YOUR NAME, BANNER ID: 900555555 (you can hand write this) 2

Appalachian State University

College of Health Sciences

Department of Nursing

2017 Application to the Bachelor of Science in Nursing Program

Application to the BSN program must be received no later than January 17th

Applicants must have been accepted to ASU prior to January 17th in order to be considered for admission.

Both the application (downloaded from Department of Nursing website) and all associated application materials must be received by the deadline for the application to be considered for review. Late receipt of any element may render the application ineligible for admission consideration. The Department of Nursing does not keep current ASU transcripts. All students (current and transfers) must include all college course work transcripts available along with the BSN application for admission.

Contact Information: It is essential to keep the Department of Nursing informed of any changes.

Name: ____ Application can be neatly hand written or typed (watch your formatting) ______

(first) (middle) (last)

Current Mailing Address:

______

Street City State Zip

Current Phone: (____) ______Emergency /Alternate Phone: ______

(Cannot be the same as Current or Cell phone numbers)

Cell Phone: (____) ______Email Address: ______

Please indicate where mailings are to be sent and if different than above address:

____ If this address is the same as the one listed above, just write “same.”______

Street City State Zip

Please submit your application packet (BSN application and official sealed transcripts) to:

Donna Whitt

Appalachian State University Department of Nursing

Edwin Duncan Hall, Suite 310A

P. O. Box 32151

Boone, NC. 28608-2151

For questions about the submission of your application please contact:

Ms. Donna Whitt

828-262-8005

Applicant Status: Please indicate your status (Check one and provide requested information)

X Current Appalachian Student Banner ID#: ____900123456______

Transfer Student Date you were accepted to ASU______Banner ID#______

Returning Appalachian Student Date you were re-admitted to ASU ______

Are you a Second Degree Student? Yes/No Degree/Date______

The following data are for statistical purposes only & will not be used in admission decisions:

Gender: M F Date of Birth ______

Ethnic Group/Race: ______(fill in letter from Legend below) Please scroll to select correct group

Legend: I – American Indian or Alaskan Native N – Native Hawaiian or Other Pacific Islander

O – Asian M – Multiracial heritage

B – Black or African American U – Race/Ethnicity unknown

H – Hispanic or Latino C – Choose Not to Report

W – White

Citizenship Status: U.S. Citizen Resident Alien Non-resident Alien

Name of High School attended & date of graduation______

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Current & Previous Education: List all colleges or universities attended, with most recent listed first*. If you completed a CNA program, please list that as well and provide a copy of your certification and registration.

College/University / City, State of College/University / Start End Dates
(Month/Year) / Degree or Semester Hours Completed
Appalachian State University / Boone, NC / 8/15 – present / 30 hours
Central Piedmont Comm. College / Charlotte, NC / 6/16-8/16 / 3 hours
AP Credit / (name of your High School, Town, State) / 8/14 – 5/15 / 3 hours
South Piedmont Comm. College / Monroe, NC / 6/14 – 7/14 / 6 hours, C.N.A.

* Each applicant (including current ASU students) must submit all college official transcripts to the Department of Nursing in order to be considered for admission to the Nursing Program. Applicants are also responsible for submission of an official transcript at the completion of the current semester.

General Education Requirements

Students are allowed to have no more than (3) outstanding general education courses upon entry into the BSN program. ALL general education courses must be completed prior to the beginning of the Fall Semester of the student’s second year in the BSN program in order to progress.

Please list any general education courses that you will not have yet completed by the start of the nursing program. Please do not include UCO 1200 credit or RC 1000. These are required courses for major declaration and must be completed prior to starting the BSN program.

Name of Course / Prefix and
Course Number / Where (List the school name) do you plan to complete the course?
Ex. Intro To Film / ENG 2170 / ASU
1. American History / HIS 1200 / ASU
2. Page & Stage / THR 2005 / ASU
3.

CURRICULUM PLAN 2016-2017

Applicant’s Catalog year_2015-2016_____ See Notes page on how to determine your catalog year.

Please indicate the semester and year in which each nursing prerequisite course was completed (or if currently enrolled), the institution at which the course was completed, and the grade earned. List all science lecture and lab grades separately, if applicable. Students must have either completed or be currently enrolled in all of the courses listed below to be eligible for consideration.

