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Georgia Baptist College of Nursing
of Mercer University

Application for Admission Master of Science in Nursing Program

Directions:

Completion of the online application will be easier if you have the following information readily available.
* denotes fields that are necessary to complete the application.

Academic Background (dates of attendance, degree(s) awarded)
Information regarding any disciplinary actions
Standardized Tests (scores if available)

Enrollment Information
* Term of Application:	Spring Summer Fall
* Part Time or Full Time:	Full Time Part Time
* Area of Specialty:

Personal Information
* First Name:
Middle Initial:
* Last Name:
Maiden/Former Name:
* Street Address:
* City:
* State
* Zip/Postal Code:
	Please provide a 9 digit zip code.
Province:
* County:
* Country:
* Birth Date: (mm/dd/yyyy)
* Birth Place:
* Social Security Number: Do not use dashes(-)
Home Phone:
Cell Phone:
* Primary e-mail:
*Emergency Contact:	Name:
	Relationship:
	Phone:
Gender:	Female Male
Marital Status:	Married Single
Religious Preference / Denomination:

Ethnicity: Select one:	Hispanic/Latino origin Not of Hispanic origin
Race: Select one or more:	American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White Other
* Citizenship:	* Are you a U.S. Citizen? Yes No
	If not, what is your residency status?
	* Is English your native language? Yes No
	If not, please list native language:
	What is your country of citizenship?
	Are you in the U.S. under a visa; if yes, what type?

Professional Association
* Have you ever been inducted to Sigma Theta Tau International?	Yes No
* How many years have you worked as a professional registered nurse?

* Academic Background
* College/University Attended:	* City/State:	* Dates:	* Degree/Major:

An updated official transcript must be sent directly to Georgia Baptist College of Nursing of Mercer University from each school previously attended. International Students must have a third party translation of their transcripts. Mercer graduates need to submit only transcripts of work completed since graduation from Mercer University.

Transcript Credentialing Service for Non - US Degree
Have you requested that your international transcripts be evaluated by one or more of the following services?
Education Credential Evaluators (ECE) (www.ece.org)	Yes No
Joseph Silny & Associates (www.silny.com)	Yes No
World Education Services (WES) (www.wes.org)	Yes No
Please note that the Commission on Graduates of Foreign Nursing Schools (CGFNS) is NOT approved for the academic evaluation of international transcripts.
The College of Nursing Georgia Baptist College of Nursing of Mercer University does not require either a background check or drug screening for admission. Failure to be honest in the completion of the application question (below) regarding prior conviction may result in an honor code violation and could result in dismissal from the program.
Clinical Agencies As a graduate nursing student, you may be required to provide a criminal background report and/or drug screening, at your own expense, if required by the clinical agency to which you are assigned, with results reported directly to the clinical agency, not Mercer University faculty or staff. If the clinical agency finds the results of the drug screening or criminal background check to be unacceptable, Georgia Baptist College of Nursing may not be able to provide further educational experiences, which could impede the student´s progression and completion of the nursing degree.
* Criminal Background Information
* 1) Have you ever been placed on probation, dismissed, or suspended from any college or university for reasons pertaining to academic integrity?
Yes No
If yes, send a Personal Statement that includes all facts that you believe bear on the significance of this circumstance to Anderson_j@mercer.edu (Director of Admissions).
* 2) Have you ever been convicted of, or pled guilty or no contest to any felony or misdemeanor (excluding minor traffic violations)?
Yes No
If yes, please provide further information on a confidential basis by submitting an electronic response to Anderson_j@mercer.edu (Director of Admissions).

* Standardized Tests

* Have you taken the MAT? Yes No

* Have you taken the GRE? Yes No

Please provide a self-reported score to Anderson_j@mercer.edu (Director of Admissions).
Please request an official score report be sent as soon as possible to:

Nursing Admissions
3001 Mercer University Drive
Atlanta, GA 30341

If you have not taken the MAT or GRE, have you registered? Yes No

Anticipated Test Date:

Have you requested official scores be sent to Georgia Baptist College of Nursing of Mercer University?
Yes No

Have you taken the TOEFL? (International students only) Yes No
Date (MM/DD/YYYY)	Reading	Listening	Writing	Speaking	Composite

Official TOEFL results must be submitted directly from the Educational Testing Service.

ADDITIONAL REQUIREMENTS

An essay (300 words) is required for completion of your application:
Describe your professional goals and reasons for seeking graduate education.
Submit a resume or vitae.
Provide names and titles of three (3) professional references (at least one should be a master’s prepared nurse.) The list should be provided to Nursing Admissions.
Provide a copy of your current unencumbered professional registered nursing licensure.
You may email items listed above to nursingadmissions@mercer.edu or submit them by mail.
Nursing Admissions
3001 Mercer University Dr.
Atlanta, GA 30341
Submit official transcripts from each college or university attended; these should be mailed to our Admissions Office directly from your college, OR you may submit official copies in sealed envelopes.

If you have questions about your application, call our office at 678-547-6700. You should receive an acknowledgement to your application within 3-5 days.

Mercer University is committed to providing equal educational programs or activities, and equal employment opportunities to all qualified students, employees, and applicants without discrimination on the basis of race, color, national or ethnic origin, disability, veteran status, sex, sexual orientation, age, or religion, as a matter of University policy and as required by applicable state and federal laws, including Title IX. Inquiries concerning this policy may be directed to the Equal Opportunity/Affirmative Action Officer/Title IX Coordinator, Human Resources Office, 1400 Coleman Avenue, Macon, Georgia 31207, phone 478-301-2788, or in cases of Title IX concerns, these concerns may be referred to the Office of Civil Rights.

Atlanta Emergency Hotline Number: (678) 547-6111
Macon Emergency Hotline Number: (478) 301-5335