r

PRELICENSURE STUDENT CHECKLIST

PORTFOLIO ITEMS: Place in front of portfolio in a plastic sleeve. Student should provide a
brief title and the date in the appropriate box when adding/deleting an item from the
portfolio. Facu/tyteaching each course will sign in their appropriate box and also place
initials in the box next to the student's written description. (If online, use electronic code for
signature when returning to student.) The colored boxes represent the requi-red minimum
number of items for each criterion
NURS 240
CHECKPOINT
FACULTY SIGNATURE & DATE:
NURS 250
CHECKPOINT
FACULTY SIGNATURE & DATE:
NURS340
CHECKPOINT
FACULTY SIGNATURE & DATE:
NURS350
CHECKPOINT
FACULTY SIGNATURE & DATE:
NURS440
CHECKPOINT
FACULTY SIGNATURE & DATE:
Binder with
Dividers (submit in 240)
Criterion 1
COl_l6.130RATIVE
LEADERSHIP
(Min. of 2 items)
Criterion 2 THEORETICAL
BASE FOR PRACTICE
(Min. of 2 Items)
Criterion 3 GENERALIST
NURSING PRACTICE
(Min. of 2 Items)
Criterion 4
SCHOLARSHIP FOR
PRACTICE
(Min. of 2 Items)
'\ --J
)/,,

:/
kvi (.w c{;-
'U-t,-{ v-c >'\ (....! )
( 2 I
I /l J/c
I
/ j J,
'f 'f. . ' I
/ -- /
J
y I >) ;,
L /{ ,.,,: _,.)
I
Criterion 5 Vc1.r,o If \).! rrl'/ or
HEALTH CARE
of 2 Items) __________ _______ ----+-----+-----+-------
ENVIRONMENT "' :yi ':," , l c.!'.W
Criterion 6 ' 1 r : / ;Y Suv1 u... )l"zt11<(c.l.i.
PROFESSIONALISM (Min. ' / uc. v vi'"'"\ .,,;; f, "-C-t1"'-
of 2 Items)
Resume (1)
15