DICKINSON STATE UNIVERSITY
Associate in Applied Science in Practical Nursing (AASPN) Program Application
(Application MUST be received in the Department of Nursing no later than February 1)
Name Date
Address
(street address) (city) (state) (zip)
Email Address DSU Empl ID Number
(if applicable)
Phone / Date of high school graduation or GED
(Home) (Cell)
Have you applied/been accepted to Dickinson State University (as required)? Yes No Pending
It is the student’s responsibility to keep current contact information on file in the Department of Nursing.
Incorrect contact information may result in delay or exclusion of admission to the program.
Your application will be considered INCOMPLETE and WILL NOT BE PROCESSED if the required
official evidence is not submitted WITH THIS APPLICATION.
I have included an official final or partial high school transcript which indicates:
High school cumulative minimum GPA of 2.25 (college supersedes high school); AND
High school Algebra (minimum of C); AND High school Chemistry (minimum of C)
TR Scholar Yes No
I have included an official college transcript which indicates:
College cumulative GPA of 2.25 (college supersedes high school);
College Algebra (minimum of C); AND College Chemistry (minimum of C)
I have included an official transcript of my GED scores which indicate:
GED Average Standard Score (minimum 145 or 450); AND
GED Math score (minimum 145 or 410); AND GED Science score (minimum 145 or 410)
1. I plan to request ADMISSION to the nursing program for Fall (academic year); OR
2. I plan to request READMISSION to the nursing program for Fall or Spring of the (academic year)
Please be advised all students admitted or readmitted to the programs are required to complete annual criminal
background checks (necessary for clearance for participation in clinical) & functional ability assessments.
All students who have previously attended any other college/university must submit copies of nursing course
syllabi to the Department of Nursing for consideration of course substitution.
List college/university attended & forward official transcript, (if not currently on file), to DSU Department of Nursing:
Mail application with required evidence to: Department of Nursing, Dickinson State University, 291 Campus Drive, Dickinson, ND 58601; OR
Attach application to email and send to: dsu.nursing@dickinsonstate.edu; OR Fax to 701-483-2524
If you have questions about the application, please contact the Department of Nursing at 701-483-2133 or 1-800-279-4295, x2133 5/12;4/14;7/16
PERMANENT RESIDENTS AND INTERNATIONAL STUDENTS ONLY
I have included an official copy of my TOEFL Test Scores (Test of English as a Foreign Language)
which indicate minimum required scores of:
Listening > 22 ; Reading > 22 ; Speaking > 26 ; and Writing > 24
