You are on page 1of 7

4901 E. University Blvd.

, Odessa, Texas 79762


(432) 552-2560 (432) 552-2561 (Fax)

Dear Applicant to the Baccalaureate Program:

As you prepare your application to the University of Texas of the Permian Basin College of Nursing, we
applaud you in your decision to pursue nursing as a career.

All applications will be reviewed and given serious consideration. Applicants must meet all
admission criteria prior to being enrolled in the Nursing Program.

The first course in the curriculum, Transcultural Nursing, will be offered in the Summer or Fall
semester prior to admission. This course must be taken at UT Permian Basin.

As you consider the responsibilities of professional nursing practice, please be aware of the requirement to
pass a criminal background check prior to clinical courses and again during the application for licensure.
In addition, applicants will be asked to confirm a clear disciplinary record.

Follow the directions in the application closely. Consider each question very carefully and answer as
completely as you can. If you have any questions, please call (432) 552-4560. We look forward to
receiving your completed application.

Sincerely,

Dorothy Jackson, PhD, RN


Associate Professor
Dean of the College of Nursing
Medical Center Hospital Endowed Chair
The University of Texas of the Permian Basin

Notice Concerning Your Information The Texas Public Information Act, with a few exceptions, gives you the right to be informed about the
information that UT Permian Basin collects about you. It also gives you the right to request a copy of that information and to have the
University correct any of that information that is wrong. You may request to receive and review any of that information, or request
corrections to it, by contacting the Office of Public Information Affairs, UT Permian Basin, 4901 E. University Blvd., Odessa, Texas 79762.

Page 1
BSN-Application-04-2016
The University of Texas of the Permian
Basin Nursing Program Admission
Procedures

Admission to The University of Texas of the Permian Basin and to the Nursing Program involves two separate application
processes. Contact the Office of Admissions by writing to the Office of Admissions, UT Permian Basin, 4901 E. University
Blvd., Odessa, Texas 79762 or calling (432) 552-2605 or email Admissions@utpb.edu. Important: Applicants must be
formally admitted to The University of Texas of the Permian Basin for the semester they intend to begin upper-division
nursing courses, meeting all University deadlines as published in The University of Texas of the Permian Basin Admission
website.

How to Apply to the Nursing Program

Application submission: Students must be enrolled in the last semester of required prerequisite coursework or have
completed all prerequisite course requirements. (as indicated in the application #9 and 9.1) All prerequisite courses must be
completed prior to the beginning of the first semester in the Nursing Program. Transcultural Nursing must be taken in the
Summer or Fall semester prior to admission to the Nursing Program. This course must be taken at UT Permian
Basin.

All required information and documents must be received by the application deadline, to be considered for
admission. Incomplete applications will not be considered.

To apply for admission to the Nursing Program, submit the following by the appropriate deadline directly to
College of Nursing, UT Permian Basin, 4901 E. University Blvd., Odessa, Texas 79762.

1) Completed Nursing application, including personal essay (see Directions on Application).

2) SEPARATE and OFFICIAL transcripts from each college/university you have attended other
than UT Permian Basin must be submitted to College of Nursing, UT Permian Basin,
4901E. University Blvd., Odessa, Texas 79762.
3) Criminal background checks are performed on all applicants offered admission to the UTPB
Nursing Program. All students will be required to provide contact information to begin the
criminal background check process at the time of the interview. Information about the process is
available at the Texas Board of Nursing (BON) website at http://www.bon.state.tx.us/.
Students who do not receive a clear background check from the BON must pursue a Declaratory
Order process with the BON to confirm eligibility for licensure. Students who must pursue the
Declatory Order to confirm eligibility for licensure will need to set an appointment with the
Dean of the College of Nursing to discuss this process. Results of this Declatory Order must
be submitted to the Nursing Program. The Declatory Order process permits the Board to
make decisions regarding an applicant's eligibility for licensure prior to entering this
nursing program. If you think something may come up on your criminal background
check, please send a signed and dated letter to the BON describing the incident(s) on your
criminal background with certified copies of court documents.
5) Official TEAS (Test of Essential Academic Skills, version 5 or higher) test results must be
sent by ATI to the UTPB Nursing Program; photocopied test results will not be accepted.
You may register to take the TEAS Test at the ATI Testing website, www.atitesting.com.
Follow the link, "Register for TEAS." Please choose U of TX of the Permian Basin TEAS to
have your scores sent to us.

BSN-Application-06-2017 Page 2
6) Two completed Reference Forms in signed sealed envelopes. (See College of Nursing Application Forms)

7) A $25 application fee will be placed on your student account. Once on your account, you may pay online
through your my.UTPB account or with the Accounting Office. A copy of the paid fee receipt is required at
the time of your interview.

