application master of science in nursing MSN Application 1

(1)

(2)

(3)

Graduate Application Procedures

Nell Hodgson Woodruff School of Nursing

Emory University

Applicants to the Nell Hodgson Woodruff School of Nursing at Emory University are considered for admission on an individual basis. The Admission Committee will not review an applicant’s file until all materials have been received by the Office of Admission and Student Services. The Committee’s decision to offer or deny an applicant admission to a program, or to request additional information before making a final decision, is based on the applicant’s complete record. Final acceptance into an academic program in the School of Nursing is contingent upon satisfactory completion of all prerequisite coursework. A final transcript must be submitted prior to enrollment.

Applicants are encouraged to submit self-managed applications: collecting all required materials, including sealed official transcripts and sealed letters of recommendation, and submitting them in a single envelope will expedite the processing and review of an applicant’s file. Applicants may contact the Office of Admission and Student Services at any time during the application process with questions or concerns. They may also view the status of their applications by accessing OPUS (www.OPUS.emory.edu), which is the Emory online student information system. Instructions on how to use this system will be sent to each applicant once the application form and fee have been received.

APPLICATIONS

n Applicants are encouraged to submit the application form, fee, essay, and recommendations online at www.nursing.emory.edu using the online

application.

APPLICATION DEADLINES

n The priority deadline for admission and scholarships is January 15 for summer or fall semesters and October 1 for spring semester. n Applications completed after January 15 or the October 1 deadline will continue to be reviewed on a space-available basis.

APPLICATION PROCEDURES

All MSN, RN-MSN and Post-Master’s applicants must submit:

n A complete School of Nursing graduate application form. The Office of Admission and Student Services can acknowledge receipt of other

materials once this form has been received.

n A $50 application fee in the form of a check or money order made payable to Emory University. This fee is nonrefundable and does not apply

toward registration fees. The application fee is only waived for those applicants who are currently attending Emory or Oxford College, or are current employees of Emory University or Emory Healthcare.

n Current RNs must provide one letter of recommendation from an academic or clinical instructor from their nursing program, one letter of

recommendation from a clinical supervisor; and one letter of recommendation from a nursing peer. An applicant who has not yet worked as a registered nurse may submit three letters of recommendation from his or her undergraduate clinical teaching faculty who have direct knowledge of his/her clinical skills.

n A statement of purpose describing personal and professional reasons for selecting nursing as a career. The statement of purpose is an

im-portant part of the application process. The Admission Committee members read it for content, grammar, and spelling. It should reflect the applicant’s own writing ability and interest in nursing. Additional information on the statement of purpose can be found on page 5 of the application form.

n Resume and/or CV including work experience, community service, leadership roles, and research opportunities. n A completed prerequisite information form (see page 7 of the application form).

n Official transcripts from each college or university attended, regardless of whether or not a degree was conferred, including a college transcript

indicating completion of a BSN degree from a school accredited by the National League for Nursing or the Commission on Collegiate Nurs-ing Education. Transcripts received become the property of the School of NursNurs-ing and can neither be given to the applicant nor transferred to another institution. The Office of Admission and Student Services must receive transcripts in an unopened envelope bearing the registrar’s official seal.

n Applicants will receive a request to schedule the required interview with a designated faculty member in their graduate specialty once all other

application materials have been received by the Office of Admission and Student Services. Phone interviews are available.

n Applicants must submit official scores on the Graduate Record Examination (GRE) or Millers Analogies Test (MAT) that are no more than

five years old. The GRE institutional code for Emory University is 5187 and the department code for the School of Nursing is 0610.

n RN-MSN applicants must provide proof of graduation (official transcript from registrar with degree information) from a National League for

Nursing or Commission on Collegiate Nursing Education accredited associate degree or diploma program in nursing.

n MSN-MPH applicants must submit a separate application to the Rollins School of Public Health (RSPH) and submit all required credentials.

(4)

Application Checklist

Complete in full the School of Nursing application form. Submit the $50 (U.S. dollars) application fee.

Submit resume or CV. Additional information regarding resume can be found on page 5.

Submit a statement of purpose. Additional information regarding the statement of purpose can be found on page 5 of the application form.

Submit three letters of recommendation. Additional informa-tion regarding the letters of recommendainforma-tion can be found on page 5 of the application form.

Submit one official transcript from the registrar of each college or university attended, whether a degree was earned or not.

Complete in full the prerequisite information section listed on page 7 of the application form.

