Dear Prospective RN-BSN Student,
We are delighted of your interest in our innovative national on-line RN-BSN program. The
University of Missouri Kansas City (UMKC) and the School of Nursing at UMKC are
accredited http://sonhs.umkc.edu/about-us/accreditation/ . Our program is designed to assist
you in developing your knowledge and skills in twelve AACN BSN competencies namely:
clinical/professional judgment, communication, theory, research and provision of evidencedbased care, health promotion and disease prevention, leadership/management, technology
utilization, professional valuing/caring, professional role development, global perspectives,
health care systems and policy, and teaching/learning.
The curriculum, framed around these 12 competencies, provides a rich opportunity to
significantly enhance your skills and effectiveness as a professional nurse: in personal and
interpersonal relationships, effectiveness in managing human health outcomes, and effectiveness
in our complex health care delivery system. We encourage students to become life-long learners
by engaging them in the process of self-reflection, critical thinking, clinical reasoning, individual
goal setting, and self-transformation encompassed in a supportive, respectful team-building
environment. Hence, we view students and faculty as collaborative partners in the educational
process.
During the final year of the RN-BSN curriculum, student teams will work collaboratively with
RN-BSN supervisory practice experience faculty, healthcare organizations or healthcare-related
entities to collaboratively design and implement team-directed practice experiences that
transcend across populations. The process you will undertake during your team-directed practice
experiences will empower you to assume a leadership advocate role in improving care in a
complex, dynamic healthcare environment.
If you would like to schedule an appointment, or have further questions, please feel free to
contact the Academic Advisor, Lauren Klemmer at klemmerl@umkc.edu or (816) 235-6277.
The UMKC School of Nursing and Health Studies is an exciting program for students to be
enrolled in and our nursing programs are among the best in the nation. We hope you will join
us in the near future.
Sincerely,
Melissa Joy Roberts JD, MSN, FNP-BC
Associate Dean for Academics
UNIVERSITY OF MISSOURI-KANSAS CITY
SCHOOL OF NURSING AND HEALTH STUDIES
On-line RN-BSN Program
Enhance Your Professional Development & Growth
The Ideal Candidate to the RN-BSN Program is someone who:
 Desires to examine today’s health care issues and explore the future challenges that await the
nursing profession.
 Meets admission criteria of 2.5 GPA (Students can be conditionally admitted with a min. GPA of 2.0).
 Is able to balance a challenging academic work load with professional / personal responsibilities.
o Students who work > 12 hours/week may consider part-time study
o Students who work < 12 hours/week may consider full-time study
 Wants to engage in intellectual and professional dialogue with peers, instructors and colleagues
in order to broaden professional development.
Key Points:
•
This is an online program so at no time is the student required to come to campus.
•
Students engage in distinctive team-directed practice experiences.
•
Most students transferring in only need 11-12 classes to earn their BSN.
•
Full-time plan of study can be completed in 4 semesters (see page 7) and flexible part-time
plans of studies are also available, including the option of taking one class per semester.
•
Start times are year round but N481, N482, N483, and N484 are taken one at a time and
offered during specific semesters.
•
UMKC support services are available to all distance education students.
•
All students are assigned an Academic Advisor and Faculty Mentor.
•
Peer mentoring is available by senior RN- BSN students.
2
Course Requirements
56 credit hours by graduation = must be General Education (GE) Credit Hours
Yes, it’s true! Technically, there are no prerequisites to begin the program. Of these
56 credits there are only six ‘specific’ general education classes required prior to
graduation (see below for details). A grade of ‘C’ or higher is required for them. If
items 1-6 (below) are not found on your transcripts, they will automatically be added
to your Plan of Study.
The following class is a prerequisite to N-481
1. English Composition I (No CLEP is accepted for English Composition I or II at
UMKC).
The following class is a pre/co-requisite to N-482.
2. English Composition II
The following two courses may be completed at any time prior to graduation and
UMKC offers an online section during certain semesters, however prior students
recommend taking them at the community college before entering UMKC:
3. Philosophy – any three credit hour course from the Philosophy department.
4. History or Political Science - a three credit hour course with a ‘Constitution’
component.
