Fillable Application for Admission: Accelerated LPN RN (NURS 135) (Southern University at Shreveport)

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Application for Admission: Accelerated LPN RN (NURS 135) (Southern University at Shreveport)

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Southern University at Shreveport
School of Nursing
610 Texas Street, Suite 500-D
Shreveport, Louisiana 71101
(318) 670-9641
Application for Admission: Accelerated LPN – RN (NURS 135)
Deadline for submission: March 1
st
(Fall Semester); August 1
st
(Spring Semester)
**Official transcripts from all colleges and universities previously attended must be sent to the
School of Nursing (See above address)**
Yes No
1. Have you taken the NACE I PN-RN Exam? ___ ___
2. Do you have an overall GPA of 2.5 or above? ___ ___
What is your current overall GPA? _________
Current GPA
3. Have you completed 12 credit hours at SUSLA? ___ ___
4. Have you obtained a grade of “C” or better in the following
pre-requisite courses or their equivalents? Science courses may
not be older than 5 years.
SCHE 110S: General Chemistry Lec ___ ___
SENL 101S: Freshman English I ___ ___
SENL 102S: Freshman English II ___ ___
SBIO 212S: Microbiology ___ ___
SBIO 221S: Human Anatomy & Physiology I Lec ___ ___
BIOL 222S: Human Anatomy & Physiology II Lec ___ ___
SMAT 121S: Pre-Calculus Algebra ___ ___
SMAT 131S: Finite Math ___ ___
SPSY 211S: Developmental Psychology ___ ___
Name ________________________________
Last First MI
Last 4 SS# ___ ___ ___ ___
Address _______________________________
Street
Date of Birth __ __ / __ __ / __ __ __ __
_______________________________
City State Zip
Ph# (Home) ________________________
(Cell) __________________________
Enrollment ____________________________
Semester/Year
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Yes No
5. Have you submitted official transcripts from all colleges and
universities attended to the Nursing office? ___ ___
6. Have you declared nursing as your major? ___ ___
7. Have you previously been enrolled in a nursing clinical course at
any other college or university? ___ ___
If yes, when was the last date of enrollment? ___________
Semester/Yr
8. Do you hold any other degrees? ___ ___
List degrees ______________
______________
9. Do you currently hold a health care license? ___ ___
List licenses held_________
_________
10. Have you ever had a license that was revoked, suspended
or restricted? ___ ___
11. Have you attached verification of current LA Practical Nursing license? ___ ___
12. Have you attached evidence of IV certification? ___ ___
13. Have you completed the attached essay? ___ ___
Applications will not be accepted unless the essay is attached.
**ATTENTION STUDENT ** Your application will not be considered unless the School of
Nursing has received all official transcripts and your score on the NACE I PN-RN Exam.
Revised 11/2019
___________________________________ ____________________________
Student Signature Date Submitted
___________________________________ _____________________________
Nursing Representative Signature Date Received
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Name____________________________________________________________
Essay
Answer the following question thoughtfully.
Please limit your response to 1-2 pages (typed, double-spaced)
Why have you chosen nursing as your career path?
Revised 11/2019
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Application for Admission: Accelerated LPN RN (NURS 135) (Southern University at Shreveport)

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Completed 17 September 2020

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