Request official scores on the Graduate Record Examination (institution code: 5187; departmental code: 0610) or Miller Analogies Test be sent to the School of Nursing.

International Applicants Only

Request official scores on the Test of English as a Foreign Language (TOEFL) be sent to institution code 5187 (Emory University). This requirement is for non-native speakers of English only. Scores must not be older than two years. Request an official CGFNS credentials evaluation be sent to

the School of Nursing (only for internationally trained regis-tered nurses).

Submit a photocopy of green card or other paperwork indicating current immigration status.

(5)

Name

Last Name First Name Middle Name Preferred Name SSN

Address _______

Street Address Apt# City State Zip Code

Graduate Application

PERSONAL INFORMATION — Please type or print

Other Name(s) under Which Documents Might Be Received

Citizenship Status: U.S. Citizen Nonimmigrant alien (Visa type _______) Permanent resident alien

Refugee Asylee Other______________ (please explain) (Attach a copy of both sides of your I-94 or alien registration card.)

Will you be requesting a visa? Yes (If yes, which type?) ______________________________ No Do you currently hold a visa? Yes (If yes, which type?) ______________________________ No

Is English your first language? Yes No (If no, what language?) __________________________________________________ Language of College instruction (if not English) ___________________________________________________________________________

TOEFL score: Date Taken/Will be taking ______________/ ___________/ _____________ Score

Internet-based test (TOEFL score only needed if English is not your first language.)

Home Phone Number ___________________________________ Fax Number ________________________________________ Cellular Phone Number _________________________________ Email Address _______________________________________ Business Phone Number__________________________________ Birth Date __________________________________________

Month Day Year

Place of Birth___________________________________________ Country of Citizenship _______________________________________ City State

STATISTICAL INFORMATION

The following information is voluntary and refusal to provide it will not result in any adverse treatment. It will be kept confidential and will be used only in accordance with Title VI of Civil Rights Act of 1964.

Marital Status: Single Married Divorced Gender: Male Female

Ethnicity: Are you Hispanic/Latino? Yes No If yes, please describe your background _________________ ___________________________________________________________________________________________________________________ American Indian/Alaska Native Asian Black Not Specified/Unknown

(6)

EDUCATIONAL BACKGROUND

List in chronological order all colleges or universities that you have ever attended including all schools you are currently attending, regard-less of dates or academic performance or if the credit appears on another institutions transcript. List additional schools on a separate page.

College Name Location Attendance Degree Granted Date Received

From: mm/yy —To: mm/yy or Expected or Expected

TEST SCORES

Please provide the following information regarding your GRE or MAT test scores. Official Scores are required to complete the application. GRE Date Taken/Scheduled to Take Verbal Score Quantitative Score Analytic Score

MAT Date Taken/Scheduled to Take Raw Score Percentage for Major Percentage for Group

PROGRAM INFORMATION

Expected Entry Term: Fall 20___ Spring 20___ (Part-time Only) Summer 20____ (Part-time Only) I have previously applied to the School of Nursing: Yes (semester ______ year _____) No

Intended Degree Program: Master of Science in Nursing

Master of Science in Nursing/Master of Public Health (A separate application is required for RSPH)

RN-Master of Science Bridge Program (for Associate or Diploma Prepared RNs) Post-Master Certificate (Available in all areas except Emergency Nurse Practitioner) Please check desired MSN Specialty area:

Acute Care Nurse Practitioner* Pediatric Nurse Practitioner – Acute Care* Adult/Gerontology Nurse Practitioner Pediatric Nurse Practitioner – Primary Care Emergency Nurse Practitioner* Women’s Health/Adult Health Nurse Practitioner** Family Nurse-Midwife Women’s Health Care (Title X)

Family Nurse Practitioner Women’s Health Nurse Practitioner Nurse-Midwifery

*Effective fall 2012, enrollment in these specialties requires one year of professional work experience as an RN. **Pending fall 2011 approval, this program may be discontinued.

RN LICENSURE

Date of initial licensure __________/__________/__________ Are you licensed in Georgia? Yes No Have you ever had an RN license suspended, placed on probation or revoked? Yes No

If yes, please attach a statement explaining the circumstances.

(7)

NURSING EXPERIENCE

A minimum of one year of work experience as a registered nurse in, or related to, the selected specialty area is recommended. Applicants who have not completed one year of work as a registered nurse must submit an essay on the points listed below.

