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Undergraduate Application for Admission

Thank you for your interest in Excelsior College. Licensed nuclear medicine technologist
Complete this application if this is your first time applying Licensed registered nurse
to Excelsior College or if you were enrolled in the School of Licensed practical/vocational nurse
Nursing within the last five years and have since earned addi- Licensed massage therapist
tional college-level credit. Certified pharmacy technician
If you have withdrawn from a business, health sciences,
liberal arts, or technology degree program within the last five School of Nursing Candidates
years, please contact your Academic Advising Office as you may In addition to official transcripts, nursing candidates must
not be required to submit an application. submit a copy of a current license or certification to verify pro-
If you are a graduate of a business, health sciences, liberal fessional status in an appropriate health care profession. This
arts, technology, or nursing degree program, please contact license should be mailed with your application or faxed to the
your Academic Advising Office as you may not be required to Undergraduate Application for Admission Team at 518-464-
submit an application. 8833. Nursing courses completed at institutions other than
Excelsior College are only evaluated upon enrollment.
Required Documents
You are required to submit official copies of transcripts as part of
Financial Assistance
You must first complete the FAFSA (Free Application for Federal
Carefully tear this page along the perforation and keep for reference.

the application process. Official transcripts/documents are those
that a college, testing agency, or education office sends or gives Student Aid) in order to be considered for any form of financial
to you in their sealed envelope, which you then forward unopened assistance. Available financial assistance includes federal
to Excelsior College. Some sources may not release official tran- grants and loans, institutional scholarships, and private loans.
scripts/documents to you. In that case, request the source For more information, visit www.excelsior.edu/financialaid.
submit your transcripts directly to the Excelsior College Office Note: Students in examination-based programs, including
of Registration and Records. Do not submit unofficial copies. the associate degrees in nursing, are not eligible for federal
Transcripts from accredited institutions must include the financial aid, but may qualify for institutional scholarships.
institution’s official seal and registrar’s signature (signature
is usually a stamp), two forms of student identification on the Military Candidates
transcript (e.g., Social Security number and current address; Candidates who have served or are currently serving in a branch
current address and date of birth), and contain an issuance of the U.S. Military must submit the following documentation:
date within six months or less. Navy and Marine Corps: SMARTS Transcript

School of Business & Technology Air Force: Community College of the Air Force
(CCAF) Transcript
Course descriptions must be submitted with  official tran-
scripts. Time limits on transfer credits are outlined as follows. Army (Active/Guard/Reserve) AARTS or Form DD 295
Army (Veterans) AARTS or Form DD214 Report of
Business Degrees Candidates
Separation (only if enlisted and separated prior to
Business courses that are more than 20 years old will not October 1981).
be counted towards the business component of the degree
Coast Guard: Coast Guard Institute Transcript
and cannot be appealed.
Technology Degrees Candidates Service members with DLI Training: DLI Transcript
Computer information systems/computer sciences courses and DLPT Score Report
for the Bachelor of Science in Information Technology
degree have a 10-year time limit from date of enrollment, International Candidates
and they cannot be appealed. International candidates from non-English speaking countries
Electronics/computer courses for degree programs other must show evidence of sufficient English language proficiency
than the Bachelor of Science in Information Technology through one of the following three options:
have a 10-year time limit, which can be appealed. 1. Submission of TOEFL (Test of English as a Foreign
Transfer credits for which an appeal can be made require Language) taken within the last two years
submission of a completed time limit appeal form with this 2. Successful completion of Excelsior College’s ENGx111:
application. The time limit appeal form can be downloaded from English Composition or the UExcel ENGx110 College Writing
our Web site at www.excelsior.edu/timelimitappeal (requires a examination
free MyExcelsior Web site user account). 3. Submission of evidence of the successful completion of
at least nine credit hours of academic work in courses
School of Health Sciences delivered in English at an institution of higher education
Credit may be awarded for the following licenses and certifica- in the United States
tions. Please include a copy with your application if applicable.
Licensed radiolographic technologist
Licenses radiation therapist
Application Instructions i

