Nursing - DNP Program Application
School of Nursing DNP Application
The School of Nursing does not admit any students with pending citations, misdemeanors, or felony charged. You may apply again at a later time if you no longer have any pending charges. You must present case closed court document when applying to the School of Nursing. A letter from your lawyer is not sufficient; you MUST have case closed court documents.

Items with an * indicate a required field.
Today's Date *    
First Name *
Middle Initial *
Last Name *
Maiden or Former Name(s)
Address Line 1 *
Address Line 2 *
City *
State *
Zip *
Country *
Phone *
Email *
Are you nationally certified as a Nurse Practitioner? *  Yes
  No
Are you nationally certified as a Clinical Nurse Specialist *  Yes
  No
Are you nationally certified as a Midwife? *  Yes
  No
Have you completed a graduate level course in Statistics? *  Yes
  No
Have you completed a graduate level course in Nursing Research? *  Yes
  No
Have you completed a graduate level course in Health Assessment? *  Yes
  No
Do you have a pending citation, misdemeanor, or felony charge? *  Yes
  No
Have you ever been convicted of a misdemeanor or felony? *  Yes
  No
If YES, list what misdemeanor or felony and when: *
Have you ever been arrested or received a citation for any misdemeanor or felony charges? *  Yes
  No
If YES, explain. List Dates, Specific Charges, County/State, and Status of Charge(s): *
 
List Nursing Experience
Employer/Dates of Employment/Job Title #1
Employer/Dates of Employment/Job Title #2
Employer/Dates of Employment/Job Title #3
Employer/Dates of Employment/Job Title #4
Employer/Dates of Employment/Job Title #5
For current employment, describe your role: *
 
Education: List all college level institutions attended (most recent first). Clearly indicate dated and degrees granted or to be granted. Include any diploma and certificate programs completed.
Official Name of Institution/Inclusive Dates/ City & State/Degree and date granted (#1)
Official Name of Institution/Inclusive Dates/ City & State/Degree and date granted (#2)
Official Name of Institution/Inclusive Dates/ City & State/Degree and date granted (#3)
Official Name of Institution/Inclusive Dates/ City & State/Degree and date granted (#4)
Official Name of Institution/Inclusive Dates/ City & State/Degree and date granted (#5)
Was your master's program in nursing accredited? *  Yes
  No
List Professional Organizations to which you currently belong and indicate any office held in the past 5 years.
List any honors or awards received in the past 5 years.
Where did you hear about our DNP program? *
Have you submitted an application to the Graduate School? *  Yes
  No
Have you received notice from the Graduate School that you have been cleared for Graduate Studies at Ball State University? *  Yes
  No
---SIGN NAME HERE--- *

By typing my name above, I acknowledge and understand that in order for my School of Nursing application to be reviewed that, in addition to submitting the School of Nursing application and supplemental materials by the school of Nursing application cycle deadline, I must also apply and be cleared for graduate studies by the Graduate School by the School of Nursing application cycle deadline. (Please allow a minimum of 2-4 weeks to be cleared by the Graduate School once they have received all of the required materials.) If I do not meet all of the above requirements I will not be considered for admission into the Nursing Masterís Program. For information about the application cycle deadlines and the required supplemental materials for the School of Nursing please visit: http://cms.bsu.edu/academics/collegesanddepartments/nursing/academics/doctorateofnp/dnpadmissreq/dnpappproc