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RN to BSN Application

Applications will be reviewed for the fall and spring sessions and must include the items listed below. If applying by paper application, please email the completed form to twade2@uscupstate.edu or fax: 864-250-6731.

Send official transcripts showing the completion of all prerequisite courses with a grade of C or better to:

Admissions Department
USC Upstate
800 University Way
Spartanburg, SC  29303

All applicants must have a diploma or associate degree in nursing from an ACEN (formerly NLN) accredited institution and an active, clear, unrestricted nursing license within the United States.

Please complete the information below to submit an online application for the spring or fall semester. 

Please note: an* indicates a required field.

General Information  

First Name:  *

Middle
:         

Last Name:  *  

Other names under which your record may be listed (i.e., maiden name, nickname)

Date of Birth:*

Current Telephone Numbers

Home:  Work:  Cell:*

Email Address:*
** We will use this email address to communicate important information to you including admission decisions. You may want to include the emails twade2@uscupstate.edu and sblevins@upstate.edu in your contacts to ensure that you receive all emails regarding your application.  Please check your email regularly and contact us immediately if ANY contact information changes.**

Mailing Address

Street:*

City:*

State:*  Zip:*  County:

USC Upstate Student ID# (if known):  

Demographic Information 

Admissions decisions are not affected by this information and it will be kept confidential. It is requested for statistical reporting only and is optional, but it will help us better serve your needs.

Gender: 
Ethnic Background: 
U.S. Citizen?: 

Colleges or Universities Attended for Credit (please list ALL schools, including USC Upstate):

Institution Name Entrance Date Date Left Enrolled? Y/N Degree/Diploma Earned


Please indicate any disabilities or special needs that you have:  

RN License Information

Do you have a current RN License that is in good standing?  *

If yes, please list your license number and the state in which you practice: 

License Number:  State: 

If no, what date do you plan to take your NCLEX? 

Checklist for Criminal Record Background Check 

I will send in my information and fee for the Criminal Record Background Check (CRBC) to the CRBC company, and will sign to have the information released to the Dean of the Mary Black School of Nursing.

Initials:*

I give the Mary Black School of Nursing at USC Upstate permission to receive the results of my CRBC and to provide such results to clinical agencies for the restricted purpose of determining my suitability to participate in the clinical practicum courses in the Mary Black School of Nursing Baccalaureate Nursing program. The results of my CRBC may not be shared with any other entity without my express written permission.

Initials:*

I understand that I am to advise the Mary Black School of Nursing at USC Upstate of any arrests or criminal charges subsequent to my completing this form and that failure to do so may result in dismissal from the nursing program.

Initials:*

I understand that the Mary Black School of Nursing at USC Upstate will keep the CRBC reports in a confidential area, and that these reports will be maintained for 3 years following my last completed nursing course at USC Upstate.

Initials:*

I understand that if it is necessary to reapply for initial acceptance to the Mary Black School of Nursing at USC Upstate, the CRBC will need to be repeated. I further understand that if there is ever an interruption in my enrollment, I will have the CRBC repeated when I return to the nursing program.

Initials:*

Additional Comments:  

Sign & Submit

By typing your name in the "Signature" field below, you agree that you have read and you understand all stated admission requirements and instructions for applying to the Mary Black School of Nursing. You also certify that the information on this application is true and complete to the best of your knowledge.

Signature (please type your full name):*  Date:*