Application


MSN – Family Nurse Practitioner (MSN-FNP)


MSN – Nurse Educator (MSN-NE)


MSN – Nursing Informatics (MSN-NI)


Post-Master’s Certificate – Family Nurse Practitioner (PMC-FNP)


Post-Master’s Certificate – Nurse Educator (PMC-NE)


Post-Master’s Certificate – Nursing Informatics (PMC-NI)


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 – June 2 through November 1


•    Summer Semester – November 2 through April 1

University Admission Acknowledgement:*


I certify that I have received confirmation from the Graduate School that I have been accepted into Albany State University in good standing.


Program for which you are applying:*
Program pathway for which you are applying:*

Applications are not accepted without a verifiable student ID.

Are you a Georgia resident?*
Citizenship:*


Provide employer name and address, position title, employment dates, whether you were part-time or full-time, and area of clinical experience.

Resume Attachment Acknowledgement:*


I have attached a current resume/curriculum vita alongside this application.


In which community type do you intend to practice after graduation?*
Professional Reference Acknowledgement:*


Please submit three (3) professional references. Provide the names of the individuals who you have requested to write a reference for you in the areas indicated below. Include the person’s name, title, and relationship to you. Good choices are employers, coworkers, and former nursing faculty. Avoid personal friends, classmates, and other individuals within Albany State University’s graduate-level program(s).


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.


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.


Required Documents


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.

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