8) Provide evidence of Immunizations. Please refer to the Admission Criteria for immunization requirements.

Application Deadlines:
Fall Admission: March 1st
Spring Admission: September 15th
For more information contact: Nursing@utpb.edu
Applicants will be notified of admission decisions prior to registration.

BSN-Application-06-2017 Page 3
UT Permian Basin College of Nursing
Application for Entry to BSN Program

Please type or print clearly:

1. A. UTPB ID: B. Date of Birth (mm/dd/yyyy) / /

C: Place of Birth:
City County State Country

2.

Full Legal Name


(Last) (First) Middle (Maiden)

Semester applying: Fall 201 Spring 201


4.
Address:
A. Permanent

/
Street Telephone

City State Zip Code

B. Local

/
Street Telephone

City State Zip Code

Email Address:

C. Residency Status [ ] Texas Resident [ ] Non-Resident [ ] Foreign

5. Have you ever been found responsible for violation of the student conduct policy at this university or any other
university?
[ ] yes [ ] no

6. Have you ever been arrested, cited, or charged with any violation of the law?
[ ] yes [ ] no

BSN-Application-06-2017 Page 4
7. List all colleges, universities, and professional schools you have attended, including UT Permian Basin. Indicate the
dates of attendance and degrees awarded: (Note: The Office of Admissions and the Nursing Program each
require a separate official transcript from each college attended.)

School or Institution: Dates Attended: Major: Degree Awarded:

8. Are you a CNA [ ] yes [ ] no; LVN/LPN [ ] yes [ ] no; RN [ ] yes [ ] no

9. List any certifications or health care training you have completed. (Include dates and names of programs.)

10. List previous employment. Specify dates, type of work, where employed, and approximate number of hours per
week:

Place of Employment: Dates Worked: Type of Work: Hours Worked:

11. List volunteer activities in a health care environment (include dates and times) (Attach document if more space is
needed)

12. List other community service and extracurricular activities (include dates and times).
(Attach document if more space is needed)

13. List academic and other honors received: (Attach document if more space is needed)

BSN-Application-06-2017 Page 5
14. Please indicate Prerequisite courses you have completed. Please list the college or university; the course number,
your grade, credit hour of each course, and the year completed. Incomplete applications will not be considered.

Credit Year
Institution Course # Prerequisite Completed Grade Completed
Hours
(Math) College Algebra

(BIOL) Biology I

(BIOL) Biology I Lab

(BIOL) Biology II

(BIOL) Biology II Lab

(CHEM Chemistry I

(CHEM Chemistry I Lab

(BIOL) Human Anatomy

(BIOL) Human Anatomy Lab

(BIOL) Human Physiology

(BIOL) Human Physiology Lab

(BIOL) Microbiology

(BIOL) Microbiology Lab

Must be taken at UTPB BIOL 2303 (BIOL) Nutrition

(PSYC) Introductory Psychology

Must be taken at UTPB PSYC 3301 (PSYC) Statistics

(PSYC) Lifespan Growth & Development

(ENGL) English I

(ENGL) English II

(ENGL) Literature 2300 Level

Oral Communication

(HIST) History I

(HIST) History II

BSN-Application-06-2017 Page 6
(PLSC) Political Science I

(PLSC) Political Science II

Visual & Performing Arts

15. I understand that at this time my records show that I lack the following course prerequisites necessary for enrollment
in Upper Division Courses in Nursing. I plan to complete these courses during:

Summer [ ] 201 ; Fall [ ] 201 ; Spring [ ] 201 ;

Please list the college or university at which you will complete these prerequisites.
Institution Prerequisite Needed (Course 3 & Name) Fall or Spring/Summer Session

Must be taken at UTPB NURS 3302 Transcultural Nursing Fall [ ] Summer [ ]


N
Fall [ ] Summer [ ]
N

Fall [ ] Summer [ ]

Fall [ ] Summer [ ]

Fall [ ] Summer [ ]

Fall [ ] Summer [ ]

16. Personal Essay

Directions: Describe how your personal strengths, experiences and aptitudes will contribute to your success in
nursing school and a career in nursing; include community service, leadership experience and health
care experience. Write no more than two typed double-spaced pages with 1-inch margins in standard
12-point, Times New Roman font. This essay will be used to evaluate your ability to communicate
your ideas clearly, the completeness of your response and your motivation for applying to the UT
Permian Basin College of Nursing.

Documents Required to Complete Nursing Application:


Application
Official Transcripts
Immunization Records
Personal Essay
Official TEAS Scores
Two completed Recommendation Forms in signed, sealed envelopes

A $25 application fee will be placed on your student account. Once on your account, you may pay
online through your my.UTPB account or with the Accounting Office. A copy of the paid fee receipt
is required at the time of your interview.

BSN-Application-06-2017 Page 7