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School of Nursing Baccalaureate Admission Application for the Academic Year 2014-2015

IMPORTANT MESSAGE TO APPLICANTS APPLICATION PERIOD October 1 - November 30, 2013 Applications must be hand delivered to the School of Nursing office or postmarked no later than November 30th. Those postmarked after November 30, 2013 are considered late and will not be reviewed.

ELIGIBILITY REQUIREMENTS Applicants must meet the requirements as indicated in items 1-6 below to be eligible for academic year 2014-2015 admission to a nursing major. 1) Be a California Resident. Applicants to our APO programs for Registered Nurses are exempt from this requirement. 2) Be a current SF State student.

or Be eligible for admission to undergraduate studies at San Francisco State University. An application to the University must be submitted online via CSU Mentor at www.csumentor.edu for eligibility to be determined. IMPORTANT REMINDERS FOR SF STATE STUDENTS →Current SF State students who have earned 96 units or more may not apply to an impacted major. The School of Nursing is complying with this university policy. http://www.sfsu.edu/~admisrec/reg/academicplanning.html →SF State students who have not been enrolled for two or more full semesters must reapply to the University via CSU Mentor unless on a planned educational leave of absence. http://www.sfsu.edu/~bulletin/current/genpol.htm#ppg12

3) Have an All College GPA of 3.0 or higher at the time of application. 4) Have taken the nursing prerequisites (or comparable courses) noted below. A minimum grade of C is required.

No more than one of these courses can be in progress during spring semester/winter quarter 2014.

COURSE TITLE SF STATE COURSE NUMBER Written Communication (Please refer to SFSU Bulletin) Oral Communication (Please refer to SFSU Bulletin) Critical Thinking (Please refer to SFSU Bulletin) Quantitative Reasoning – Statistics Math 124 Human Anatomy with Lab BIOL 220 or BIOL 328 Human Physiology with Lab BIOL 212/213 or BIO 610/611 Survey of Chemistry with Lab CHEM 101/102 General Microbiology with Lab BIO 210/211

5) Must have completed all nursing prerequisite courses by the end of spring semester/winter quarter 2014.

Prior to beginning the application process, please take the time to thoroughly read this document to assure an accurate, complete application is submitted. Clarification questions can be directed to the School of Nursing reception desk. Failure to complete all steps and requirements as outlined below can disqualify the application. Hyperlinks and web sites are provided throughout this document to facilitate applicants’ understanding of the requirements and to assist with successfully submitting the application.

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6) BSN on-campus and Sequoia Hospital/SF State BSN at Cañada College applicants must have taken the Test of Essential Academic Skills (TEAS) version V. An ATI Academic Preparedness Level of “Proficient” or higher is required. Please be advised: Page 1 of the TEAS V Individual Performance Profile must be submitted with the School of Nursing

application. *Prior to but no later than November 30, 2013, an official electronic TEAS V transcript must have been

requested from ATI Testing (www.atitesting.com) and sent as follows: --SF State/Sequoia Hospital BSN at Cañada applicants- send to “San Francisco State U Cañada” --BSN on SF State campus applicants- send to “San Francisco State University”

*Applicants who take the TEAS V at the SF State Testing Center need not submit a TEAS transcript. However a physical copy of the Individual Performance Profile remains a requirement and must be submitted with the application packet.

APPLICATION INSTRUCTIONS AND GUIDANCE Follow the direction provided in Parts I, II, and III below to either select or type responses onto the application form. Print the application, sign & date it and then mail or deliver in-person to the address indicated on page seven. Handwritten applications are not acceptable.

A. Use the drop down menu to select the program to which you are applying. Please be advised:

An application can be submitted to only one nursing program per admission cycle. Registered Nurses without a bachelor’s degree must apply to the Advanced Placement Option (APO)

program; Registered Nurses who possess a bachelor’s degree can apply to an APO program or to our RN-MSN program via a separate graduate application process.

Ensure the nursing program selected on CSU Mentor corresponds with the program selected on this School of Nursing application. The information below will assist with the program selection process. Incorrect applications will not be reviewed.

If you are applying to: Then you Must select this program on CSU Mentor: Advanced Placement Option (APO) → Nursing (APO-RN) SF State/Sequoia Hospital BSN → Nursing (SEQUOIA HOSP NON RN) BSN on SF State campus → Nursing (NON RN) **Second Baccalaureate applicants select the respective "2nd BS" program option.**

B. Indicate whether you are a Currently Enrolled SF State Student, Accepted a Spring 2014 SF State Admissions Offer, a Fall 2014 Transfer Applicant, or a Second Baccalaureate Applicant. B1. Currently Enrolled SF State students (or those who were eligible for Fall 2013 registration) indicate the number of earned units. This information can be found on the “Minimum Units Required for the Degree...” section at the end of your DARS report. SF State students who have 96 or more units should not submit this application as they are not eligible per university policy: Changing a Major for Senior With 96 or More Units: http://www.sfsu.edu/~admisrec/reg/academicplanning.html. B2. Currently enrolled SF State students (or those eligible for Fall 2013 registration) indicate their major.