The following two courses are already included on your Plan of Study unless
there are equivalent courses listed on your transcript:
5. N345 - Quantitative Analysis in the Health Sciences (Statistics)
6. N395- Pathophysiology
-Most RN programs include a lower division (100s or 200s level) ‘Health
Assessment’ course but on rare occasions, upon advisor review, it can serve as an
equivalent to the N401 which is an upper division (300s or 400s) course.
-If transferring general education credits do not total at least 56 credits (technically,
the total must be 50 credits since N345 and N395 will count for six of the 56
credits), then your personalized Plan of Study will include “upper division general
education hours” on it.
-If you have already earned a bachelor’s degree from a regionally accredited college,
you are exempt from the first four general education classes above.
-No transfer work will be accepted within the last 30 credit hours of the BSN
degree.
64 credit hours by graduation= must be Nursing Credit Hours
A maximum of 28 lower division nursing credit hours can be transferred from prior
nursing course work and then students will take the 36 UMKC nursing hours (N481,
N482, N483, N484, N485, N486, N476, N401, N326).
120 credit hours required for graduation = the minimum to graduate with a BSN from UMKC)
3
CERTAIN STATE RESTRICTIONS: Each state has different registration and approval
regulations for online degree programs offered within their state. We are not approved to offer
online degree programs in all states. To see if you are eligible to apply to this on-line program,
please visit http://info.umkc.edu/online/state-authorization/. In addition, if you live in an
approved state but move to a different state before completing the program, and that state does
not recognize/allow UMKC programs, you will not be able to complete your program in that
state.
RN-BSN Completion Program
TUITION & FEES –
Everyone pays in-state tuition & fees! Plus RNs in this online
program are automatically given a break of $61.03 /cr hr. so instead of $362.03 per credit hour
(cr hr), the total is $301.00/cr hr. The following is the fee breakdown; $272.30/credit hour (cr
hr)= tuition for students regardless of where they live; $13.70/cr hr = Info Tech fee; $15.00/cr
hr. Additional fees: Even though this an all online program, since the group project for N485
& N486 may take place in the community setting, there is a Clinical Nursing fee of $187.20/cr
hr. Students are also charged for 1 clinical nursing hour for N401, as a portion of their class is
considered clinical lab. Each Fall semester a $15.00 fee is assessed to cover the cost of course
evaluations. Below is a list of the most common courses (based on Summer 2015 fees) which
totals $13,952.40. Each student is automatically allowed to make monthly payments for the
cost of their semester, please contact the Cashier for details 816-235-1365 (press 2). For
Financial Aid and Nursing Scholarships information see page 10.
1.
2.
3.
4.
5.
6.
3 cr
3 cr
3 cr
3 cr
3 cr
6 cr
N326 Applied Physiology = $903.00
N345 Quantitative Analysis in the Health Sciences (statistics) = $903.00
N395 Pathophysiology = $903.00
N476 Scientific Inquiry = $903.00
N401 Health Assessment = $1090.20
N481 Block I: Tools For Personal Effectiveness = $1806.00 (requires 8+ books)
(in most cases, this is one of the first classes students take in the RN-BSN program)
7. 3 cr N482 Block II: Tools For Interpersonal Effectiveness = $903.00
8. 6 cr N483 Block III: Effectiveness In Human Health Outcomes = $1806.00
9. 6 cr N484 Block IV: Effectiveness In Complex Health Systems = $1806.00
10. 3 cr N485 Application To Practice I = $1464.60
11. 3 cr N486 Application To Practice II = $1464.60
4
Application Deadlines: For Spring = November 1; For Summer = May 1; For Fall = June 15
Students can apply 9-12 months before their planned start date. Both applications and ALL transcripts
are to be submitted before the deadline. Applications are processed in the order they are received, so
earlier application means earlier access to enroll.
