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Become a Licensed Registerd Nurse

Nurse Application

The objective of the Institute for Healthcare Excellence is to assist international nurses in coming to the U.S. to pursue graduate healthcare education and in becoming well-paid U.S. registered nurses during their first year of study. We accomplish this objective through our uniquely developed nurse preparation and licensure program, and enrollment in a master of business administration with a concentration in healthcare. Our partner schools are Sullivan University in Louisville, Kentucky and Northwest Christian University in Eugene, Oregon.

Nurses are able to work soon upon arrival, earning-while-they-learn, though our work-study program. All classes are on Saturdays or evenings. While completing our nurse licensure program and taking graduate courses, our students are placed in a variety of work settings during the first year. After becoming licensed U.S. nurses, students are placed in well-paying healthcare organizations where they work while completing their graduate studies.

For those international nurses currently licensed as U.S. registered nurses, we have a streamlined program where we assist them in transferring their license to the state in which they will attend school (Oregon or Kentucky) so they can begin working as nurses within a few months. In order for these nurses to gain F-1 visa status through which employment authorization is provided, these students are also enrolled in the master’s of business administration program at one of our partner academic institutions.

If you would like to be considered for our program, please provide the following information.

Institute for Healthcare Excellence
Candidate Application

Biographical Data

Last Name:
First Name:
Middle Name:
Gender: Male Female
Date of Birth (mm/dd/yyyy):
Country of Citizenship:
Country of Residence:
Address Line 1:
Address Line 2:
City:
State:
Zip:
International Country (Not U.S.A.):
International Postal Code:
Daytime Phone Number:
Home Phone Number:
Email Address:
Passport Number (For international students):

Education

Name of Secondary School (High School):
City:
State:
Country (If Not U.S.A.):
How long was your program in years?
Date of Graduation (mm/yyyy):

Nursing Education

Name of school of nursing attended:
City:
State:
Country (If Not U.S.A.):
What type of program did your graduate from?
4 Year Bachelor Nurse
3 Year Diploma Nurse
How long was your program in years?
Date of Graduation (mm/yyyy):
Did you have theoretical and clinical education in the following? (Check all that apply)
Nursing care of the adult
Maternal/infant nursing (excluding gynecology)
Nursing care of children (pediatrics)
Psychiatric/mental health nursing (excluding neurology)
Community/public health nursing
Was your nursing program at least three years long and separate from your secondary education?
Yes No

Nursing Certification

State/Province/Country where you are currently certified to practice as a nurse:
License / certification number:
Date of licensure (mm/dd/yyyy):
Licensure expiration date (mm/dd/yyyy):
How many years have you been a licensed registered nurse in your country?
Have you worked at least 960 total hours as a nurse over the last five years?
Yes No
Are you currently a licensed U.S nurse? Yes No
If yes, in which U.S. State are you licensed:
Date of this license (mm/dd/yyyy):
License number:
License expiration date (mm/dd/yyyy):
Have you passed the NCLEX-RN examination? Yes No
If yes, what date did you pass the exam? (mm/dd/yyyy)
What state authorized you to sit for the NCLEX-RN exam?
Do you have a CGFNS VisaScreen Certificate?
Yes No
If yes, what date was it awarded
(mm/dd/yyyy)?

English Language Proficiency Examination
Identify which exam taken and score within the last two years.

TOEFL
Paper/Pencil Score:
Computerized Version Score:
TOEIC
Score:
IELTS
Overall Score (Academic Module):
Spoken Band Score:

Program Interests

Program Interest (please check what applies):
I am interested in becoming a U.S. licensed nurse with one year I am currently a licensed nurse in the U.S and wish to work in the U.S. Payment Options (full nurse-licensure program). I am interested in the following payment option (check one):
$6,000. I wish to pay for the entire program upon arrival providing a 20% discount from the $7,500 standard fee. $7,500. I prefer to make payments over time. $1,500 will be due upon arrival, followed by monthly payments beginning in month three for 12 months. Interest applies. Payment (only for a U.S. nurse licensed in a state other than the one in which she/he will attend school):
$2,500 (plus fees). I currently hold a valid U.S., state-issued nursing license and want to become a licensed nurse in the state in which I will attend school (Kentucky for Sullivan University; Oregon for Northwest Christian University) At which of the following universities would you be interested in pursing the master's in business administration in healthcare administration (check one)
Sullivan University (Louisville, Kentucky)
Northwest Christian University (Eugene, Oregon)
I would be interested in beginning the program in (select one):
Immediately
2-3 Months
4-6 Months
Unsure
How Did You Hear About Us?
Question/Comments:

Applicant's Certification

(Applicant must check box) I hereby apply for admission to the Institute for Healthcare Excellence and certify that the information in this application is true, complete, and correct to the best of my knowledge. By checking this box the applicant agrees that this electronic signature is to be accepted as a written signature.

Please type full name exactly as it appears on your passport:
Date (mm/dd/yyyy):