(Microsoft®.S.S. CLEP. CompTia®. CCAF. Excelsior College exams.excelsior. RN to BS in nursing and RN to MS in nursing  Admission to both the BS in nursing program and RN to MS in nursing program is limited to Registered Nurses (RNs) who are currently licensed in the United States. Associate degree in nursing students only: Please note some state boards of nursing have additional requirements for licensure. Please keep in mind. OR Professional/corporate training courses that are ACE. Albany. Copy of current license (or copy of transcript indicating completion of program) Licensed Psychiatric Technician from AR and CO only Copy of current license with expiration date Licensed or Certified Midwife Copy of current license or certification and copy of transcript  tudents who have successfully completed at least 50 percent of the S Official transcript clinical nursing credit hours with a minimum grade of C in an associate. Excelsior College accepts credit from the following sources: you must use ONE of the following approved agencies: Accredited colleges and universities Educational Credentials Evaluators.g. Records at 7 Columbia Circle. Be sure to visit www. ICCP. Sun. DD295. scale.org UEXCEL®. SAS. Cisco. and ICDL) * Please note: If you have had an evaluation completed by WES and did not specifically note it was needed for Excelsior Official transcripts from any of the acceptable sources College. due to the complexity of this evaluation.or National PONSI-evaluated World Education Services (WES): Order a comprehensive course-by-course report by visiting www. baccalaureate. Nursing Candidates: Special Instructions and Admission Requirements Nursing courses completed at institutions other than Excelsior College are only evaluated upon enrollment.wes. Coast Guard Institute transcript. ORACLE.0 or higher on a U. Respiratory Technician. Associate Degree in nursing (please check the box corresponding to your current level of nursing experience): Licensed Practical or Vocational Nurse (LPN or LVN) Copy of current license with expiration date Paramedic Copy of current license/certification with expiration date Certain Classifications of Military Medical Personnel Official AARTS. Inc. RN license with expiration date ii Application Instructions . must submit an official transcript from the school. NY 12203 in order for your review to be completed.ece. you must request an update to your evaluation by above must be submitted to the Office of Registration and WES prior to submitting to Excelsior College.S.S. or RN diploma nursing program within five years of completing their last nursing course. (ECE): College credit examinations (e.org or calling Professional Computer Certification Examinations 212-966-6311. Order a Subject Analysis Report by visiting www. Copy of subject analysis report from ECE or comprehensive course-by-course report from WES reflecting graduation from a school of medicine with a minimum GPA equivalent to a 2.edu/board_requirements for current information specific to each state. Registered Nurse (RN) Copy of current U.. DANTES) or calling 414-289-3400. SMARTS. or DD214  espiratory Therapist. Physician or Physician’s Assistant trained and/or licensed in U. R Copy of current certification or license with Respiratory Care Practitioner expiration date Physician trained and/or licensed outside of U. the review will take a minimum of six weeks from the time Excelsior College receives all required documentation. International Transcripts Evaluation of Prior Credits For evaluation of credentials from outside of the United States.

No. Ave.. For Office Use Special Population  Undergraduate Application for Admission All Applicants: Third Party Please print or type all information requested and review responses for accuracy. I would like to subscribe to this service.. You can also view this document at the Excelsior College Web site. proficiency tests. 1 No credit/courses 2 1–30 credits 3 31–60 credits 4 61–90 credits 5 91–126 credits 6 Over 126 credits 7 Don’t know Application 1 for Admission . and so forth. please list all previously earned degree(s). as well as Apt.) Yes. military courses. you will receive via email an Academic Evaluation Summary that explains which credits you still need to earn.. or Suite number if applicable) City State Zip Code Country (if not USA) Phone Numbers with Area Code (please indicate “D” for day or “E” for evening): (D/E) (D/E) (Home) (Business) (Business Extension) Email Address _________________________________________________________________________________________________ Do you wish to receive Excelsior College updates via email broadcasts? Yes. Date of Birth Gender (M = male. Social Security Number (USA) Current Legal Name Last Name First Name Middle Initial Birth/Maiden Name (if different from current last name) Other name(s) by which you may have been identified in relevant academic records Permanent Address Number and Street (include Rd. etc. I do not wish to subscribe at this time. No. I would like to subscribe to this service. F = female) Do you have a high school/high school equivalency diploma? Yes No Have you previously earned a degree? Yes No If yes. Type of degree earned Date degree earned Name of institution granting degree: ___________________________________________________ ______________________________ __________________________________________________ ___________________________________________________ ______________________________ __________________________________________________ ___________________________________________________ ______________________________ __________________________________________________ Enter the code number which represents your estimate of the total number of college credits you have earned through college courses. I do not wish to subscribe at this time. St. Do you wish to receive electronic document delivery of your Academic Evaluation Summary via email? (Whenever the College evaluates the credits you have earned.

