Calvin University Nursing Program Application

For transfer students.

Personal Information

Application Type

First Name

Preferred Name - name you would like us to use

Last Name

Middle/Maiden Name

Your Cell Phone Number

Email Address

Student ID

Local Address - complete address of where you are living currently

Local: Address

Local: City

Local: State

Local: Zip

Permanent Address - where you consider home when not at school

Permanent: Address

Permanent: City

Permanent: State

Permanent: Zip

Summer Address

Summer: Address

Summer: City

Summer: State

Summer: Zip

Academic Information

Current Advisor

Year you started at Calvin

Parent/Spouse Information

Parent/spouse name

Parent/spouse address

Parent/Spouse city

Parent/Spouse state

Parent/Spouse zip

Parent/Spouse phone number

Policy Agreement

I understand that as a part of the clinical onboarding process I will need to:

complete a drug test
complete and submit proof of required immunizations and a TB test.
complete and submit proof of a Basic Life Support for course (CPR for Healthcare providers)
complete a background check
complete a central registry clearance

Further details about these items will be reviewed during nursing student clinical orientation. If I have questions now, I can contact the nursing department chairperson.

I understand these requirements

I agree with the onboarding processI disagree with the onboarding process

Background Information

Have you ever been convicted of a misdemeanor or felony?

YesNo

Please briefly describe the nature of the crime(s), the date and place of conviction and the legal disposition of the case.

High School Information

What year did you graduate from high school?

While you were a high school student, were you dually enrolled in any college classes?

YesNo

If yes, college class(es) taken:

Transfer Student Information

Are you a transfer student?

YesNo

Transfer College #1 Name and dates attended

Transfer College #1 degree(s) earned

Transfer College #2 Name and dates attended

Transfer College #2 degree(s) earned

Course Planning

List all courses you will be taking during Spring 2026

List all courses you will be taking during Summer 2026

If any of the courses listed above were/are to be taken at a college other than Calvin, please list the college(s):

You must get prior approval from the Registrar's Office stating course equivalency for any non-Calvin courses. You must get prior approval from your Calvin nursing department advisor for any non-Calvin nursing prerequisite course.

Final Verification

The information that I have provided above on this application is complete and accurate to the best of my knowledge.

YesNo

If No, please explain why:

This will serve as your electronic signature. Type your name below:

You can print a copy of your answer after you submit

Contact Information