Accelerated BSN Application

Accelerated Bachelor of Science in Nursing

Application for Admission
Name:*

First NameMiddle or MaidenLast Name
Any other name that may appear on your academic records:

First NameMiddle NameLast Name
Date of Birth:*

MonthDayYear
Date
Social Security Number:*
Home Address:*

Street Address

Street Address Line 2

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Postal / Zip Code
County
Phone (home):*

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Phone (cell/other):

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Email address:*
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Employer:
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Work Phone:

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How would you describe yourself?
Gender:

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Ethnicity:

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Race:

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If multi-racial, provide percentage for each category checked:

	Percentage
American or Alaskan Native
Black or African American
Hawaiian or Pacific Islander
Asian
White

Accelerated BSN

Application for Admission

Questions? Call 740-826-8038
College Transcript/Transfer Information

Please list all of the colleges you have attended:
College/University Name:
City/State:
Date Started:

MonthDayYear
Date
Date Ended:

MonthDayYear
Date
Degree Earned:
Major Program:
GPA:
I attended another college
College/University Name:
City/State:
Date Started:

MonthDayYear
Date
Date Ended:

MonthDayYear
Date
Degree Earned:
Major Program:
GPA:
I attended another college
College/University Name:
City/State:
Date Started:

MonthDayYear
Date
Date Ended:

MonthDayYear
Date
Degree Earned:
Major Program:
GPA:
I attended another college
College/University Name:
City/State:
Date Started:

MonthDayYear
Date
Date Ended:

MonthDayYear
Date
Degree Earned:
Major Program:
GPA:

Please submit the $20 non-refundable application fee (payable to Muskingum University) to Muskingum University, Graduate & Continuing Studies, 260 Stadium Drive, New Concord, Ohio 43762-1837.

Applications without a signature or $20 application fee will not be processed.
I certify that the information provided on this application is complete and correct to the best of my knowledge. I understand that I am responsible for arranging for the forwarding of official transcripts from schools I have attended, and that such transcripts become the property of Muskingum University and will not be returned.
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Sources of Consumer Information: Graduate academic programs and policies (including costs, fees, refunds, financial aid and accreditation) are described in the Graduate Catalog. Additional information about graduate programs is available from the Office of Graduate and Continuing Studies, and from program directors. Muskingum University, as an educational institution, does not discriminate on the basis of race, color, religion, sex, national or ethnic origin, handicap, physical challenge, disability, sexual orientation, socio-economic status and political affiliation.

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Accelerated Bachelor of Science in Nursing