If you are currently enrolled in a course, place IP (in progress) in the GRADE column.

Courses listed in bold are North Carolina Community College equivalents. Minimum accepted grade is listed in parentheses.

PREREQUISITE COURSES / SEMESTER
YEAR / INSTITUTION / GRADE
CHE 1101 Introductory Chemistry I CHM 151 (B-) / Fall 2015 / ASU / B+
CHE 1110 Introductory Chemistry I Lab CHM 151A (B-) / Fall 2015 / ASU / A-
CHE 1102 Introductory Chemistry II CHM 152 (B-) CHM 152 / Summer 2016 / Central Piedmont CC / A
CHE 1120 Introductory Chemistry II Lab CHM 152A (B-) CHM 152 / Summer 2016 / Central Piedmont CC / A
ES 2031 Anatomy and Physiology I BIO 165 or 168 (B-) / Fall 2016 / ASU / B+
ES 2032 Anatomy and Physiology II BIO 166 or 169 (B-) / Spring 2017 / ASU / I P
BIO 2200 Introduction to Microbiology BIO 275 (B-) / Spring 2017 / ASU / I P
STT 1810 Basic Statistics MAT 151/152/155 (C)
Write in the Statistics course you took or are taking: STT 1810, STT 2810, STT 2820, or AP ECO 2100 / 2013-2014 / High School / AP Credit
PSY 1200 Psychology: Historical, Social and Scientific
Foundations PSY 150 (C) PSYC 1101 / Summer 2016 / UNCC / C+
PSY 2210 Psychology of Human Growth and Development PSY 241 (C) / Fall 2016 / ASU / B+
SOC 1000 The Sociological Perspective SOC 210 (C) / Spring 2016 / ASU / A
PHL 2000 Philosophy, Society and Ethics PHI 240 (C) or PHL 3015 Medical Ethics / Spring 2017 / ASU / I P
NUT 2202 Nutrition and Health BIO 155 or NUT 110 (C) / Spring 2016 / ASU / A

Requirements Upon Notification of Provisional Admission

Upon notification of provisional admission to the BSN Class of 2019, students will be required to submit the following by a date yet to be determined. Specific directions and other information will be sent with notification of admission to the program.

1. Criminal Background Check and Drug Screen

2. Physical and Safety and Technical Skills Evaluation

3. Two step TB testing

4. Required immunizations and titers.

5. All students must successfully complete an American Heart Association Healthcare Provider CPR class and
present their official certification document for review by Mrs. Whitt. The card must be valid for a minimum of one
year from the beginning of Summer Session 2017.

Application Review Verification

I have reviewed the following components of my application to the BSN major, and have checked the box before each statement to indicate that each component of the application process is complete.

I have been admitted to ASU. Date of acceptance__2/2015__ (must be prior to 1/17/17) (approximate month/year)

I have included my official transcript(s) to the Department of Nursing. (This applies to all applicants including the ASU student)

I have the minimum overall grade point average of 3.0 on a 4.0 scale on all undergraduate courses attempted. I understand that this is the minimum GPA for application but is not a guarantee of admission.

I understand that ALL general education courses must be completed prior to the beginning of the Fall Semester of my second year in the BSN program in order to progress.

I have reviewed and understand the Requirements Upon Notification of Provisional Acceptance section of the application.

I understand that my application will not be considered by the faculty admissions committee unless all components of the application are submitted by the deadline.

I understand the ASU BSN program admission process and requirements, and if I receive provisional admission, I will promptly respond to further admission requirements as described above and in my acceptance letter and subsequent correspondence.

I have designated my catalog year.

I hereby certify that all of the information provided by me in my application packet is true and accurate to the best of my knowledge. I understand that submitting false documents or making false statements may result in my not being admitted to the ASU nursing program OR my dismissal from the nursing program.

