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

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 own professional liability insurance.
        Malpractice Insurance? Yes No
        Insurance Company Name
        Policy #
        Expiration Date (mm/dd/yyyy)
        (Send a photocopy of insurance policy with expiration date)

  • Have evidence of training in standard (universal) precautions.   standard (universal) precautions.


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.

 

Send applications, RN license, supporting materials, and references to:

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