BALL STATE UNIVERSITY
COLLEGE OF APPLIED SCIENCES AND TECHNOLOGY
SCHOOL OF NURSING
GRADUATE PROGRAM APPLICATION
Today's Date
Name    
Address
City State Zip
Telephone (Home) (Work) (Cell)
E-Mail Fax


List nursing experience in reverse chronological order:
Employer Dates
(mm/yy - mm/yy)		 Job Title
1.
2.
3.
4.

For current employment, describe your role:

Education: List in chronological order all college-level institutions attended. Clearly indicate dates and degrees granted or to be granted.

Official name of institution Inclusive Dates
(mm/yy - mm/yy)		 City and State Degree and date granted
1.
2.
3.
4.

Was your baccalaureate nursing school accredited? Yes No

Are you a member of Sigma Theta Tau? Yes No

Select one of the following tracks:
    Leadership
   Education
   Administration

 Nurse Practitioner
    Adult
    Family
    Clinical Nurse Specialist

Post Master's Certificate
    Adult Nurse Practitioner
    Family Nurse Practitioner
    Educator

The following are requirements for admission to the Graduate Program in Nursing:
  • Graduate from a baccalaureate program, accredited by the National League for Nursing or the Commission on Collegiate Nursing Education, that included an upper-division nursing major.
  • Meet requirements for admission to graduate study at Ball State University

  • Have earned a minimum overall cumulative grade-point average (GPA) of 2.8 on a 4.0 scale OR upper-division GPA or 3.0 in the baccalaureate program.
  • Complete an undergraduate research course, 3.0 quarter/ 2.0 semester hours, with a grade of C or above.
          Undergraduate research course number


  • Evidence of completion of a physical assessment course (for clinical, nurse practitioner track).
         Undergraduate assessment course number

  • Hold current license as a registered nurse in the state of practice.
        RN License #
        State of Practice
        Expiration Date: (mm/dd/yyyy)
        (Send a photocopy of license)


  • Have evidence of training in standard (universal) precautions.   standard (universal) precautions.
  • Have evidence of CPR Training
    The following are requirements for progression in the Graduate Program in Nursing:
  • Have a minimum of one year of clinical experience before enrolling in clinical courses for new graduates.

  • Have recent clinical experience (three of the past five years) before enrolling in clinical courses for experienced nurses.

  • Health clearance is required for all clinical courses. Provide evidence of Hepatitis B immunization and Mantoux test or chest x-ray for TB.

  • Maintain a 3.0 (B) grade-point average (GPA).

References: List three professional references.
                      Provide ONE letter of reference.

Name Address Telephone
1.
2.
3.

Write a paper (about one page) 


Discuss your :
  • Philosophy of nursing (about two paragraphs),
  • Professional goals (about 1-2 paragraphs), and
  • Reasons for seeking a master's degree at Ball State University.

Certification: I hereby certify that I have not attended institutions of higher education other than those listed above, that the information is correct and complete, and that I will submit any other information deemed necessary by the School of Nursing.

 

Please print and send applications, RN license, supporting materials, and references to:

Dianne Parish
School of Nursing
Ball State University
Muncie, IN 47306