Enrollment Deadlines: Students must enroll themselves online in their classes. Due to the high popularity
of online courses it is highly recommended to enroll as early as possible by following their Personalized
Plan of Study precisely (emailed to them with their Acceptance Letter). Class enrollment begins in April
for Summer, May for Fall, and November for Spring.
FIVE EASY STEPS for applying to the On-Line RN-BSN Completion Program
1. Make sure you meet the admission requirements.
- Go to http://sonhs.umkc.edu/academics/bsn/rn-bsn/
- then scroll for the “Program Admission Requirements”
2. Choose which way you would like to fill out the UMKC Admissions Application for transfer
students: (application fee is waived for returning students who have completed at least 1 course)
a. Electronic application (try using Fire Fox instead of Internet Explorer):
https://umkc.umsystem.edu/psp/prdpr/EMPLOYEE/HRMS/c/UM_ADMISSIONS.UM_WEB_AP
P_LOGIN.GBL?AITS_HDR_CODE=3&IsFolder=false&campus=STNKCITY
$35.00 fee payable with a credit card
OR
b. Printable application: http://www.umkc.edu/admissions/docs/umkc_application.pdf
$45.00 fee payable by check
3. Do not send transcripts to the School of Nursing and Health Studies! Transcripts are to be sent from
every institution you have ever attended (however no high school transcripts are necessary) to either:
5100 Rockhill Road
AC – 120
Kansas City, MO 64110
( OR )
a faster way is to simply have your institution EMAIL
your Official Transcript to:
umkc-admtranscript@umkc.edu
4. Please mail the following 4 items to the mailing address listed below:
a. http://info.umkc.edu/sonhs/wp-content/uploads/2014/10/rn-bsn-app.pdf
(RN-BSN Supplement Application - see page 11 of this packet)
b. $20 Nursing Application Fee (application fee is waived for returning students)
(check or money order made out to UMKC School of Nursing and Health Studies)
c. http://info.umkc.edu/sonhs/wp-content/uploads/2014/10/pers-resp.pdf
(Personal Responsibility Statement- see page 12 of this packet)
d. Proof of your RN license showing the expiration date (go to the SBON website and print the page
that lists your name, license number, and expiration date). Please do not send a copy of your
license. In the event that you are preparing to soon take the NCLEX, you are expected to submit
proof of licensure before the first day of class to the School of Nursing and Health Studies.
5. You will be sent two Acceptance Letters; one via U.S. postal mail from the University, and one via
email from the School of Nursing and Health Studies which will include your Personalized Plan of
Study, instructions to enroll, and an immunization form (you allowed to have 90 days to return it).
Please feel free to call or email with your questions but I am able to respond faster to email.
It is a pleasure to be of further assistance.
Sincerely,
Lauren Klemmer
Academic Adviser for RN-BSN Program
klemmerl@umkc.edu
Phone: 816-235-6277
Fax: 816-235-6593
Mailing Address:
UMKC School of Nursing & Health Studies
Attn: RN-BSN Program
2464 Charlotte St.
Kansas City, MO 64108
Edited 09-11-15 lek
5
UMKC RN-BSN Program Course Descriptions: General Education & Nursing Credit Hours
NURSE 326
Applied Physiology 3 hrs A 300 level physiology course, and must be taken before N-395 (Pathophysiology).
NURSE 345
Quantitative Analysis In The Health Sciences 3 hrs This course focuses upon the skills required for the
utilization of scientific findings in evidence-based care. The conceptual basis of descriptive and the inferential statistics found in
the properties of the normal distribution, comprise the core of these skills. Using the normal distribution as a structure for
understanding descriptive and inferential procedures, the course presents information necessary to the selection, computation
and interpretation of basic statistics relevant to evidence based-care in the health sciences. Discussions of variables,
measurement and tabular and graphic presentation of data precede the development of computation skills.
NURSE 395
Pathophysiology 3 hrs This course will focus on alterations in biologic processes that affect the body's internal
homeostasis. A conceptual approach will be used to emphasize general principles of pathophysiology. The etiology,
pathogenesis, clinical manifestations, and sequelae of various alterations of human structure and function will be examined.
