Applications received beginning June 1 through September 1
for a Spring (January) Start
Return Application and $50 fee to:
WTAMU MSN Program
Box 60969
Canyon, TX 79016
APPLICATION FOR ADMISSION TO THE DEPARTMENT OF NURSING GRADUATE PROGRAM
A $50 non-refundable application nursing fee is required for application. (Make check payable to WTAMU Nursing. (This application
must be completed in full for processing. _______________________________________________
Date:
DOB:
Buff Gold Card (ID) #
Name:
(Other names):
Address:
Phone:
Email:
RN License #
State:
Expires:
(Applicant must have an active, unencumbered RN license in the state clinical practice will be completed.)
MSN Area of Specialty you are applying for:
☐Nursing Comprehensive MSN (5703); State Area of Focus:
☐Family Nurse Practitioner (FNP) (5707);
☐POST
Program (5703)
☐Check here if you are currently in the accelerated RN to BSN/MSN program at WTAMU. (5713 or 5717)
Applications Documents:
Application to WTAMU Graduate School
Application to WTAMU Nursing Department
Resume’ Included
Goal Statement Included
Immunization Documents
References: (please list two non-academic, clinical supervisory references and include electronic contact information. An electronic
reference form will be sent for completion and return.)
Name:
Position:
Email Contact Information:
Departmental Notation: Email sent:
Name:
Date Rec’d:
Position:
Email Contact Information:
Departmental Notation: Email sent:
Date Rec’d:
*All admission documents needed to be received by the deadline in order to be considered for admission.
With few exceptions, state law gives you the right to request, receive, review, and correct information about yourself collect on this form.
Rev. 8/2014
Applications received beginning June 1 through September 1
for a Spring (January) Start
Academic Information:
Please provide information concerning the colleges and universities you have attended. Please request official transcripts from all schools attended sent to
the Graduate School. The Graduate School will copy and scan for departmental use. A catalog description must accompany any master level course work
considered for transfer credit and must not be more than six years old.
School:
Degree:
School:
Degree:
School:
Degree:
School:
Degree:
School:
Degree:
Statistics Course was completed at:
Grade:
Are you now, or have you ever been a member of Sigma Theta Tau?
Please share any Honors, Awards, Financial Assistance, Fellowships, Scholarships, or Assistantships you wish the
Committee to be aware of:
Employment Information:
Place of current employment:
Location:
Present Position:
Application Summary:

Submit application for Graduate School and Graduate Nursing Program Application by the deadline.

Applicants must have a cumulative GPA for the last 60 hours of college credit of at least a 3.0 on a 4.0 scale. Failure in any nursing
coursework will be taken into consideration. A Nursing GPA will also be calculated and taken into consideration.

Applicants for the nurse practitioner role must document 2 years of experience as an RN.

Applicants may submit a resume to document this requirement.

Applicants will schedule a phone interview with the Associate Department head for Nursing Graduate Programs or a designee.

Providing the Department of Nursing with two clinical (non-academic clinical supervisor) references and contact information. This
must be accomplished in a timely manner so that responses from references can be included in the application packet by the
application deadline.

Applicants will write/include a goal statement that will be evaluated based on:
o Clear focus related to a goal statement
o Supportive detail regarding the goal statement
o Organization of goal statement (clear introduction, body and conclusion)
o Clarity, grammar and punctuation
o Goal statement is typed with a word count of between 500-750 words
*All admission documents needed to be received by the deadline in order to be considered for admission.
With few exceptions, state law gives you the right to request, receive, review, and correct information about yourself collect on this form.
Rev. 8/2014