1st Year Supplementary Application Form
University of Prince Edward Island Nursing Program for September 2016 Admission
DEADLINE FEBRUARY 15, 2016
Personal Information
Name: __________________________________________________
Date of Birth ______________________
(DD/MM/YYYY)
UPEI is interested in knowing the following for the purposes of tracking.
Are you a Licensed Practical Nurse (LPN) Yes
No
(Circle One)
(if an LPN, please refer to item 4 on the last page of this form for description of transfer credits)
Aboriginal peoples include individuals who are status, non-status, Metis or Inuit.
Based on this do you consider yourself an Aboriginal person? Yes
No
(Circle One)
Selection Process
Each year applicants compete for the seats available in the program. Five courses are required for admission of high school
and university applicants, while four courses are required for admission of mature applicants. Applicants must meet the
minimum requirements as stated in the UPEI calendar. Meeting the minimum requirements does not guarantee entry.
Communication and communication skills are critical in Nursing. The School of Nursing adheres strictly to the English
Language Proficiency requirements of the University of Prince Edward Island. Information regarding the English Language
Proficiency Requirement can be found at http://www.upei.ca/programsandcourses/english-language-proficiencyrequirements.
The Office of the Registrar ranks all eligible first year candidates as follows; (1) 95% on the average in Biology, Chemistry,
English and Math required for admission; and (2) 5% on work and volunteer experience, especially as it pertains to
Nursing. Applicants completing university degree level courses in one or more of the core courses listed above will have
10% added to each university course result for the purposes of admission evaluation. University applicants must have a
“satisfactory semester” as defined in the UPEI calendar in the semester directly preceding admission to Nursing.
Normally sixty-five (65) seats are available to the four year Nursing Program each year. Applicants whose average in
Biology, Chemistry, English and Math courses is determined to be at least 88% at the time final results for 1st semester
grades are received will receive an “Early Offer” of admission. Those not receiving an Early Offer will be ranked in the
applicant pool. Approximately 65 offers, including Early Offers, will be made by the third week of March. We anticipate up
to 10-15 applicants may not accept the offer. These seats will then be offered in the third week of May to the highestranking applicants that have been identified as alternates after the ranking list has been amended as a result of receiving
updated grade results. Normally 3-5 seats remain open after this stage. Applicants deemed as alternates and enrolled in
courses are to have all prerequisite courses completed by June 30. Final official transcripts must be received at the
Registrar’s Office no later than July 15th. Shortly after July 15th any remaining seats will be offered to the highest-ranking
alternates. Successful applicants are required to pay a non-refundable tuition deposit, which goes toward their first semester
fees.
First year applicants are required to submit the following:
1) the undergraduate application and $50 application fee ($75 for International applicants)
2) this supplementary Nursing application form
3) high school transcript (when 1st semester final results can be reported)
4) a C.V. or resume if you are a mature student (at least 22 years of age before October, 2016)
5) post-secondary transcript(s) for any post-secondary study taken. For those enrolled in courses, arrange to have
your transcripts sent when 1st semester results can be reported
6) if required, an acceptable English Language Proficiency Test result (information found at the link listed above)
Submit your complete application package (transcripts can follow) to:
The Registrar’s Office
550 University Avenue
Charlottetown, PEI
C1A4P3
2
1.
Academic Courses
Please list any courses currently in progress or that you plan to complete by June 30th. Report any changes to the
Professional Schools Admissions Program Coordinator, jrmacdougall@upei.ca
____________________
Course
_________________________
Institution
___________________
Date Complete
____________________
Course
_________________________
Institution
___________________
Date Complete
____________________
Course
_________________________
Institution
___________________
Date Complete
____________________
Course
_________________________
Institution
___________________
Date Complete
____________________
Course
_________________________
Institution
___________________
Date Complete
The following sections are used to determine the points awarded an applicant for Nursing related experience. It is very
important for ALL first year applicants to complete this section. Applicants receive up to 5 points. Points are awarded for
experiences up to the date of the submission of this form (deadline no later than February 15th).
2.
Work, Volunteer Experience, Interests
(A) Please list any paid work experience. Be specific about the employment dates. List these experiences in order of
relevance to the health professions, where applicable. Your supervisor’s name and phone number must be listed.
___________________ ________________ ____________________ _________
From(mth/yr)- To(mth-yr)
Place of Employment
Position Held
Full or Part-Time
___________________ ________________ ____________________ _________
From(mth/yr)- To(mth-yr)
Place of Employment
Position Held
Full or Part-Time
___________________ ________________ ____________________ _________
From(mth/yr)- To(mth-yr)
Place of Employment
Position Held
Full or Part-Time
______________________________
Supervisor’s Name & Phone Number
______________________________
Supervisor’s Name & Phone Number
______________________________
Supervisor’s Name & Phone Number
(B) List any volunteer community service. Be specific about the volunteer dates. Begin with any volunteer experiences
related to the health profession where applicable. Examples of volunteer experience include hospital volunteer, canvasser
for the Cancer Society, Sunday School teacher, coach etc. Your supervisor’s name and phone number must be listed.
___________________ ________________ __________ _____________________
________________________
From (mth/yr) - To (mth-yr)
Supervisor’s Name & Phone Number
Volunteered for
# of hours/week
Description of Activities
___________________ ________________ __________ _____________________
________________________
From (mth/yr) - To (mth-yr)
Supervisor’s Name & Phone Number
Volunteered for
# of hours/week
Description of Activities
___________________ ________________ __________ _____________________
________________________
From (mth/yr) - To (mth-yr)
Supervisor’s Name & Phone Number
Volunteered for
# of hours/week
Description of Activities
3
(C) Briefly describe your extracurricular activities/interests.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
In signing this form, I agree to abide by the rules and regulations of the University of Prince Edward Island and the School
of Nursing. I certify that the statements in my application package are true and complete to the best of my knowledge and
that I have attended no other institution other than those listed in this application. I understand that erroneous information
in this application could result in my disqualification as an applicant to the program. All information provided by you in
your application is kept strictly confidential by the Registrar’s Office and the Admissions Committee.
_______________________________________________________
Signature
_________________________
Date (DD/MM/YY)
Please Note:
(1) Letters of recommendation are not accepted nor required.
(2) If an offer of a seat to the School of Nursing is made to you a non-refundable deposit of $500 is required (the deadline
for providing this deposit will be stated in your acceptance letter). Extensions to this deadline are not granted. As well, a
criminal record and vulnerable sector check is required for all accepted applicants.
(3) To meet the application deadline your application package must be postmarked or dropped off at the Registrar’s Office
no later than February 15, 2016. Please note that transcripts can follow if your school is not able to report your 1 st semester
final grades at the time you make application.
(4) LPNs accepted into the 4 year Nursing program will receive the following transfer credits:



if a Holland College LPN graduate since 2009 you may receive 27 credit hours of transfer credit but will be
required to complete Psy 101/102, Bio 121/122, and V PM 101
if a Holland College LPN graduate prior to 2009 you will receive 9 credit hours of open elective transfer credit
if a LPN graduate from any other LPN program you will receive 9 credit hours of open elective transfer credit,
with the possibility of further transfer credit if you submit course descriptions for all courses taken in your LPN
program
(5) Any student accepted to the first year of the Nursing program and potentially receiving transfer credit for NURS 101
and NURS 102 will be required to complete a Math competency test before transfer credit is granted.
Application Deadline February 15, 2016