Knowledge from the basic and clinical sciences will be integrated.
NURSE 401
Health Assessment For Clinical Practice 3 hrs This course is designed to provide a systematic approach to
the physiological, psychological, socio-cultural and developmental assessment of individuals emphasizing findings considered to
be within normal limits. The health history is emphasized as a tool for assessing mental and physical status. This course is
designed for students with previous health care education, including knowledge of biochemical functions of systems and
concepts of normal. This course consists of guided self-study and on-site clinical practicum.
NURSE 476
Scientific Inquiry 3 hrs This course focuses upon the development of those skills necessary to apply research
finding to the evidence-based care of nursing. This application requires that students develop the skills to intelligently and
critically read and utilize current research literature. The specific steps in the research process. Including ethical issues, are
presented and discussed with emphasis upon the identification of quality research through critical analysis of research reports.
Pre or CO-Requisite: NURSE 345 or equivalent.
NURSE 481
Block I: Tools For Personal Effectiveness 6 hrs This is the first in the four-course sequence. The student will
discover that the foundation for professional nursing practice is personal effectiveness. Personal effectiveness is contingent upon
an understanding of the historical roots of the profession, the meaning of professionalism, image and power bases, professional
standards, moral development, political role socialization and professional values. Personal effectiveness is enhanced through
valuing and use of theory and research, critical thinking and decision-making, informatics' technology, the ability to manage time
and stress, and the use of a career plan and informatics.
NURSE 482
Block II: Tools For Interpersonal Effectiveness 3 hrs This is the second in the four-course sequence. The
student will discover that interpersonal effectiveness is a prerequisite to effective management of the care of humans and teams.
Interpersonal effectiveness is contingent in an understanding of professional care and caring, ethics in health care, legalities of
practice, communication theories and the dynamics of groups and teams. Interpersonal effectiveness is enhanced through the
use of such skills as conflict resolution and negotiation, managing change, marketing, team membership, group management,
political awareness, technology utilization and communication techniques. Content appropriate to these areas will be covered
within this course. Prerequisites: NURSE 481
NURSE 483
Block III: Effectiveness In Human Health Outcomes 6 hrs This is the third in the four-course sequence. It
builds upon the personal and interpersonal skills acquired in the first two block courses and focuses on effectiveness in human
health outcomes. The student will discover that effectiveness in human health outcomes is a primary goal in the delivery of an
optimum continuum of health care that encompasses health promotion, disease prevention and illness care across the lifespan.
Achieving effectiveness in human health outcomes across the wellness-illness continuum and the individual-to-community
continuum is contingent on acquiring an understanding of epidemiology, levels of care, communicable disease control, case
management, theories applicable to aggregate populations, cultural competence, evidence -based care and information
technology. Prerequisites: NURSE 482
NURSE 484
Block IV: Effectiveness In Complex Health Systems 6 hrs This is the final course in the four-course
sequence. Students will build upon the knowledge and skills acquired in the prior three course in order to examine the essentials
of structure and designs, behavior and culture, synergy, workplace diversity, health care finance, and power and politics within
complex health systems. Organizational theories, leadership, management and nursing's social responsibility in an emerging
global health care environment will also be explored. Prerequisite: NURSE 483
NURSE 485
Application To Practice I 3 hrs This course is the first of two clinical application courses designed to
complement didactic content from the four-course block sequence (NURSE 481-NURSE 484) Student will discover that the
knowledge they are acquiring in didactic course work can be immediately applied to practice. The students will integrate an
increasingly complex knowledge base with an emphasis on developing effectiveness: a) personally; b) interpersonally and ; c) in
the health management of populations if clients within the complexity of community based organization, practice settings, and
communities. Student cohort group-in collaboration with preceptors from community based organizations and faculty identify field
experiences, projects, and direct care experiences based on real need. The processes and outcomes of those experiences will
be collective and provide solutions for the health care community. Projects and experiences may therefore be complex,
extending across two semesters. Prerequisites: NURSE 481:Pre or Co-requisite: NURSE 482
NURSE 486
Application To Practice II 3 hrs This course is the second of two clinical application courses designed to
complement didactic content from the four-course block sequence (NURSE 481-NURSE 484). Working in cohort teams, the
students will apply new skills and knowledge to real issues and problems in the delivery of nursing care with an emphasis on
teamwork performance and action plan implementation, evaluation, and revision. The students will integrate an increasingly
complex knowledge base with an emphasis on developing effectiveness: a) personally; b) interpersonally; and c) in the health
management of populations of clients within complex community based organizations and faculty will further develop and/or
implement the approved NURSE 485 plan of action. The processes and outcomes of those experiences will be collective and
provide solutions for the health care community. Prerequisites: NURSE 483, NURSE 485. CO-Requisite: NURSE 484.