For up to three licenses/certifications. a 28-1905 form must be completed by your education counselor and submitted to the Bursar’s Office for third party billing. scholarships. (a) Are you Hispanic or Latino/Latina? Yes No (b) Please select the racial/ethnic group(s) you identify with regardless of your answer to the above question (you may select more than one): American Indian or Alaska Native Black or African American White Asian Native Hawaiian or Other Pacific Islander Please select the one response which best reflects your citizenship status.Please answer both questions (a) and (b) below. U. 1 I want to enroll immediately 2 Within 3 months 3 Within 6 months 4 Within 1 year Enter the code number which represents your estimate of when you expect to complete your degree program.va. if applicable .gov. 1 Within 1 year or less 2 Within 2 years or less 3 Within 2 years or more 4 Not sure Nursing Applicants Only: See nursing admission requirements on page ii. Have you ever been enrolled in any program at Excelsior College (formerly Regents College)? Yes No If yes.gibill. or federal aid? Yes No If eligible for tuition assistance. If you have Chapter 31 Vocational Rehabilitation benefits.S.S. institutional aid. enter your discharge date: Month Year If you are currently serving in the United States Armed Services. citizen U. Permanent resident Foreign national Do you plan to apply for financial assistance to include tuition assistance. have you completed VA form 22-1990? Yes No If you have used your benefits and are changing parent schools. private loans. Nursing courses completed at institutions other than Excelsior College are only evaluated upon enrollment. please complete the correct form online at www. please enter the code number of the Branch: 10 Army – Regular 30 Marines – Regular 50 Coast Guard – Regular 15 Army – Reserves 35 Marines – Reserves 55 Coast Guard – Reserves 20 Navy – Regular 40 Air Force – Regular 60 National Guard – Army 25 Navy – Reserves 45 Air Force – Reserves 65 National Guard – Air If you are eligible or currently receiving GI Bill benefits. indicate: State in which you hold License Expiration Date Former name(s) by which you License Number certification or licensure (mm/dd/yyyy) have been identified. have you completed VA form 22-1995? Yes No If you answered No. when? _ ______________________________________________________________________________ Enter the code number which represents your estimate of how soon you plan to begin your degree program. please enter the code number of the chapter: 70 MGIB-AD (Chapter 30) 95 Educational Assistance 105 Survivors’ and Dependents’ 010 Post-9/11 (Chapter 33) 75 MGIB-SR (Chapter 1606) Test Program (Section 901) Educational Assistance 115 Vocational Rehabilitation* 80 REAP (Chapter 1607) 100 Educational Assistance Program (Chapter 35) 999 Not sure 85 VEAP (Chapter 32) Pilot Program (Section 903) Have you used your benefits previously? Yes No If not. are you planning to use it at Excelsior College? Yes No Are you a military veteran? Yes No If yes.

All Applicants: Degree Selection Information Enter an “X” in the box next to the program into which you would like to be admitted. NURSING LIBERAL ARTS TECHNOLOGY Associate in Applied Science/ AS Associate in Science AAT Associate in Applied Science in Associate in Science in nursing AA Associate in Arts Technical Studies (with area of BRN BS Completion Program (RNs only) focus) Enter an “X” in the box next BSL Bachelor of Science to the one technologies area you are MRN RN to MS in nursing (with in Liberal Studies (no major) selecting. Military students should specialization)* Enter an “X” in the BAL Bachelor of Arts select the area of focus which box next to one specialization you in Liberal Studies (no major) corresponds to their MOS/Rating. Please call an Admis- 3 sions Counselor before completing this application. RN Technology Management license.S. and Mathematics focus) Enter an “X” in the box next to Tourism Management Music the one area of focus you are selecting. Select only one program. are selecting. BST Bachelor of Science in Technology Literature in English EOL End of Life (with area of focus) Enter an “X” in Mathematics GER Gerontology the box next to the one technologies Music HED Health Education area you are selecting. you may be interested in pursuing our Master of Science in nursing degree. Business and Management Communication Studies Generalist Computer (hardware) BSB Bachelor of Science in Business Electronics (to include Journalism (with concentration) Enter an “X” in Electromechanical and Electronic Media Studies the box next to the one concentration Instrumentation specialty) Organizational Communication you are selecting.  Nuclear Public Relations ACCTG General Accounting Power Plant (non-nuclear) Strategic Communication FIN Finance Where my credits fit best GENBU General Business Economics History BPT Bachelor of Professional Studies – GLOBL Global Business Literature in English Technology Management (with area of HSMGT Hotel. BS Bachelor of Science (with major) Computer (hardware) CSM Clinical Systems Enter an “X” in the box next to the Electronics (to include Management one major you are selecting. accredited) RSMGT Risk Management Biology BIX Bachelor of Science in Information and Insurance Communication Technology (with concentration) BAX Bachelor of Science in Accounting Choose one: Enter an “X” in the box next to the (NYS CPA Track) Communication Studies Generalist one concentration you are selecting. Restaurant. Journalism GEN General Media Studies INF Information Security HEALTH SCIENCES Organizational Communication NET Network Management Public Relations BHS Bachelor of Science in Health BNX Bachelor of Science in Nuclear Strategic Communication Sciences (with emphasis) Enter Engineering Technology (ABET Economics accredited) an “X” in the box next to the one History specialization you are selecting. MHR Management of Political Science ELECT Electrical Technology Human Resources Psychology IT Information Technology MIS Management Sociology NUC Nuclear Technology Information Systems MARK Marketing BA Bachelor of Arts (with major) BEX Bachelor of Science in Electronics OPMNG Operations Enter an “X” in the box next to the Engineering Technology (ABET Management one major you are selecting. Political Science MGT Management Computer (hardware) Psychology BHC Bachelor of Science in Electronics (to include Sociology Health Care Management Electromechanical and Electronic MHA Bachelor of Science in Health Care Instrumentation specialty) Management/Masters in Business  Nuclear Administration (with or without Power Plant (non-nuclear) concentration — choose one area) Where my credits fit best no concentration Human Performance Technology *If you have earned a bachelor’s degree from a region- Information Security ally accredited institution and hold a current U. . Electromechanical and Electronic NED Nursing Education Biology Instrumentation specialty) INF Nursing Informatics Criminal Justice  Nuclear Choose one: Power Plant (non-nuclear) Administration of Criminal Justice BUSINESS Where my credits fit best Corrections ANT Associate in Science AAB A  ssociate in Applied Science in Homeland Security in Nuclear Technology Administrative/Management Law Enforcement and Public Safety Studies Criminal Profiling AST Associate in Science in Technology ASB Associate in Science (Business) and Investigative Analysis (with area of focus) Enter an “X” in Communication the box next to the one technologies BPB Bachelor of Professional Studies – Choose one: area you are selecting.