1. Describe the differences between beginning nursing practice and advanced nursing practice 2. Describe any previous experience that would substitute for clinical experience

STATEMENT OF PURPOSE

Please submit a typewritten single or double spaced essay, not to exceed two pages in length, addressing the points listed below. Your response will be regarded as confidential and you are encouraged to elaborate in each area thoroughly and openly. The essay is an important part of the application process. The Admission Committee members read it for content, grammar and spelling. It should reflect your own writing ability and interest in nursing.

I ATTEST THAT EVERYTHING IN THIS STATEMENT OF PURPOSE IS TRUE AND WRITTEN BY ME.

Please Sign __________________________________________________________________________________________________________ 1. Your accomplishments since completion of a basic nursing education

2. Your reasons for pursuing graduate study at this point in your career 3. Your reasons for choosing a particular specialty area

4. The expected contribution of the master’s degree to your personal and professional development 5. Leadership positions you have held and your own participation in community service activities/projects 6. Your intentions and goals after completing the MSN degree

RESUME AND/OR CV 1. EMPLOYMENT HISTORY

Please list any positions held since you began working, beginning with the most recent. 2. PUBLICATIONS

Please give evidence of any original work or investigation (thesis, article, published and unpublished research). List each item with title, date and place of publication.

3. ACTIVITIES AND HONORS

Please list your collegiate or community activities and designate any leadership positions that you have had as well as any honors that you have received.

LETTERS OF RECOMMENDATION

Please list three persons from whom you will request letters of recommendation. Current RNs must provide one letter of recommendation from an academic or clinical instructor from their nursing program, one letter of recommendation from a clinical supervisor, and one letter of recom-mendation from a nursing peer. An applicant who has not yet worked as a registered nurse may submit three letters of recomrecom-mendation from his or her undergraduate clinical teaching faculty who have direct knowledge of his/her clinical skills.

Name Title Phone Number Email Address Academic or Personal/Professional

(8)

CONTACT INFORMATION

Who or what influenced your decision to apply to the Nell Hodgson Woodruff School of Nursing at Emory University?

To what other nursing schools are you applying?

To the best of my knowledge, the information furnished in this application is complete, true and correct, and the statement of purpose is written by me. I understand that falsification or purposeful misrepresentation of my qualifications may result in the denial of my ad-mission application. I agree that if admitted to the Nell Hodgson Woodruff School of Nursing at Emory University, I will, during such time as I may be enrolled as a student, abide by all the rules, regulations, practices and policies of Emory University as they may be at the time of my admission or as they may be changed during my continuance as a student. I further agree to pay any fines or assessments that may be made against me for violation of campus traffic or safety rules, including parking, and for such charges to be added to my tuition and rent statements from Emory University.

Signature ______________________________________________________ Date ________________________

Emory University does not discriminate in admissions, educational program or employment on the basis of race, color, religion, sex, sexual orientation, national origin, age, disability or veteran/Reserve/National Guard status and prohibits such discrimination by its students, faculty and staff. Students, faculty and staff are assured of participation in University programs and in the use of facilities without such discrimination. The University also complies with all applicable federal and Georgia statutes and regulations prohibiting unlawful discrimination. All members of the student body, faculty and staff are expected to assist in making this policy valid in fact. Inquiries and complaints should be directed to the Equal Opportunity Programs Office, Emory University, Administration Building, Atlanta, Georgia 30322-0520.

Spouse, Guardian, or Life Partner

Name___________________________________________________ Employer__________________________________________________ Occupation______________________________________________ State of Residence___________________________________________ Address

Street Address Apt# City State Zip

College(s) attended and highest degree earned

Please list the names, relationship to you and years of attendance of any family members who have been students at Emory University.

(9)

PREREQUISITE INFORMATION

All applicants must complete the section below, indicating the completion of their prerequisite work as appropriate for their intended degree. All prerequisite coursework must be completed before enrolling in any of the nursing programs at the Nell Hodgson Woodruff School of Nursing. All courses subject to evaluation by the Office of Admission and Student Services.

