SON - RN to BSN Nursing Application Form [doc]

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TO:
FROM:
Prospective RN to BS in Nursing Students
Deepika Goyal, Ph.D., RN, FNP-C
Advanced Placement Coordinator
Thank you for your interest in the RN to BS in Nursing Program at San Jose State
University. Enclosed you will find information about the Advanced Placement Program for
Licensed RNs. Currently, the RN to BS program accepts 60 students each Fall semester
The Valley Foundation
School of Nursing
only, the first 30 completed and eligible applicants will begin in Fall, the other 30 will begin the
One W ashington Square
San José, CA 95192-0057
Voice: 408-924-3131
Fax:
408-924-3135
Web: www.sjsu.edu/nursing
Applications for the Nursing major for fall are due during the November filing period.
Director:
Dr. Katherine Abriam-Yago
1. RN to BS in Nursing Application Form (see page 2)
nursing program the following spring but will take at least one university class in fall.
Applicants apply online to the university at http://www.csumentor.edu
Due to the Nursing office by March 4, 2016 for Fall 2016 Admission Cycle
2. Official transcripts from all schools attended
3. Copy of your Writing Skills Test (WST) results
4. Copy of your RN license (or permit)
5. Copy of your acceptance letter to SJSU
If you have a degree or have taken courses at a school outside the United States, you
should contact the Student Services Center (408) 283-7500 regarding eligibility and
assistance with the application process. We strongly urge you to attend one of the general
information and group advising sessions. Please see school of nursing website for
updated information session dates and times
Contact Dr. Deepika Goyal with questions after reading the information and attending an
information session. Phone: 408-924-3149 Email: deepika.goyal@sjsu.edu
.
Nursing Office for General Nursing Information:
(408) 924-3131
The California State University:
Chancellor’s Office
Updated 8-7-15 dg
SAN JOSE STATE UNIVERSITY
The Valley Foundation School of Nursing
RN to BS in Nursing Application Form
You must complete an SJSU application online at www.csumentor.edu AND submit a the
RN to BS Nursing application form (below) to the School of Nursing
Applicants must be 1) California residents; 2) have a valid California RN license/permit; 3) Meet SJSU
transfer requirements; 4) have a minimum overall GPA of 3.0; 5) have completed English 1A, Speech,
Statistics, Chemistry and Critical Thinking and any additional transfer requirements.
Application for Fall/Year
Name
Gender
Race/Ethic Background
Languages Spoken
Birth date (month/day/year)
____________________
SJSU ID#
SSN ____________________
Previous or Maiden Name(s)
Address
City, State, Zip
Home Phone
Work Phone
Email
Please list College(s) attended:
,
Application checklist:
Copy of RN license
Official Transcripts, all colleges attended
Copy of WST results
SJSU Acceptance Letter
Updated 8-7-15
,
Transfer Worksheet - Please Complete & Attach to Your Nursing Application
Transfer requirements. See http://artic.sjsu.edu/
Find your community college(s) under GE Breadth
Area
Area A: English Language
Communication & Critical Thinking
A1 Oral Communication
A2 Written Communication
A3 Critical Thinking
Area B: Scientific Inquiry &
Quantitative Reasoning
B1 Physical Science
B2 Life Science
B3 Laboratory Activity
B4 Mathematics/quantitative
reasoning (Statistics)
Area C: Arts & Humanities
C1 Arts
C2 Humanities
Area D: Social Sciences
D1 – D9 per your school
Area E: Lifelong Understanding and
Self Development
Area F: American Institutions
Updated 8-7-15
School
Semester/Quarter/Year
Course
Name
Grade
If you have previously attended SJSU please indicate Classes Completed below:
Area
School
Area R
SJSU
Area S
SJSU
Area V
SJSU
Area Z*
SJSU
Other
SJSU
Other
SJSU
Semester/Year
Course Name
Grade
Nursing 138 taken Sem 6 nursing prog
*Take any one of these courses to satisfy area Z: HPRF 100W, NUR 100W, KIN 100W, BIO 100W, RECL
100W, Psych 100W
Updated 8-7-15
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