RN to BSN Nursing Public Pathway Granite State College (GSC) has partnered with the Community College System of New Hampshire (CCSNH) to build an affordable pathway to a Bachelor of Science in Nursing (BSN). Students with an Associate Degree in Nursing (ADN) from a CCSNH institution are eligible for this pathway. This affordable option allows students to remain at or return to a CCSNH institution to take third year courses toward the BSN degree program and conclude their fourth year studies, including all NUR courses and CRIT 502, at Granite State at a reduced tuition rate for in-state residents. Begin by completing this form and submitting it to the Admissions Office at the CCSNH institution. Review the Specific coursework you will need to complete at https://www.granite.edu/degree- programs/bachelors-degrees/cssnh-nursing-partnership/. In addition to submitting this form to the CCSNH institution, you must also complete an application to Granite State College; this application is available online at: https://www.granite.edu/become-a-student/apply-now/undergraduate-apply-now/. Student ID: ____________________________________ Last Name: ____________________________________ First Name: __________________________ Middle Initial: ______ Former last name(s) if any: _____________________________________ Mailing Address: _______________________________________________________________________________________________________ Street City State Zip Code E-mail address: ______________________________________________________________________________________ Primary phone number: ________________________ Alternate phone number: ________________________ Birthdate (MM/DD/YYYY): ________________ CCSNH Institution where ADN was or will be completed: Anticipated Completion of ADN (Month/Year): __________________ Entry term for 3rd year at CCSNH: __________________________ Anticipated start term at GSC: _____________________ (Example: Fall 2017) (Example: Fall 2017) In order to be fully admitted to the BSN degree program at Granite State College, students must successfully graduate with the Associate Degree in Nursing (ADN) with a CGPA of 2.00 or higher and pass the NCLEX-RN Licensing examination. Conditionally admitted students who have not yet submitted proof of conferred ADN and passed the NCLEX-RN may only take non-NUR courses and NUR 602 and may not proceed with other NUR courses until they have an active R.N. license. Students who have completed a CCSNH ADN program, satisfy the admission requirements described above, and are eligible for New Hampshire residency for tuition purposes will receive the discounted tuition through this partnership as long as they remain in good academic standing and retain that residency status. Students who have previously completed a Bachelor’s or Master’s degree in another field will not need to take the third year courses; those students will be required to only take the 30 credits of NUR courses and CRIT 502: Conducting Critical Inquiry at GSC and MATH 504: Statistics (if not satisfied in transfer). In addition to submitting this form to the CCSNH institution, you must also complete an application to Granite State College to become dually enrolled; this application is available online at: https://www.granite.edu/become-a-student/apply- now/undergraduate-apply-now/. If you completed college courses at a location other than the CCSNH institution listed above, it is your responsibility to request official transcripts from each previously attended college for your GSC application. Advisors from the CCSNH institution cannot determine transferability of 3rd year courses from other institutions to GSC; please consult with a GSC advisor for more details. Per the terms of this pathway, students seeking Financial Aid for the 3rd year general education courses being completed at a CCSNH institution must complete and submit this form to the Admissions Office and complete the FAFSA, listing the CCSNH institution’s school code. Financial Aid for 4th year courses completed at Granite State College will be awarded through Granite State and you may review that process at http://my.granite.edu/financial-aid. Though admission is on a rolling basis, it is recommended that students plan to apply at least 4-6 weeks prior to the start of the term for timely processing. The Community College System of New Hampshire (CCSNH) and the University System of New Hampshire (USNH) give all students, regardless of sex, race, color, creed or national origin, equal opportunity for admission and a quality education. The University System reserves the right to add, withdraw or revise any course, program of study, provision or requirement described herein. I authorize the Community College System of New Hampshire institution listed above to share educational records, including all official college transcripts, with the University System of New Hampshire institution up to the enrolling term indicated on the application. I understand that if I have completed any other college-level academic work that is credited toward my ADN from any other institution, I will also need to provide official copies of those transcripts to Granite State College. I agree to abide by all other conditions of the RN to BSN Pathway partnership between CCSNH and USNH. Applicant Signature: _________________________________________________ Date: _________________________ Great Bay Community College Lakes Region Community College Manchester Community College 320 Corporate Drive 379 Belmont Road 1066 Front Street Portsmouth, NH 03801 Laconia, NH 03246 Manchester, NH 03102 (603) 427-7605 (603) 366-5210 (603) 206-8100 NHTI, Concord’s Community College Nashua Community College River Valley Community College 31 College Drive 505 Amherst Street 1 College Place Concord, NH 03301 Nashua, NH 03063 Claremont, NH 03743 (603) 230-4011 (603) 578-8900 x 1528 (603) 542-7744 x 5322 White Mountains Community College 2020 Riverside Drive Berlin, NH 035770 (603) 752-1113 x 3002 OFFICE USE ONLY. Community College Authorization: This student has or will complete the ADN program as of the _______________________ term, and is eligible for the RN to BSN Pathway. Comments: _________________________________________________________________________________ Signature: ________________________________________________ Date: ____________________________ Entered on SAAADMS: ___________________________ Letter Sent: __________________________________ Entered on SGASTDN: ___________________________ Transcript Sent: _______________________________ .