C. Last name: indicate your legal name; if you have used other names please indicate those on line G rather than here.

D. First name: your legal name E. Middle name or initial: optional

PART I. PROGRAM SELECTION AND DEMOGRAPHIC INFORMATION

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F. Other legal names that you have used: please indicate marital names, previously used names so that we can be sure that all transcripts and information are appropriately recorded.

G. SF State ID number: Enter your SF State ID # here. If you are a student at SF State, you will have an ID number. If you are not currently a SF State student then an ID number will be assigned to you after submitting the CSU Mentor application. We therefore strongly recommend that you submit the CSU Mentor application prior submitting this School of Nursing application.

H. Demographic Information: this information is optional and is not used for candidate selection or as part of the admissions process but rather is helpful to the School, College and University in describing our students to others and for reporting aggregated data to state and national accrediting bodies. H1. Gender: Please select your gender. H2. Ethnicity: Please select your ethnicity and/or specify.

I. Mailing address: enter a complete address where mail can be sent to you in the months that follow. J. E-mail Address: provide us with an e-mail address that can be used to contact you in the months that follow. K. Phone: provide us with the phone number where you are most accessible (cell, home, or work).

PREREQUISITE GRID Enter the prerequisite course number and course title, the semester or quarter and year in which the course was taken, the school at which the course was taken, *the semester units, and grade for each prerequisite course onto the grid. For courses in progress enter “I.P”; for a course planned for spring semester or winter quarter 2014, indicate that accordingly. Tip: If you need a second line to list your courses please hold the shift key and hit enter while in the box. * Quarter Units must be converted into semester units. A Unit Converter tool is available on the following web page: http://www.sfsu.edu/~gradstdy/unit-converter.htm TRANSCRIPTS It is important that transcripts are received in a timely manner to facilitate determining your eligibility for undergraduate studies at SF State. All transcripts, including those containing fall 2013 grades, must be sent to the SF STATE OFFICE OF UNDERGRADUATE ADMISSION immediately upon their request but no later than FEBRUARY 10, 2014. You will not be notified when the University has received your transcripts but can check using the SF State Admission Status service on the SF State Gateway. It is your responsibility to assure transcripts are received in a timely manner as requested by the SF State Office of Undergraduate Admission. Do not send transcripts directly to the School of Nursing.

PART II. PREREQUISITE COURSEWORK AND TRANSCRIPT

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The following supplemental criteria will be considered by the Nursing Admissions Committee.

A. Health-related work or volunteer experience (BSN on campus and SF State/Sequoia Hospital applicants). This includes any experiences where you have worked directly with patients in any health-related organization (e.g. hospital, health clinic). **Verification on organization stationery must be included. CNAs, EMTs, & LVNs should include evidence of current certification or licensure and recent employment in addition to a verification letter.

B. Multi-cultural community experience (BSN on campus and SF State/Sequoia Hospital applicants). This includes any experiences where applicants have worked or volunteered with underserved or vulnerable populations. (E.g. homeless center, hospice, senior facility, etc.) **Verification on organization stationery must be included.

C. Bilingual or Multi-linguistic fluency (BSN on campus and SF State/Sequoia Hospital applicants). Self-reported/fill in the blank.

D. Live and/or work in the Sequoia Healthcare District (Atherton, Belmont, Menlo Park, Portola Valley, Redwood City, San Carlos, or Woodside) for at least two years. Include a utility bill, letter from an employer, or other supporting evidence containing your name and address (Sequoia Hospital BSN at Cañada applicants only).

E. Completed at least half the prerequisite units within the San Mateo County Community College District (Cañada College, College of San Mateo, or Skyline College). (Sequoia Hospital BSN at Cañada applicants only).

F. Letter of Intent for Sequoia Hospital. The agreement is on page 6 of this document. You must sign, date, and include it with your nursing application packet only if you are applying to the Sequoia Hospital BSN at Cañada program.

G. Advanced Placement Option (APO) applicants must indicate their California RN status and submit a copy of both sides of their current California registered nurse license. If you are not licensed in California please indicate when you anticipate receiving your RN license.

H. Applicant signature and date **Verification documentation must: 1) Explicitly indicate which supplemental criterion is being fulfilled. 2) Describe the organization. 3) Describe the specific volunteer or work activities performed. 4) Indicate the duration of the volunteer or work experience.

