Graceland University

NURSING UNDERGRAD APPLICATION (BSN-RN)

Call 816-423-4675 or email lhale@graceland.edu with any questions.


PERSONAL INFORMATION
Please enter your full legal name:
Full First Name*
Middle
Last*

Preferred Greeting Name (Liz for Elizabeth, Bill for William, etc.)
Previous Last Name (Maiden name for example)
Other names

Email* (For example me@aol.com is a valid format.)

Confirm Email*

Home Address*



City*
State/Province*
Zip/Postal Code*
Country*
Home Phone* Example: 111-222-3333
Cell Phone Example: 111-222-3333
Citizenship*
Resident Alien* Yes No (If yes, a copy of your permanent resident card is required.)
Birth Country*

Birth Date: Month* Day* Year* Enter all 4 digits of the year
Gender* Male Female
Social Security Number (U.S.) or Canadian SIN Example: 111-22-3333

High School Graduation Year
Religious Preference
Social Networking Preference


ENROLLMENT INFORMATION
I plan to attend starting July of the year*


FINANCIAL AID

Please indicate if you are any of the following:
A Graceland University Employee
The dependent of a Graceland University Employee
A SkillPath Seminars Employee
The dependent of a SkillPath Seminars Employee
The dependent of a Community of Christ Appointee or World Church Employee


EDUCATIONAL DATA
List in chronological order ALL high schools and colleges you have attended.

I have a GED.
I was home schooled.

Name of Institution*
City, State/Province*
GPA* Date Graduated* (mm/yyyy) College hours earned

Name of Institution
City, State/Province
GPA Date Graduated (mm/yyyy) College hours earned

Name of Institution
City, State/Province
GPA Date Graduated (mm/yyyy) College hours earned

Name of Institution
City, State/Province
GPA Date Graduated (mm/yyyy) College hours earned

Please list the Nursing Programs you are considering, including Graceland.

How did you learn about Graceland University?

Why did you decide to apply to Graceland?


Licensure
Have you ever been licensed as a health care provider (R.N., L.P.N., R.R.T., etc.) in any state?
No Yes
List any licenses. Please be sure to include the state, the license number and the renewal date.


CONTRACT

I agree to support the rules and regulations of the University as specified in official publications.

I realize that this application becomes a part of my permanent record at Graceland.

Having completed this application to the best of my ability, I hereby request admission to Graceland University.

PLEASE NOTE: Other admission requirements, as listed in the university catalog, must be met before your application is considered complete. Please click here for information on additional admissions requirements.

APPLICANT'S NAME*


(Please click only once.)
* Required field

POLICY ON NONDISCRIMINATION

Graceland University does not discriminate against any student or prospective student on the basis of race, color, religion, age, sex, national origin, disability, or sexual orientation. We are a caring community dedicated to the physical, intellectual and spiritual well-being of each individual. Gracelanders join together to create an atmosphere of openness, mutual respect and diversity.