6
UNIVERSITY OF MISSOURI-KANSAS CITY
SCHOOL OF NURSING & HEALTH STUDIES
RN-BSN PROGRAM
For Summer Start
(may take one class per semester if desired)
Example Plan of Study
Full-Time Summer to Fall Plan
Part-Time Two Year Plan
Summer Semester (6)
N481 Tools for Personal Effectiveness (6)
Summer Semester (6)
N481 Tools for Personal Effectiveness (6)
Fall Semester (9)
N345 Quant. Analysis in the Health Sciences (3)
N401 Health Assessment (3)
N482 Tools for Interpersonal Effect. (3)
(this is an 8 week course October-December)
Fall Semester (6)
N482 Tools for Interpersonal Effect. (3)
N345 Quant. Analysis in the Health Sciences (3)
Spring Semester (9)
N326 Applied Physiology (3)
N483 Effectiveness in Human Health
Outcomes (6)
N485 Application to Practice I* (3)
Summer Semester (6)
N476 Scientific Inquiry (3)
Fall Semester (12)
N484 Effect. in Complex Hlth Systems (6)
N486 Application to Practice II*(3)
N395 Pathophysiology (3)
*Parts I & II of a student practice experience
Spring Semester (9)
N401 Health Assessment (3)
N483 Effectiv. in Human Health Outcomes (6)
Summer Semester (6)
N476 Scientific Inquiry (3)
N326 Applied Physiology (3)
Fall Semester (6)
N485 Application to Practice I* (3)
N395 Pathophysiology (3)
Spring Semester (9)
N484 Effect. in Complex Hlth Systems (6)
N486 Application to Practice II*(3)
*Parts I & II of a student practice experience
7
UNIVERSITY OF MISSOURI-KANSAS CITY
SCHOOL OF NURSING & HEALTH STUDIES
RN-BSN PROGRAM
For Fall Start
(may take one class per semester if desired)
Example Plan of Study
Full-Time Fall to Fall Plan
Part-Time Two Year Plan
Fall Semester (12)
N481 Tools for Personal Effectiveness (6);
(this is an 8 week course August - October)
N482 Tools for Interpersonal Effect. (3);
(this is an 8 week course October-December)
N345 Quant. Analysis in the Health Sciences (3)
Fall Semester (9)
N345 Quant. Analysis in the Health Sciences (3)
N481 Tools for Personal Effectiveness (6)
Spring Semester (12)
N483 Effectiveness in Human Health
Outcomes (6
N401 Health Assessment (3)
N485 Application to Practice I* (3)
Summer Semester (6)
N326 Applied Physiology (3)
N476 Scientific Inquiry (3)
Fall Semester (12)
N484 Effect. in Complex Hlth Systems (6)
N486 Application to Practice II*(3)
N395 Pathophysiology (3)
Spring Semester (6)
N476 Scientific Inquiry (3)
N482 Tools for Interpersonal Effect. (3)
Summer Semester (3)
N326 Applied Physiology (3)
Fall Semester (12)
N483 Effectiv. in Human Health Outcomes (6)
N485 Application to Practice I* (3)
N401 Health Assessment (3)
Spring Semester (12)
N484 Effect. in Complex Hlth Systems (6)
N486 Application to Practice II*(3)
N395 Pathophysiology (3)
*Parts I & II of a student practice experience
*Parts I & II of a student practice experience
8
UNIVERSITY OF MISSOURI-KANSAS CITY
SCHOOL OF NURSING & HEALTH STUDIES
RN-BSN PROGRAM
For Spring Start
(may take one class per semester if desired)
Example Plan of Study
Full-Time Spring to Spring Plan
Part-Time Two Year Plan
Spring Semester (12)
N345 Quant. Analysis in the Health Sciences (3)
N401 Health Assessment (3)
N481 Tools for Personal Effectiveness (6)
Spring Semester (9)
N345 Quant. Analysis in the Health Sciences (3)
N481 Tools for Personal Effectiveness (6)
