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Doctor of Nursing Practice
BSN to DNP
Application Packet
Mailing address for completed application packet:
Missouri State University
Department of Nursing
901 S. National Ave.
Springfield, MO 65897
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Dear Prospective BSN to DNP Student:
The Department of Nursing appreciates your interest in the BSN to DNP Doctor of Nursing Practice (DNP) program at Missouri State University (MSU). The University has been offering graduate programs since 1996 and we are pleased you are pursuing graduate
education. Doctoral education provides nurses with many exciting and rewarding opportunities. The BSN to DNP program prepares graduates for the Family Nurse Practitioner certification examination.
Our DNP program is focused on community leadership to improve health disparities. The program is offered for full-time study for registered nurses with a Bachelor of Science in Nursing Degree from an accredited institution and the department currently is pursuing CCNE accreditation for the DNP program. All graduate programs at MSU have been continuously accredited. The Family Nurse Practitioner program has a long history of success with a greater than 99% national certification first time pass rate since the program began.
The Department makes every attempt to accommodate the adult learner. Many of the courses are online; clinical courses are block scheduled for one day of on-campus classes. In addition, there will be two to three required on-campus visits for orientation and DNP project requirements during the program. Students are able to remain employed while completing the program. Grants and scholarships may be available to assist qualified full-time students.
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Missouri State University
BSN to DNP Doctor of Nursing Practice Application for Admission
Date of Application:______________
Mr. Mrs. Ms. Other_______ * Social Security # __________________________ Date of Birth__________________________
Legal Name (on RN License): Last______________________First_______________________ Middle Name___________Maiden____________ Preferred First Name:_________________ Suffix: (Jr, Sr, III, etc.)_______________
Address: ___________________________________________________________________________ (Street and Number) (City) (State) (Zip Code) State of Legal Residence: ____________
Primary Phone Number: _____-_____________ Home Mobile Work Secondary Phone Number: ____-____________ Home Mobile Work **E-mail Address:_____________________________________________________________ Citizenship: US Citizen International Permanent Resident/Resident Alien
Non-citizens must apply to the International Student Services Office Visa Status____________ *Your Social Security Number is optional for the application, however if you are admitted it is required for grants, scholarships, and financial aid.
**After submission of your application, check your email often for important updates on the application process.
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Degree Name of Institution DATE Graduated CUM GPA CCNE or ACEN (NLNAC) Accredited Yes/No BSN Other degrees or certificates
I. Provide RN license for each state in which you hold a current license.
State:___License Number________________Expiration Date:_________ Active Inactive State:___License Number________________Expiration Date:_________ Active Inactive State:___License Number________________Expiration Date:_________ Active Inactive State:___License Number________________Expiration Date:_________ Active Inactive
II. Have you ever had an action taken against your nursing license? Yes No
If yes, please attach separate documentation explaining the situation and resolution including date of action.
III. Have you ever been convicted of a felony, drug or alcohol offense, or action against another person? Yes No
If yes, please attach separate documentation explaining the charge, offense, and resolution including date of action.
Part B Specialization Information
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IV. Are you currently employed in any of the following settings? (Please check all that apply)
Community Health Center Migrant Health Center Homeless Health Care Public Housing Primary Care Rural Health Clinic State or Local Health Dept. National Health Service Corps Federal Qualified Health Center
Indian Health Service Ambulatory Practice Sites
Primary Care/Family Practice Physician Office None of the Above
V. Curriculum Vitae (CV):
Although a CV is required as part of the application, it is not a substitute for items on this application. Therefore, please do not reference the CV such as “See CV” etc. on this application. All blanks are required to be filled in.
VI. Attach a CV that includes the following information, in chronological order from most current to least current with dates:
All higher education institutions attended, including degrees earned Nursing work experience (time on job indicated in months)
o 1 year equivalent of full-time experience in nursing is required before the summer start
Other work experience Leadership experience Community service
A scholarly essay is a required part of your application. The essay length is 500-1,000 words. The reference format for the writing the essay is the APA format. See the following text. American Psychological Association. (2010). Publication Manual of the American Psychological
Association (6th ed.), Washington D.C.
Your essay will be evaluated for scholarly writing style, content, and APA format and will be utilized in the overall analysis of your application.
