Bachelor of Science in Nursing

Bachelor of Science in Nursing Supplemental BSN Admissions Application For Licensed RNs Only

Complete and return this form to the UH Hilo Admissions Office, Office of Student Services, 200 W. Kawili St., Hilo, HI 96720-4091. Applications are due by January 15th for fall admission and October 15th for spring admission. Applicants will be notified by the UH Hilo School of Nursing via their primary email address regarding admission decisions. All forms related to this application can be found at www.uhh.hawaii.edu/depts/nursing or at the UH Hilo Admissions Office.

PERSONAL DATA

Name______SS#/Student ID______last first middle

Local Mailing Address______Zip Code______P O Box/Street City State

Permanent Address______Zip Code______P O Box/Street City State

Phone Number :______(H)______(W)______(C)

Email Address: Primary______Secondary______

Are you a resident of the State of Hawaii? Yes_____ No_____ If not, state of residency______

Ethnic Group______Gender: ____Male ____Female

(Admission to the Nursing Program is non-discriminatory. These questions are asked since various laws require statistical reports on ethnic origins of students.)

APPLICATIONS: Unless applicant is a current UH Hilo student, applicant must submit a UH Hilo Application for Admission before submitting this Supplemental BSN Admission Application. Only official transcripts submitted to the UH Hilo Admissions Office will be used for nursing admission decisions.

COMPLETION OF PREREQUISITE COURSES: All prerequisite courses must be completed prior to starting the nursing program. Applicants should perform a self-assessment using the BSN Basic Advising Checklist (available to download from the “forms” link on the nursing website) and attach a copy to this application.

LETTERS OF RECOMMENDATION: Two (2) letters of recommendation are required for each applicant. Letters should be from teachers or immediate supervisors who have no familial relationship with the applicant and can give a first-hand account of the student’s abilities. Letters must be attached to this application. Letters may be placed in a sealed and signed envelope for confidentiality, if preferred.

NURSE LICENSE: A copy of an active Hawaii RN license must be attached.

UH NURSING FACULTY ADVISING: Applicants should obtain academic counseling from a UH Hilo Nursing faculty adviser regarding their qualifications for admission within one semester prior to submitting the application. Applicants in Distance Learning remote sites should contact the University Center Counselor on their island. Please indicate the following:

Name of University Center Counselor:______Date of last contact:______

Name of UH Hilo nursing faculty adviser:______Date of last contact:______

BSN/Adm/RNtoBSN app Page 1 of 4 2014_jf PRIOR NURSING PROGRAM

Name of School______Degree/Certificate: ____AND ____Diploma* Year Graduated______School Nationally Accredited ____Yes ____No (If not nationally accredited applicant needs to submit course descriptions of all nursing courses)

*Graduates nursing programs which are not nationally accredited must take the NACE II in order to obtain college equivalency credits.

STATEMENT OF INTEREST

1. Explain in your own words why you are seeking a Bachelor of Science Degree in Nursing (BSN).

2. Describe how a BSN degree would facilitate your career goals.

BSN/Adm/RNtoBSN app Page 2 of 4 2014_jf Bachelor of Science in Nursing Letter of Recommendation

Letters should be from teachers or immediate supervisors who have no familial relationship with the applicant and can give a first- hand account of the student’s abilities.

______Applicant’s Name: Last, First, Middle Initial Student ID Number

______Mailing Address: P O Box/Street, City, State, Zip Code Email address

APPLICANT: Please check and sign in accordance with the Family Educational Rights and Privacy Act of 1974.

I ( ) herby waive ( ) do not waive my right of access to this letter of recommendation.

Applicant’s signature______Date______

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ TO WRITERS OF LETTER OF RECOMMENDATION:

We are particularly interested in the applicant’s ability to pursue nursing coursework and maintain successful academic standing in the Baccalaureate Nursing Program. Please mail the completed form to applicant named above. You may submit your Letter of Recommendation by placing the letter in a sealed, signed envelope. Please return this Letter of Recommendation so that the applicant can submit this application by the deadline of January 15.

I. Rate the applicant on each of the following items, using a five-point scale:

5-truly outstanding (top 10%); 4-superior; 3-above average; 2-average; 1-below average; N-inadequate knowledge to rate.

( ) Critical Thinking ( ) Writing ability ( ) Interpersonal Skills ( ) Oral expression ( ) Motivation and drive ( ) Emotional maturity and stability ( ) Scholarship ( ) Self-reliance and independence

II. How comfortable would you be with this applicant being your nurse? (Circle your choice.)

Very comfortable Somewhat comfortable neutral not comfortable

III. (Optional) Using a separate page or the back of this form, please express in your own words your assessment of the applicant’s particular qualifications for nursing. Briefly indicate the time period and nature of your contact with this applicant.

Date______Type Name______

Institution______Signature______

Address______Title______

Contact phone number(s) ______

Relationship to Applicant ______

BSN/Adm/RNtoBSN app Page 3 of 4 2014_jf Bachelor of Science in Nursing Letter of Recommendation