Summer Semester (6)
N482 Tools for Interpersonal Effectiveness (3)
N326 Applied Physiology (3)
Fall Semester (12)
N395 Pathophysiology (3)
N483 Effectiveness in Human Health Outcomes(6)
N485 Application to Practice I* (3)
Spring Semester (12)
N476 Scientific Inquiry (3)
N484 Effect. in Complex Hlth Systems (6)
N486 Application to Practice II*(3)
*Parts I & II of a student practice experience
Summer Semester (6)
N482 Tools for Interpersonal Effectiveness (3)
Fall Semester (6)
N483 Effectiveness in Human Health Outcomes(6)
N326 Applied Physiology (3)
Spring Semester (6)
N395 Pathophysiology (3)
N485 Application to Practice I* (3)
N401 Health Assessment (3)
Summer Semester (6)
N476 Scientific Inquiry (3)
Fall Semester (9)
N484 Effect. in Complex Hlth Systems (6)
N486 Application to Practice II*(3)
*Parts I & II of a student practice experience
9
Financial Aid
http://www.sfa.umkc.edu/site2/
TOPHER SHORT SHORTCH@UMKC.EDU
816-235-6781
-------------------------------------------------------------------------------------------------------------------------------
Nursing Scholarships
http://sonhs.umkc.edu/affordability/scholarships/
http://www.aacn.nche.edu/students/financial-aid American Association of Colleges of Nursing*
www.aacn.org American Association of Critical-Care Nursing*
http://aamn.org/ American Assembly for Men in Nursing
www.aigc.com American Indian Grad Center*
www.aftercollege.com/content/article/aftercollege_aacn_scholarship/7610713/ AfterCollege/AACN
https://www.ajj.com/ -Anthony J. Jannetti Inc.
http://www.usphs.gov/student/ U.S. Dept. of Health and Human Services*
http://bpwfoundation.org/ Business and Professional Women/USA*
www.btllf.org Trinity Lutheran Hospital School of Nursing Alumnae Nursing Scholarship Fund
www.dar.org/natsociety Daughters of the American Revolution
http://health.mo.gov/living/families/primarycare/healthprofloans/ Dept. of Health and loan forgiveness*
http://www.discovernursing.com/scholarships#no-filters Discover Nursing*
www.ena.org Emergency Nurses Association*
www.fafsa.ed.gov Free Application for Federal Student Aid*
www.gkccf.org Greater Kansas City Community Foundation
www.hispanicfund.org Hispanic College Fund
www.hsf.net Hispanic Scholarship Fund*
http://www.libertyhospitalfoundation.org/ Liberty Hospital, Missouri
www.minoritynurse.com Minority Nurse scholarship search engine*
www.mlnmonursing.org Missouri League for Nursing (click on Scholarships from this site)*
www.modimes.org March of Dimes*
www.mopha.org/scholarships.htm Missouri Public Health Association Scholarships*
www.napnap.org Pediatric Nurse Practitioners
www.n-e-f.org Nurse Educational Funds, Inc., for Graduate Students*
www.nln.org National League for Nursing*
www.nsna.org/FoundationScholarships/FNSNAScholarships/UndergraduateScholarship.aspx National
Student Nurses’ Association*
www.rankinfoundation.org Rankin Foundation*
https://www.scholarshipamerica.org/talbotswomen/instructions.php Talbot’s
http://www.tylenol.com/news/scholarship Tylenol
www.umkc.edu/wcouncil/gaf UMKC Grad Assistance Fund
http://www.jkv.org/auxiliary/index.asp John Knox Village Auxiliary / 500 N.W. Murray, Lee’s
Summit, MO 64081/ 816-246-4343 x2865
