Admissions Questionnaire

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Admissions Questionnaire for Doctor of Nursing Practice

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Please answer the following questions to aid the admissions committee in rendering a decision regarding your application for admission to 91��.

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Source

Program: {:42}
Name: {Name (First):2.3} {Name (Middle):2.4} {Name (Last):2.6}
Email Address: {Email:4}

Please provide your name*

First Middle Last

Please provide your date of birth*

Please provide the email address you used when applying for admission.*

Essay

In one or two paragraphs please discuss how do you envision the attainment of a Doctor of Nursing Practice (DNP) degree will elevate and transform your individual nursing practice, enabling you to lead and innovate within your specialized area of healthcare?*

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Additional Information

Have you ever had to withdraw from or been required to leave another nursing program?*

Yes

Have you ever been denied a nursing license or had one revoked in any state?*

Yes

Please indicate the state in which you intend to complete Practicum while completing your licensure program.*

Certification

Acknowledgement of Admissions Policy and Certification of Answers Given*

By checking this box and submitting this questionnaire, I certify that I have reported my grades to the best of my knowledge and understand that 91�� may use this information to determine my eligibility for admission prior to the receipt of my official transcripts at their sole discretion. I acknowledge that it is the policy of 91�� that all applicants must submit official transcripts from all colleges and high schools attended, and any decision of admission afforded to me does not change the transcript requirement. I understand that my official transcripts will be used to confirm all self-reported grades and other course information provided here, and any false statements made by me in the self-reporting of my grades may invalidate further consideration for admission or result in rescinding of the offer of admission, if applicable. I further certify that all of the responses in this questionnaire are my own work, without the assistance of others.

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