State Authorization Appeal

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REQUEST INFORMATION

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Name*

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Is your program of interest within the School of Nursing?*

Please select your program of interest*

Please indicate the state in which you intend to become licensed and practice in your occupation after completing your licensure program.*

Please indicate which state you intend to be in during your first semester of courses.*

Do you intend to take online courses in your first semester of your licensure program?*

REGENT UNIVERSITY SCHOOL OF NURSING PROGRAMS REQUIRE PRACTICUM. PLEASE INDICATE THE STATE IN WHICH YOU INTEND TO COMPLETE CLINICAL HOURS FOR PRACTICUM.*

Please indicate any extenuating circumstances regarding your situation that should be further clarified or evaluated for qualification of initial licensure or certification.*