LPN – B.S. Application

This application for undergraduate admission to the LPN to B.S. program will become part of your permanent record at Dakota Wesleyan University. Dakota Wesleyan University welcomes faculty, staff, students and visitors of all faiths and promotes a policy of nondiscrimination in all areas with respect to age, race, sex, creed, color, national and ethnic origins, religious preferences, disabilities, backgrounds, and lifestyle choices.

I am applying for the following semester *

Fall 2024

Preferred Campus Location *

Sioux Falls

Personal Data

Legal Name

Gender *

Male Female Other

Current Mailing Address

Permanent Home Address

How would you prefer to be contacted? Email Text Phone

Citizenship Status

US Citizen US Permanent Resident Other

Religious Affiliation

Are you a member of the United Methodist Church?

Yes No

The following items are optional. No information you provide will be used in a discriminatory manner.

Marital Status

Social Security Number

Are you a U.S. Armed Services veteran?

Yes No

Are you Hispanic or Latino?

Yes No

Regardless of your answer to the prior question, select one or more of the following ethnicities that best describe you
American Indian or Alaska Native Asian Black or African American Native Hawaiian or
other Pacific Islander White

Educational Data

High School Attended

High School Counselor

GED date (if applicable)

Credits

Institution 1

Name

City

State

Country

Attended from

Attended to

Degree

Institution 2

Name

City

State

Country

Attended from

Attended to

Degree

Institution 3

Name

City

State

Country

Attended from

Attended to

Degree

Institution 4

Name

City

State

Country

Attended from

Attended to

Degree

Institution 5

Name

City

State

Country

Attended from

Attended to

Degree

Healthcare Work Experience

Current/Most Recent Position

Weeks

Months

Years

Type of Facility

Your Role

Previous Position

Weeks

Months

Years

Type of Facility

Your Role

Previous Position

Weeks

Months

Years

Type of Facility

Your Role

Enrollment Data

Are you seeking a degree?

Yes Not at this time

More About You

Family/Friend

Location

Website/Social media/Online

Alumni

What other colleges or universities are you considering for your education?

What factors will be most important in your college decision?

Goal Statement

Please write a paragraph about your career goals. How do you plan to use your B.S. degree in nursing?

Other

Have you ever been found responsible for a disciplinary violation at any secondary or post-secondary school you have attended, whether related to academic misconduct or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal, or expulsion from the institution? *

Yes No

Please give an approximated date of each incident and explain the circumstances

Have you ever been convicted of a misdemeanor, felony, or other crime? *

Yes No

Please give an approximated date of each incident and explain the circumstances

I certify that all information in my application is my own work, factually true, and honestly presented. I understand the omission or misrepresentation of any information including enrollment in other colleges or universities is sufficient grounds for canceling my admission or registration.

The university reserves the right to deny admission or continued enrollment to any student who imposes an unreasonable risk of harm to the health, safety, welfare or property of the university, members of the university community or him/herself.

Dakota Wesleyan University is accredited by the Higher Learning Commission of the North Central Association, 30 North LaSalle Street, Suite 2400, Chicago, IL 60602, (312)263-0456, www.ncahlc.org, South Dakota Department of Education, South Dakota Board of Nursing, National League for Nursing, United Methodist University Senate, and Commission on Accreditation of Athletic Training Education. The university is approved by the state of South Dakota on the basis of the National Association of State Directors of Teacher Education Certification (NASDTEC) standards.