PART III. SUPPLEMENTAL SECTION AND ADDITIONAL MATERIALS

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SCHOOL OF NURSING BACCALAUREATE ADMISSION APPLICATION for the Academic Year 2014-2015 PART I. PROGRAM CHOICE AND DEMOGRAPHIC INFORMATION For Office Use A. Please select the program you are applying to.

B. SF State Student Status.

B1. If you are currently a SF State student, how many units have you earned?

B2. If you are currently a SF State student, what is your current major?

C. Last Name D. First Name E. Middle Initial/Name (optional) F. Other Names G. SF State ID # H. Demographic Information (optional)

H1. Gender: H2. Ethnicity

I. Mailing Address J. Email Address K. Phone Number

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PART II. PREREQUISITE COURSEWORK For Office Use

Prerequisites Course # and title

Semester or Quarter

Taken

School Semester Units

Lecture Grade

Lab Grade

Oral Comm./Speech

Written Communication

Statistics

Critical Thinking

Microbiology w/ lab

Anatomy w/ lab

Physiology w/ lab

Survey of Chemistry w/ lab

PART III. SUPPLEMENTAL SECTION AND ADDITIONAL MATERIALS

A. Health-related work or volunteer experience. (BSN on campus & SF State/Sequoia Hospital BSN only. If yes, then verification must be included.)

B. Multi-cultural community experience. (BSN on campus & SF State/Sequoia Hospital BSN only. If yes, then verification must be included.)

C. Bilingual or Multi-linguistic fluency. (BSN on campus & SF State/Sequoia Hospital BSN only. If yes, then indicate language(s); self reported.)

D. Live and work in the Sequoia Healthcare District for at least two years. (BSN Cohort at Sequoia only)

E. Completed at least half the prerequisite units within San Mateo Community College District.

(SF State/Sequoia Hospital BSN only)

F. Letter of intent for Sequoia Hospital - please see page 8.

(SF State/Sequoia Hospital BSN only)

G. Do you have a current California RN license? When will you receive your RN license?

(all Advanced Placement Option Programs)

H.

I hereby certify that all the information I have submitted in this application to support of my application for admission to the San Francisco State University School of Nursing is complete and true to the best of my knowledge and belief. I understand that knowingly providing false, incomplete or misleading information may be grounds for denial of admission or, if discovered after an offer of admission has been made, for withdrawal of the offer of admission or dismissal from the School of Nursing and San Francisco State University. Signature Date

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I agree that, in return for being admitted to the Sequoia Hospital/SFSU Baccalaureate Nursing Program at Cañada College (the Program), I will accept employment as an RN at Sequoia Hospital, Redwood City, California, if offered a full-time position there upon my graduation from the Program and my passing the NCLEX examination, and that I will not seek to terminate my employment at Sequoia Hospital for at least two years after beginning my employment there. Signature: Date:

SCHOOL OF NURSING

BACCALAUREATE ADMISSION APPLICATION SEQUOIA HOSPITAL LETTER OF INTENT

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The School of Nursing application and supplemental verification materials must be submitted at the same time, in one envelope. Your application packet must be hand delivered or postmarked no later than the application deadline. Retain a copy of the complete application packet for your records. Send the completed School of Nursing application to: Send official transcripts sent to: Nursing Admissions Committee San Francisco State University San Francisco State University Office of Undergraduate Admission, SSB 101 School of Nursing 1600 Holloway Avenue 1600 Holloway Ave, Burk Hall 371 San Francisco, CA 94132 San Francisco, CA 94132

ADVANCED PLACEMENT OPTION (APO) BSN APPLICANTS School of Nursing Baccalaureate Admission Application has been typed as per its instructions.

CSU Mentor application to SF State application has been submitted to the same nursing program as the one selected on this application by November 30, 2013.

Copy (both sides) of California RN license has been included. ALL OTHER BSN APPLICANTS

The School of Nursing Baccalaureate Admission Application has been typed as per its instructions.

Requested a TEAS V transcript to be sent from ATI Testing to the appropriate program as per instructions.

A copy of TEAS V Individual Performance Profile is included in the School of Nursing Baccalaureate Admission Application packet.

Letters of verification have been sent to the applicant, and are included in the School of Nursing Baccalaureate Admission Application packet (If fulfilling health or multicultural supplemental criteria).

Included the Sequoia Hospital Letter of Intent (Sequoia Hospital BSN at Cañada applicants only)

CSU Mentor application to SF State application has been submitted to the same nursing program as the one selected on this application by November 30, 2013.

ONE ENVELOPE APPLICATION SUBMISSION

APPLICANT CHECK LIST

Beginning October 14, 2013, an email will be sent once per week during the application period confirming School of Nursing Baccalaureate Admission Applications received the prior week. Due to necessary processing time, applications received on or after November 25th will receive confirmation on or around December 16, 2013.