Traditional ASN Program Application

Traditional ASN 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

• Spring Semester (Even Years Only) – June 2 through November 1

• Summer Semester – November 2 through April 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 65.0% 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

Prior Nursing Program Enrollment:*

Have you previously been admitted to a nursing program, whether at Albany State University or another institution?

Yes

If “Yes” was selected above, please specify the reason for program withdrawal:

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:*

Privacy Notice|Report Abuse

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.