Kansas City Area Healthcare Recruiters for Nursing /Healthcare Recruiters
MidAmerica Rehabilitation Hospital / 5701 W. 110th, Overland Park, KS 66062
Centerpoint Auxiliary Health Care Scholarship* / P.O. Box 2167 / Independence, MO 64055
Providence Health Service League Nursing Scholarship-Providence Medical Center
Helen Crilly Memorial Scholarship Committee / Providence Health Service League-Foundation Office
8929 Parallel Parkway /Kansas City, KS, 66112
10
UNIVERSITY OF MISSOURI-KANSAS CITY
SCHOOL OF NURSING AND HEALTH STUDIES
RN-BSN Program
Supplement to the Application for Admission
This application is ONLY for those currently an RN (or those who are soon to be an RN)
DEADLINE TO APPLY: For Spring = November 1;
Admission Requested For:
[ ] Fall
[ ] Spring
For Summer = May 1;
[ ] Summer
For Fall = June 15
Year: __________________
Name:
Last
First
Middle
Maiden/Former
Street/City/State/Zip
County (not country)
Home Phone: (
)
Work Phone: (
)
Cell Phone: (
)
E-Mail Address
Ethnicity (for statistical purposes & can be more than one race) _____________________________________
Name of Current Employer:
# Hrs Worked/Week:
Employer’s City/Zip/County:
Position/Title:
I anticipate attending courses:
[ ] Full Time (12+) cr. hrs /semester)
[ ] Part Time (6-11 cr. hrs /semester)
Financial Aid does not automatically cover Summer sem. [ ] Part Time (Summers off /6-11 cr.hrs /semester)
[ ] Very Part Time (3-5 cr. hrs /semester)
Are you a U.S. Veteran? _______ If yes, are you Active or Inactive? _______________
If you have a prior Bachelor’s Degree: Where?
When?________________
RN License Number
State
Expiration Date
Include proof of your RN licensure with this form; (go to the SBON website and print the page that
lists your name, license number, and expiration date). Do not send a copy of your license. In the event that
you are preparing to soon take the NCLEX, you are expected to submit proof of licensure before the
first day of class to the School of Nursing & Health Studies.
RN Education:
[ ] Diploma
[ ] Associate Degree
__
Institution
1.
2.
3.
State
Date Received
Waive my $20.00 fee because I have completed at least one UMKC course in the past.
How did you first learn that UMKC had this program? (Please be specific, i.e. the name
of the web site or the name of the person who told you, etc.)
Does your educational plan include Graduate Studies? If so, what program are you interested in
and what date would you like to start?
OFFICE USE ONLY: $20 Nursing Application Fee Received
09-11-15 lek
RN-BSN & GRADUATE PERSONAL RESPONSIBILITY STATEMENT
POLICIES & PROCEDURES
I read the UMKC School of Nursing and Health Studies Honor Code at http://info.umkc.edu/sonhs/wpcontent/uploads/2014/10/honor-code.pdf . As a professional, I understand and accept that it is my responsibility to become
thoroughly familiar with this document and to comply with the provisions pertaining to it. I understand that all statements in
the Honor Code are announcements of present policies only and are subject to change at any time without prior notice and
that they are not to be regarded as offers of contract. I understand that it is my responsibility to review the Honor Code each
semester so I am informed about updates and changes.
