APPLICATION FOR RN-BSN COMPLETION PROGRAM
RN-BSN Track: (Choose 1 option)
___ Online Classes
___ Traditional Classroom
Date _____________________, 20 __________
1. NAME_______________________________________________________________________________
Last
First
Middle
2. PRESENT ADDRESS___________________________________________________________________
Street
City
State
Zip Code
Telephone Number
_________ ___________________
Area Code
(Cell) ________ ___________________
Area Code
E-mail address _________________________________________________________________________
3. SOCIAL SECURITY NUMBER __________________________
4. DATE OF BIRTH ______________________________________
Month
Day
Year
GENDER: F____ M____
5. CURRENT EMPLOYER & CITY:_________________________________________________________
7.
HAVE YOU APPLIED or READMITTED TO USC AIKEN? □ Yes
□ No
(if yes) when?_____________________________
(if no)1. Submit an application to USC Aiken
2. Request all official transcripts from previous colleges be sent to USC Aiken Office of Admissions.
8. EDUCATIONAL PREPARATION
a. List all technical colleges and/or universities attended for credit
Name of Institution
City and State
Date of
Entrance
Date of
Leaving
Currently
Enrolled
Degree or Diploma
b. What courses are you presently taking?
Course
Institution
Date
c. When and where do you plan on completing any remaining prerequisites:
___________________________________________________________________
Institution
Semester
Year
9. WHEN DO YOU ANTICIPATE BEGINNING THE RN-BSN Program? August_________________
(the program begins each fall semester)
Year
10. DO YOU HAVE A CURRENT RN LICENSE?
□ Yes □ No (South Carolina RN License is required)
(if yes) _____________________________________________________________________________
State
Date of Expiration
(if no) When do you anticipate obtaining one? ______________________________________________
DATE: ___________________
SIGNATURE: ________________________________________
The University of South Carolina Aiken provides equal opportunity and affirmation action in education and
employment for all qualified persons regardless of race, color, religion, sex, national origin, age, disability or
veteran status.
RETURN THIS APPLICATION, ALONG WITH A COPY OF YOUR USCA ACCEPTANCE LETTER TO
USCAIKEN BY APRIL 1ST TO:
USCAIKEN SCHOOL OF NURSING
KAREN MORGAN
UNIVERSITY BOX 25
471 UNIVERSITY PARKWAY
AIKEN, SC, 29801
10/2014