MSN and MSN-MPH Applicants only please note, the following before filling out the form:

• Prerequisites will only be satisfied by courses where a grade of “C” or better was earned

• Health Assessment and Introductory Statistics are the only required prerequisites for MSN and MSN-MPH applicants

RN-MSN Applicants ONLY please note the following before filling out the form

:

• Prerequisites will be satisfied by courses where a grade of “C” or better was earned

• Humanities electives may include courses such as English, art, music or theatre appreciation, foreign languages, religion, or history • No general elective credit is given for pathophysiology, pharmacology, nursing, physical education, and courses such as applied art,

music, or theater

If you are applying to the RN-MSN program, please list the courses you have taken (or will take) to satisfy the following prerequisite

courses:

Check box Semester Taken # of

Subject: Science and Math Courses Course Number and Title if NOT taken (To be taken) Credits Grade

General Chemistry I or Organic Chemistry Introductory Statistics

Human Anatomy and Physiology I Human Anatomy and Physiology II

Microbiology

Subject: Social Sciences Courses (4 including 2 from the following list)

Human Growth and Development Introductory Psychology

Introductory Sociology

Introductory Anthropology

Subject: Humanities Courses

English Composition Humanities I Humanities II Humanities III

Subject: General Electives (Additional courses to bring total to 60 semester or 90 quarter hours)

Elective I Elective II Elective III Elective IV Elective V Check box Semester Taken # of

Subject: Nursing and Math Courses Course Number and Title if NOT taken (To be taken) Credits Grade

Health Assessment

(10)

(11)

Applicant Recommendation Form

Nell Hodgson Woodruff School of Nursing

Emory University

TO BE COMPLETED BY THE APPLICANT

Please complete this section and forward this form to your recommender. PRINT or TYPE

Applicant Name

Last First Middle

* Under the provision of the Family Educational Rights and Privacy Act of 1974, you may decide whether letters of recommendation written at your request are to be held confidential or whether they are to be available for your personal inspection. Please check one of the following statements and sign as indicated.

I expressly waive any rights I might have of access to this letter of recommendation under the Family Educational Rights and Privacy Act of 1974, or any other law, regulation or policy.

I do not agree to the waiver above.

Signature______________________________________________________________________________ Date _____________________ TO BE COMPLETED BY INDIVIDUAL SUBMITTING RECOMMENDATION

The above named individual is seeking admission to the Nell Hodgson Woodruff School of Nursing at Emory University. Your thought-fulness and care in furnishing the information requested are sincerely appreciated. Please feel free to complete the question areas or add any additional thoughts and comments on your official letterhead.

PRINT or TYPE

Name____________________________________________________________________________________ Title ______________________ Relationship to Applicant__________________________________Employer_____________________________________________________ Address

Street City State Zip Code

Work Phone Number _____________________________________________ Email _______________________________________________ General academic standing of applicant in relationship to other students of comparable age and status:

Upper 1% Upper 10% Upper 25% Upper 50% Unknown Please include strengths and limitations of the applicant in each of the following areas:

Interpersonal attributes (relationship with peers and authority figures)

(12)

Intellectual ability (conceptualization, ability to transfer and utilize knowledge in problem solving)

Maturity and judgment (decision making, setting priorities, dependability)

Leadership ability or potential (organization, time management)

Personal attributes that may promote or inhibit professional study (integrity, stability, sociability)

Recommendations for RNs only. Please comment on this applicant’s clinical nursing ability, including decision making, clinical expertise, innovation, and independence.

General comments: Please use the space below and/or additional pages to provide any qualifying or supporting recommendations that you wish to make.

Overall Recommendation

Highly Recommend Recommend Recommend with reservation Do not recommend

Signature _______________________________________________________________________ Date_______________________________

Please return in a signed and sealed envelope to:

NELL HODGSON WOODRUFF SCHOOL OF NURSING Emory University

Office of Admission and Student Services 1520 Clifton Road Atlanta, Georgia 30322 404.727.7980 or 1.800.222.3879

Fax: 404.727.8509 www.nursing.emory.edu email: [email protected]

(13)

Applicant Recommendation Form

Nell Hodgson Woodruff School of Nursing

Emory University

Applicant Name

Last First Middle

PRINT or TYPE

Work Phone Number _____________________________________________ Email _______________________________________________ General academic standing of applicant in relationship to other students of comparable age and status:

(14)

Signature _______________________________________________________________________ Date_______________________________

(15)

Applicant Recommendation Form

Nell Hodgson Woodruff School of Nursing

Emory University

Applicant Name

Last First Middle

PRINT or TYPE

Work Phone Number _____________________________________________ Email ______________________________________________ General academic standing of applicant in relationship to other students of comparable age and status:

(16)

Signature _______________________________________________________________________ Date_______________________________