I also reviewed the UMKC General Catalog at http://catalog.umkc.edu/ , the School of Nursing & Health Studies
philosophy, mission, vision, and goals at About Us http://sonhs.umkc.edu/about-us/ and the UMKC School of Nursing &
Health Studies Policy & Procedures at http://info.umkc.edu/sonhs/wp-content/uploads/2014/10/policy-procedure.pdf . I
understand and accept that it is my responsibility to become thoroughly familiar with the contents of these pages and to
comply with the provisions pertaining to them. I understand that all statements in these pages are announcements of
present policies only and are subject to change at any time without prior notice and that they are not to be regarded as
offers of contract. I understand that it is my responsibility to review these pages each semester so I am informed about
updates and changes. Keep in mind that UMKC’s official means of communication is via UMKC e-mail.
CONFIDENTIALITY STATEMENT
I understand that during my clinical rotations I may have access to confidential information about clients, patients,
their families, and clinical facilities. I understand I must maintain the confidentiality of all verbal, written, or electronic
information and in some instances the information may be protected by law, such as the State of Missouri and State of
Kansas Nursing Practice Act. In addition, the client’s right to privacy by judiciously protecting information of a confidential
nature is part of the American Nurses’ Association Code for Nurses.
Through this understanding and its relationship to professional trust, I agree to discuss confidential information only
in the clinical setting as it pertains to patient care and not where it may be overheard by visitors and/or other patients. And,
during each clinical rotation in the nursing program, I agree to follow each agency’s established procedures on maintaining
confidentiality.
HIV/AIDS STATEMENT
I am a student/faculty/staff member at the University of Missouri-Kansas City School of Nursing. I have read the Centers for
Disease Control Standard Precautions. I acknowledge the importance of using the Centers for Disease control standard
precautions for all physical and invasive contact with clients and with students who serve in the role of client for learning
activities. I acknowledge full responsibility for implementing the Centers for Disease Control standard precautions. I also
acknowledge full responsibility for reviewing any updates concerning use of the Centers for Disease Control standard
precautions.
FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT
It will be necessary for faculty in cooperative and/or intercampus programs maintained by UMKC with other
colleges/universities to share educational records including but not limited to course information, student’s progress, GPA
and grades. My signature below will attest to the fact that I understand this and for these purposes waive my rights under
the Family Educational Rights and Privacy Act (FERPA).
NETWORK CONSENT
I hereby authorize The Curators of the University of Missouri, a public corporation, and those acting pursuant to its authority
to a) record my participation and appearance on video tape, audio tape, polycom, Wimba, film, photograph or any other
medium; b) use my name, likeness, voice and biographical material in connection with these recordings; c) exhibit or
distribute such recording using a private digital video network, or other mechanisms, in whole or in part without restrictions
or limitation for any educational purpose which The Curators of the University of Missouri, a public corporation, and those
acting pursuant to it’s authority, deem appropriate; d) To copyright the same in its name or any other name it may choose. I
hereby consent release use of and discharge The Curators of the University of Missouri, a public corporation, its successors
and assigns, its officers, employees and agents, and members of The Board of Curators, from any and all claims and
demands arising out of or in connection with the use of such photographs, film or tape, including but not limited to any
claims for defamation or invasion of privacy and in accordance with the terms stated above, pursuant to the consent
provisions of the FERPA, 20 U.S.C.1232 et.seq.
LICENSURE STATUS
I certify that all the information submitted with my application is complete and accurate. I also attest to the fact that my Nursing
License is unencumbered (not on Probation Status) and SHOULD IT BECOME ENCUMBERED at any time during the program I
will immediately disclose this fact to the Associate Dean and Program Director.
RELEASE OF INFORMATION
I give the School of Nursing and Health Studies at University of Missouri-Kansas City permission to release any information
requested by the health care agencies in which I may have clinical experiences. This information may include but is not
limited to my name, social security number, telephone number, health record information and disclosure of results from
background checks. Additional information may be released as requested by agencies.
I have read, understand and take responsibility for all the information stated herein.
________________________
STUDENT SIGNATURE
_________________________
NAME – PRINTED
________________________
________
SOCIAL SECURITY #
DATE