Applicant Signature Date

Consistent with Section 504 of the Rehabilitation Act of 1973 (Section 504) and the Americans with Disabilities Act of 1990 (ADA), it is the policy of Appalachian State University that no qualified individual with a disability shall be excluded from, denied the benefits of, or be subjected to discrimination in any university program, service or activity. In accordance with Section 504 and the ADA, all applicants for the nursing program must be qualified individuals who are able to meet the essential competency requirements of the program, with or without reasonable accommodations. Essential competencies include the ability to meet the cognitive, affective and psychomotor requirements of the curriculum (i.e., critical thinking, communication, interpersonal skills, mobility, tactile ability, vision, and hearing). The Department of Nursing is committed to providing access to its programs to qualified individuals with disabilities. However, the Department of Nursing is unable to make accommodations that impose an undue burden, present a threat to the health or safety of the individual or others, or fundamentally alter the nature of the curriculum including didactic components, laboratory sessions, and clinical affiliations.

In order to be admitted to and progress in the Nursing Program, one must possess a functional level of ability to perform the role required of a registered professional nurse. Upon admission, a student will be asked to certify that he or she is able to perform all of the technical standards with or without reasonable accommodations. In addition, a student will be asked to obtain medical clearance from a healthcare provider certifying that the student is able to perform all of the technical standards. Admission and progression in the program will be denied if a student is unable to demonstrate proficiency in the technical standards. If a student cannot meet the technical standards with or without reasonable accommodations, the student will be withdrawn from the Nursing Program/Course and may appeal through the appropriate process.

Statement of Non-discrimination
Appalachian State University is committed to providing equal opportunity in education and employment to all applicants, students, and employees. The university does not discriminate in access to its educational programs and activities, or with respect to hiring or the terms and conditions of employment, on the basis of race, color, national origin, religion, creed, sex, gender identity and expression, political affiliation, age, disability, veteran status, or sexual orientation. The university actively promotes diversity among students and employees.

Updated/revised 2012

Updated/revised May 2013

Updated/revised September 2013

Updated/revised September 2014

Updated/revised September 2015

Updated/revised October 2016

NOTES FROM PRE-NURSING ADVISORS

Finding your completed hours at ASU for the Current and Previous Education section (do this after your Fall 2016 grades are posted):

Use AppalNet: Student Academic Transcript.

Scroll down to Transcript Totals (view below)

Use your Total Institution Earned Hours to record your ASU total “Semester hours completed.”

Use your unofficial transcript from other institutions to properly document those total “Semester hours completed.” Please note that your total transfer hours on your ASU transcript could be less than your completed hours at another institution(s).

Finding your Catalog Year:

Your Catalog Year determines which degree requirements you need to complete in order to graduate from ASU. Typically, this is the academic year that you started at ASU. (For example: 2014-2015.) To confirm your catalog year, log into DegreeWorks and look in one of the black bars on your worksheet.

To access your DegreeWorks page:

Log into appalnet.appstate.edu.

Make sure you are on the MyAppalNet tab.

Click on the DegreeWorks logo:

Remember, if you have changed or are planning to change your catalog year, please read your DegreeWorks Notes and contact your advisor if necessary.

NOTES FROM PRE-NURSING ADVISORS (Cont’d)

Requesting your official ASU Transcript:

Remember, an official transcript must be sealed and unopened. Write your full name and Banner ID on the outside of each transcript.

Request your official ASU Transcript via AppalNet. Find detailed information onordering official transcripts via AppalNet.

Official transcripts for currently enrolled (non-graduating) students with final grades should be requested on or after Friday, December 16th, 2016.

Remember to make sure that the grades you list on your application are the same as those listed on your transcripts (unofficial or online). Don’t go from memory.

What to do if you are waitlisted for Spring 2017 Courses:

If you are currently Waitlisted for a Nursing pre-requisite course, wait to request your transcript until you are in the class. Do not submit the application without official documentation that you are taking the class this Spring. REMEMBER, the application deadline is January 17th, 2017, which is the first day of classes at ASU.

If you are currently Waitlisted for a Gen Ed only course, list it on the BSN application as a delayed course in the General Education Requirements section (page 2). If you end up taking this class in the spring, you won’t be penalized for listing it as a delayed course on your application.

Examples typed in Blue; advice highlighted in yellow is offered by pre-NUR advisors who are not part of the BSN Admission committee.