Please fill out the form below Webform April 28, 2025 Information About You First name: * Middle Initial: Last Name: * Gender: * Male Female Don't wish to answer You can use this space to self-describe: Social Security Number or Stanislaus State Student ID (Ex. SS = XXX-XX-XXXX OR Student ID = 123456789): * Date of Birth: * Format: Dec 31, 2024 Email: * Mobile Phone: * Ethnicity: American Indian or Alaskan Native Asian (if not included in another category) Asian Indian Black or African American Decline to state Filipino Hispanic or Latino Native Hawaiian or Other Non-Filipino Pacific Islander Other Unknown race & ethnicity White/Caucasian Mailing Address Street: * City: * State: * Postal Code: * Additional Information Cumulative GPA (minimum 3.0 in last 60 units to qualify): * MSN Program Graduated School Name: * MSN Program Graduated School Term & Year: * Statistics Course Completed School Name: * Statistics Course Completed Term & Year: * Statistics Course Completed Grade: * RN License Number: * RN License Expiration Date: * Application for MSN-PMHNP Bridge Program This is a voluntary and confidential application form to be used by the Stanislaus State School of Nursing. All applicants must have graduated with a Master of Science in Nursing degree from a regionally accredited college. Please review the admission criteria on the MSN-PMHNP Bridge program roadmap for eligibility. I understand that I am applying for the RN-MSN Bridge Program. In doing so, I understand the following expectations: Students commit to participate in the four bridge courses. The four bridge courses are offered in the Fall as part of the MSN program at Stanislaus State. Students will follow the schedule of courses to complete the Bridge program. The pathway will allow students to complete the pre-requisites to be eligible for the Psychiatric Mental Health Nurse Practitioner (PMHNP) Certificate Program. Students are encouraged to commit to continuing in the Psychiatric Mental Health Nurse Practitioner Certificate program after completion of the bridge courses. Students must apply to the PMHNP certificate program for admission to the Spring cohort. Please refer to the application window here. Bridge students must meet the PMHNP certificate program admission requirements. Please refer to the admission requirements here. Please submit the following documents with the completed application. MSN Unofficial transcript: Other (If you have recently attended another regionally accredited institution that needs to be considered in the last 60 units, please upload here): Additional Uploads: Additional Uploads: *Notice: By submitting this form, you acknowledge that all of the information submitted in this application is valid and accurate.