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1. You are applying to a Doctor of Nursing Practice Program. Compare and contrast this terminal degree with that of a Ph.D. in Nursing.
It is recommended that you view the DNP materials on the American Association of Colleges of Nursing (AACN) https://www.aacn.nche.educ website as a reference to your response for this question.
2. Describe your proposed DNP project and discuss how it will impact health and healthcare disparities.
Be prepared to discuss the following interview discussion topics:
1. Discuss your vision of being a leader in healthcare
2. Describe your plan for completing requirements of a doctoral level program
3. Identify your career goals and how the DNP program will help you achieve these goals 4. Identify and describe a DNP project topic that fits MSU’s focus on leadership in health
and health disparities in a vulnerable population
If accepted into the DNP program, I understand that classes are blocked one day a week on campus with additional courses online. I understand that there will be a mandatory on-campus orientation in June. The dates will be included on your acceptance letter. I further understand that failure to attend this orientation will result in my administrative withdrawal from the BSN to DNP program.
_______________________________________ _____________
Signature Date
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I authorize the release of information contained in this application to be used for the purpose of considering me for scholarship and traineeship funds and so that aggregate data concerning the Missouri State University may be compiled.
_______________________________________ _____________
Signature Date
I certify that the information provided is true and complete; I understand that withholding information requested, with the exception of information designated as optional, or giving false information may make me ineligible for admission and enrollment and may result in
termination from the program.
_______________________________________ _____________
Signature Date
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Missouri State University
BSN to DNP APPLICATION CHECKLIST
All required application items must be submitted together AT ONE TIME in a large
envelope to the MSU Department of Nursing.
Submit the application to the address on the front of this packet.
Initial that you have submitted each item in ONE envelope in the following
order:
____
Application checklist with your initials indicating completion
____
Completed BSN to DNP application
____
Curriculum Vitae (See requirements on page 3)
____
Scholarly Writing Sample (See Page 3)
____
Copy of RN license verification from State Board of Nursing Website
in every state for which you hold an active license
____
Proof of negative Tuberculosis (TB) status (within 1 year, renewed
yearly) or appropriate medical follow-up if positive
____
Evidence of Tetanus (TD) Vaccination (within 10 years, renewed
when expired)
____
Evidence of Vaccination (Series of 3) for, or immunity (by Titer) to,
Hepatitis B
____
Documented immunity to Measles, Mumps and Rubella by Titer or
MMR immunization as an Adult
____
Varicella (Chicken Pox), evidence of Titer, or Immunization Series as
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____
Evidence of Influenza (Flu) Vaccination (within 1 year, renewed
yearly)
____
Family Care Safety Registry
____
Evidence of current CPR certification: American Heart Association BLS
for Healthcare Providers
____
Three recommendations from Healthcare Professionals with a
Master’s Degree or higher that can address the applicant’s potential
as a clinician, leader, and scholar using the standardized DNP
reference form. Form available on MSU DNP Website
____
$50 Non-Refundable application fee – pay online at
https://commerce.cashnet.com/NursingDept
*Submit a copy of your paid receipt in your application packet
Pre-requisites:
____
Healthcare Informatics Course
Institution Taken__________________ Date________________
____
Multivariate Statistics Course
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Technology and Proficiency Requirements
By initialing below, you acknowledge that you are proficient or will become
proficient by the start of the program in the following computer skills:
____ Have access to a computer with an internet connection. Access to DSL or
cable connections are required. Do not rely on corporate computers for this
access as many times content will be blocked by a firewall.
____ Have basic web search and browsing skills (know what browser you are
using, understand how to open and close new browser windows or tabs,
and understand how to override pop-up blockers)
____ Have basic file management skills (create/locate/delete/move a file or
folder on your computer)
____ Understand various file formats (.doc, .docx, .pages, .wps, etc.) and able to
follow instructions on the type of file preferred by your instructor for the
course.
____ *Search for and obtain articles from online databases, the university library
and inter-library loan.
____ Be able to use Microsoft Office, iWork (Mac) or Open Office software to
create documents, spreadsheets or presentations, edit them, save them,
scan them, convert them to other formats as needed, print them and email
them as attachments or upload them to the *Blackboard
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