 SS# and current address. the Student Policy Handbook. current address and date of birth. NY 12203-5159 The issuance date of the transcript must be within six months or less and must have two forms of ID on the transcript (e. Excelsior College reserves the right to verify all transcripts/documents received to ensure authenticity. request the source submit them directly to: Excelsior College Office of Registration and Records 7 Columbia Circle Albany. Signature: _________________________________________________________________ Date: ___________________________ Excelsior College Bursar’s Office Send your completed admissions application. In that case. Submission of fraudulent documents will result in academic dismissal from the College. New York 12203-5159 4 Application for Admission . Excelsior College cannot request transcripts on the student’s behalf. Name of College/University City/State ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ *Note: Nursing courses completed at institutions other than Excelsior College are only evaluated upon enrollment. last four numbers of your SS# and date of birth). Some sources may not release official transcripts or documents to you. as set forth in this application for admission. UEXCEL®. which you then forward to Excelsior College unopened. payment and all 7 Columbia Circle official documents in the enclosed preaddressed envelope to: Albany. Examination Credits Please list below any Excelsior College® Examinations. testing agency. Official transcripts/documents are those that a college. Official transcripts must be submitted by the request of the student. I agree that if accepted for enrollment in the College. All Applicants: Documents Submitted For Evaluation Transcripts* List below each institution for which you will be submitting an official transcript that shows the college-level credit you earned. CLEP Exams. Do not submit unofficial copies. DANTES Exams. and that it is my responsibility to submit a complete admissions package. or Advanced Placement (AP) exams from which you will have score reports submitted: Type of Exam Exam Title Year Taken Credits Earned ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ Professional/Corporate Training Courses List professional/corporate training courses completed that have been evaluated by ACE or National PONSI: Name of Course Organization Year Taken Credits Earned ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ All Applicants: Signature and Date (signature and date required) I certify that the above statements are true and correct.g. or education office sends or gives to you in its sealed envelope. I understand that false information or documents may result in dismissal from the College.. I will comply with and be bound by all requirements and policies of the College. and the catalog pertaining to the program in which I am seeking to enroll.

or complete the charge card authorization below.All Applicants: Mailing/Payment Instructions Please include your $75 non-refundable application fee with this application. Make your check or money order payable to Excelsior College in U. Please do not send cash. bank. dollars drawn on a U. check enclosed money order enclosed Credit Card Authorization I authorize Excelsior College to charge _____________ (or the current fee at the time this form is received by Excelsior College) to my: MasterCard Visa Discover American Express Credit Card Account Number ________________________________________________________ Expiration Date _ ____________ Name of Cardholder (print) _______________________________________________________________________________________________ Signature _________________________________________________________________________________________________________________ Mail your completed application.S.S. payment. NY 12203-5159 Application 5 for Admission . and all official documents to: Excelsior College Bursar’s Office 7 Columbia Circle Albany.

NY 12203-5159. Portions of this publication can be made available in a variety of formats upon request. creed. NY 12203-5159 Phone: toll free 888-647-2388 or 518-464-8500 Fax: 518-464-8777 TDD: 518-464-8501 www. Albany. Albany. marital status.excelsior. Excelsior College. national origin. enroll10-097. 7 Columbia Circle. 7 Columbia Circle. religion. color. gender. race. Inquiries should be directed to the College’s Affirmative Action Officer. or sexual orientation in the educational programs and activities which it operates.edu Excelsior College does not discriminate on the basis of age. disability. 9/1/2010 EX0189 . veteran status.

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