Graduate Nursing Admission Application - Fort Hays State University

Name:

Address:
City:
State:
Zip:

Home Phone:

Cell Phone:

Social Security #:

Email:

Currently licensed as an R.N.?
Yes No

State: Number: Expiration Date:

Do you have a B.S. in Nursing?
Yes No

BSN From: Year:
*Contact RN to BSN Advisor Stacy Prickett at (785) 628-4647 if you do not have BSN

Do you have a Master's degree?
Yes No

Master's from: Year:

Master's degree in:

List all previous post-secondary education starting with latest: (Master's, Bachelor's and all college coursework). Please have official transcripts forwarded to: Fort Hays State University, Graduate School, Picken Hall, 600 Park Street, Hays, KS 67601-4099.

Name of School(s)	Address(es)	Major(s)	Degree(s)/Date(s)

List your RN experiences starting with the most recent.

Name/Address of Agency	FT/PT	Years	Responsibilities

Have you taken the Miller Analogy Test (MAT)?

Yes No Score:
If yes, please send copy of your official score to Fort Hays State University, Graduate School, 600 Park Street, Hays, KS., 67601

Have you taken an (undergraduate) health assessment course?
Yes No

Course #: Title: Semester/Year:

From: Credit hours: Grade:

Have you taken an (undergraduate) statistics course?
Yes No

Course Number: Title: Semester/Year:

From: Credit hours: Grade:

Have you taken an (undergraduate) pathophysiology course?
Yes No

Course #: Title: Semester/Year:

From: Credit hours: Grade:

Submit evidence of 2,080 hours experience as professional nurse (provided by employers) to address listed below.
Graduate School Admission

IMPORTANT INFORMATION:

Refer to the Steps to Getting Started for further information concerning admission and progression through the MSN nursing program.
For Information please call: 785-628-4256

Submit application by:
February 1 for Summer and Fall admissions
September 1 for Spring admission

Academic Affairs

Application for Admission

Master of Science in Nursing (MSN) or Post-Master's Option

IMPORTANT INFORMATION: