California State University, Fresno
School of Nursing
RN to BSN Application, Fall 2015
Name___________________ ________________________________ ________________
Last First Middle
Personal Email address (e.g., Gmail, Yahoo)__________________________________
Fresno State Email address_______________________________________________
SS#__________________ Fresno State Student ID #____________________
Where do you currently live?
____________________ _____________________ _________________ ______________
Street City State Zip Code
Permanent/Mailing Address_______________________ ____________ _______ _________
(If different) Street City State Zip Code
Cell Phone_(___)______________ Home Phone_(___)_________________
California Resident ___Yes ___No Permanent Resident County ________________
Person to be notified in Case of Emergency:
Name_____________________________________ Relationship_________________
Phone_(___)__________ Address_______________________________________
Are you currently employed as RN? _____Yes _____No
If YES, number of years________
____________________ ____________________ ________________ _________________
Place of Employment City/State Position Hours Worked/Week
CA RN license #___________________ Expiration Date___________
ATTACH A COPY OF CURRENT CA RN LICENSE (must be clear, valid, active)
Where did you receive your AS or AA in Nursing Degree?
____Fresno City ___COS ___West Hills Other School______________________
If LVN or CNA: License #____________ School ____________________ Year______
Military Status: ____Active Service ____Veteran _____Spouse of Veteran
(Attach proof of active status or copy of DD214)
Are you currently enrolled at Fresno State? ____Yes ___No
If NO, date university application submitted: ___/____/____
Current class level: ____Junior ___Senior ____Second Degree
First-time applicant to RN-BSN Program? ___Yes ___No
If NO, term/year of prior application(s)_______________
Previously or currently enrolled in another RN-BSN Program? ___Yes ___No
If YES, School__________________ Dates of Attendance____ to _____
Reason for leaving that program? __________________________________
Have you ever been dismissed from, disciplined, or placed on probation
by another nursing program or university? ___Yes ___No
If YES, attach a brief statement of explanation.
Honors & Awards___________________________________________________
Demographic Information Needed for Accreditation
This information is NOT used in determining your eligibility for admission. It is needed for reports
required by accrediting agencies. Your responses are appreciated, and any data reported by the
School of Nursing is in aggregate format only (no personal information about you is released).
Date of Birth____/____/_____ Gender_____
Ethnicity (check one):
___Alaska Native or American Indian
___Asian (not included in another category)
___Asian Indian
___Black, Caribbean or African-American
___Filipino
___Hispanic/Latino
___Native Hawaiian or Other Non-Filipino Pacific Islander
___White/Caucasian
___Two or More Races (please state)________________________________
___Other Race (please state)______________________________________
___Unknown Race and Ethnicity
Languages Spoken (other than English)__________________________________
Is English your first language? ___Yes ___No
If NO, list first language__________________
List of Colleges & Universities Attended
List ALL colleges and universities you attended, beginning with the most recent.
COLLEGE or UNIVERSITY
Attach ONE official transcript from
each college or university.
DATES ENROLLED
From Mo/Yr To Mo/Yr
MAJOR DEGREE
Date
Degree
Granted
Prerequisite Coursework
ALL Prerequisite Coursework must be completed before applying to RN-BSN Program.
PREREQUISITE
FRESNO STATE
COURSE**
COURSE
TAKEN
Course Name/#
UNITS
GRADE
WHERE
COMPLETED
TERM
/YEAR
English Composition*
ENG 5B or 10
Oral Communication*
COMM 3, 7, or 8
Critical Thinking*
PHIL 25 or 45
Statistics*
MATH 11 or PH
92
Anatomy with Lab
BIOL 64
Physiology with Lab
BIOL 65
Microbiology with Lab
BIOL 20
Chemistry with Lab***
CHEM 3A***
*These 4 courses meet CSU GE Foundation requirements (required for admission to Fresno State)
**Partial listing
***If your ADN program did not require Chemistry/Lab in RN curriculum, you may substitute an online
Chemistry without a lab.
Co-Requisite Coursework
CO-REQUISITE
FRESNO STATE
COURSE**
UNITS
COURSE
TAKEN
Course Name/#
UNITS
GRADE
WHERE COMPLETED
TERM
/YEAR
Ethics
PHIL 20 or 120
3
Social Sciences
SOC 1 or 2 or
ANTHRO 2
3
Psychology
PSYCH 10
3
**Partial listing
Personal Statement
Submit a separate one-page, typed statement of your reasons for choosing to complete your
BSN degree and your career goals upon completion (e.g., management position, further
education, nursing educator). Briefly discuss your expectations of time commitment and the
skills you believe are required for success in the RN-BSN program. Briefly outline how you
plan to make adjustments in your life in order to achieve this success. Use 12-point Times New
Roman font with one-inch margins top, bottom, and sides. This statement may be used in
awarding additional points; content, grammar, spelling, and syntax will be assessed.
Criteria for Admission
All applicants must:
1. Have a current, valid, and clear RN license
2. Be a graduate of a California BRN-approved regionally accredited ADN program
3. Live within the Fresno State service area.
4. Have completed all prerequisite courses with minimum 3.0 GPA
5. Have a cumulative 3.0 GPA
Additional points will be calculated for:
1. Graduate of Fresno City College, College of the Sequoias, or West Hills College ADN
program
2. Completion of all lower division coursework (e.g., A-E, co-requisites)
3. No repeats in Prerequisite coursework
4. No repeats in Nursing coursework
5. Be currently employed as RN or have graduated from an ADN program within the past 12
months
6. Veteran or spouse of veteran
7. Passing score on writing assessment
Applicants will be ranked by GPA (prerequisite, cumulative), and additional points earned on
secondary criteria listed.
SECONDARY CRITERIA USED
Per Impacted Status Designation
POINTS
(80 possible)
Graduate of Fresno City College, College of the Sequoias, or West Hills College
ADN program
15
No Repeats in Prerequisite Courses
10
No Repeats in Nursing Coursework
10
Completion of all Co-Requisites*
8
Completion of all Lower Division GE
8
Currently Employed as RN; Graduated from ADN Program Within Past 12 Months
6
Veteran or Spouse of Veteran
4
Passing Score on Writing Assessment (Personal Statement may be used)
4
*Partial points assigned if missing one course.
Admissions Checklist
_____Admission to Fresno State
You must have applied as an Undergraduate for Fall/15 admission to Fresno State by November 30, 2014
in order to be considered for admission in the Fall/15 RN-BS cohort. For second-degree students,
Postbaccalaureate applications for Fresno State can be found on www.mentor.org
and should be submitted
by the RN-BSN application deadline. We cannot consider any RN-BSN applicants who are not accepted into
the university.
_____Official Transcripts
One sealed, official, hard copy from each university or college attended since high school must be submitted
to Fresno State Admissions by the posted deadlines (see website). A second sealed, official, hard copy
from each must be included with the RN-BSN application by the March 31, 2015 deadline.
_____RN-BSN Application
Applications for Fall/15 are accepted from March 1
st
to 31
st
, 2015. The deadline for application submission
is March 31, 2015. Applications must be postmarked no later than March 31, 2015 or hand delivered to the
College of Health & Human Services Student Services Center, McLane Hall, Room 194 at the close of
business on that day. Applications must be complete and all required documents must be included. Late
or incomplete applications will not be accepted.
_____RN License & Driver’s License
A copy of your clear (no restrictions), valid, active California RN licensee must be submitted with your RN-
BSN application. A copy of your current California driver’s license must also be submitted.
_____CPR Certification
Submit a copy of your current American Heart Association CPR card.
_____Personal Statement
A one-page typed statement (12-point Times New Roman font, one-inch margins top, bottom, left, right)
must be submitted with your RN-BSN application. This should be comprised of your own writing and
thoughts, and should include:
Your reasons for choosing to complete the BSN at this time
Your career goals upon completion (e.g., do you want to move into management, go to graduate
school?)
Brief discussion of your expectations of the time commitment and skills that will be required for
success in this program
Brief explanation of the adjustments you plan to make in your life in order to achieve success in this
program
This statement may be used as the writing assessment in awarding points for additional admission criteria.
A panel of reviewers will assess content (writing skill, realistic expectations/adjustments), grammar, spelling,
and syntax.
Mail or deliver ALL required documents to:
California State University, Fresno
College of Health & Human Services
Student Services Center
RN to BSN Admissions
Mailstop MH-26
Fresno, CA 93740-8031
For questions, call College of H&H S Student Services Center counselors at (559) 278-5027.
You will be notified by April 15, 2015 that your application has been received. Letters of
acceptance will not be mailed out until June, 2015.
I affirm that I have carefully read and understand the information in this application. I further affirm that
all information provided on this application is correct and complete. I am aware that any inconsistencies
may lead to disqualification from admission to the program.
Signature of Applicant_____________________________________ Date__________
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