Accelerated BSN Application

Accelerated Bachelor of Science in Nursing
Please click here for the Accelerated Bachelor of Science in Nursing Application.

For questions, please contact Macey Carson at 740-826-6168

or maceyc@muskingum.edu.
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

CityState / Province

Postal / Zip Code
County
Phone (home):*

Area CodePhone Number
Phone (cell/other):

Area CodePhone Number
Email address:*
example@example.com
Employer:
Title/Occupation:
Work Phone:

Area CodePhone Number
How would you describe yourself?
Gender:

MaleFemaleNon-binaryPrefer not to answer
Ethnicity:

Hispanic/LatinoNon-Hispanic/Latino
Race:

American or Alaskan NativeBlack or African AmericanHawaiian or Pacific IslanderAsainWhite

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 740-826-8238
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.
Signature:*

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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