Accelerated (2nd Degree) BSN ProgramApplication

Accelerated (2nd Degree) BSN Program

Application

Nursing Department

ASU West Campus, Building L

2400 Gillionville Road

Albany, GA 31707

(229) 500-2329

Application Periods

• Fall Semester – January 1 through June 1

University Admission Acknowledgement:*

I certify that I have received confirmation from the Office of Admissions that I have been accepted into Albany State University in good standing.

Yes

Semester for which you are applying:*

Include semester AND year.

Ram ID:*

Applications are not accepted without a verifiable student ID.

Last Name:*

First Name:*

Middle Initial:

Maiden Name

Pronouns (select all that apply):*

He/Him

She/Her

They/Them

Other

If “Other” was selected above, please specify:

Permanent Mailing Address (Street, City, State, Zip):*

Student Email Address:*

Personal Email Address:

Cell Phone Number:*

Home Phone Number:

Work Phone Number:

TEAS Exam Score:*

TEAS Testing Date:*

TEAS Acknowledgement 1:*

I certify that my TEAS scores are above 70.0% and was attained within no more than two (2) attempts within 12 months of today’s date.

Yes

TEAS Acknowledgement 2:*

I have attached a copy of my Individual Performance Profile (i.e., TEAS results) to this application and (if taken at a non-ASU testing center) have transferred my official scores to Albany State University via a TEAS Transcript.

Yes

Institution from which baccalaureate degree was earned (name and address):*

Is the above institution a part of the University System of Georgia?*

Applicants who have graduated from an institution outside of the University System of Georgia (USG) may be required to complete additional Core coursework in order to satisfy graduation requirements mandated by the USG.

Yes

Graduating GPA:*

Graduating GPA Requirement Acknowledgment:*

I certify that my graduating GPA was above 3.00 (with no rounding) and understand that coursework completed after graduation can not be factored into this GPA.

Yes

Background Check Acknowledgement*

Please be aware that students are subjected to compulsory background checks per clinical agency requirements. If a site refuses to allow a student to attend clinical experiences, the nursing program is not obligated to find another clinical site, and the student will not be able to complete the nursing program at ASU. Therefore, it is important to conduct personal record checks prior to admission to the nursing program.

I understand

Application Submission Acknowledgement:*

I certify that the information on this form is true, correct, and complete, and I understand that intentionally providing false, incorrect, or incomplete information may disqualify me from program consideration. Additionally, I understand that completion of this application packet does not in itself grant admission to the nursing program and that I must submit another application to the nursing program if I am not selected for the indicated semester.

Yes

Today's Date:*

Electronic Signature:*

Required Documents

File Attachments:*

Attach a copy of your TEAS exam results and your LPN/paramedic certification/licensure (if applicable).

Drag and drop files here or

Personal Identifiable Information (PII) Notice:

All personal data and special categories of sensitive personal data collected or processed by Albany State University (ASU) must comply with the ASU Cybersecurity Program Plan, as authorized by the Board of Regents Policy Manual Section 10.4 Cybersecurity:

https://www.usg.edu/policies

Anyone suspecting his or her sensitive personal data has been exposed to unauthorized access, report your suspicion to:

LegalAffairs@asurams.edu

Otherwise, questions concerning GDPR can be forwarded to LegalAffairs@asurams.edu. Typing your name in the box below and submission of this application provides consent to and acknowledgment of the ASU Data Security and Privacy Policy.

Please check the box below to indicate that you have read and understood the PII policy above.

Personal Identifiable Information (PII) Consent:*

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