this requirement may need to repeated annually.
  • Additional laboratory tests, and/or immunizations, or documentation may be required for practicum courses by certain health care agencies.

NOTE: Students are responsible for maintaining the current status of their health records in their student file located in the Graduate Program Office. Only photocopies of all documentation of health related materials will be accepted, and may be faxed to 602-496-0545. Students are responsible for maintaining their own records of current CPR certification, proof of negative TB skin tests and current fingerprint card until graduation. Copies of proof of these updates must be submitted to the Graduate Program Office when due.

APPLICATION CHECKLIST

A complete application MUST be submitted prior to the application deadline for priority review. Please ensure you have submitted all of the following items:

Complete the Application for Graduate Admissions through the Graduate College at and pay the appropriate fees. Be sure to upload your Statement of Purpose, your Resume,and any creative and/or research activity materials as part of this application.

Have your transcripts from every college and university from which a Bachelors degree or higher was earned, sent to:

Arizona State University

Graduate College
Interdisciplinary Building, B-Wing, Room 170
PO Box 871003
Tempe, AZ 85287-1003

Click on the link within the application to download the Required Application Forms Packet and submit all required forms.

Complete and submit all supplemental materials to the DNP Academic Advisor:

Self-Evaluation Form

GRE Score (Analytical Writing score only is required)

**NOT requiredofpost-Masters applicants

Copy of active RN License

Copy of active Advanced Practice license (required for post- Masters with advanced practice ONLY)

Health and Immunization Documentation (complete all requirements specified on the information page)

Copy of AZ DPS Fingerprint Clearance Card (or similar documentation for out-of-state residents proving clearance of fingerprint/background check)

International students: all additional Graduate College requirements

Updated 5/31/11