BSN Program Exit Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

WKU BSN Program Exit Form is required to be completed by ANY student who accepted a seat in the BSN program in writing but has voluntarily decided not to pursue a Bachelor of Science in Nursing degree. Students not completing this form will forfeit any future status of good standing with the School of Nursing.

Students seeking a medical withdrawal or other leave must follow the policies and procedures outlined by the university. If a health condition or extenuating circumstance is such that the student is unable to complete the requirements of the nursing program, the student may voluntarily exit from the program.

Student Last Name *

Student First Name *

Student 800 # *

Date form submitted *

YYYY

Semester student entered BSN program (Fall or Spring and Year) *

Please select reason for exiting the BSN program: *

Due to decision to change major

Due to a financial issue

Due to a medical issue

Due to relocation or transferring to another institution

Due to a family issue

Other, please explain in the space below

Please explain selection of "other" in the previous question.

Give any additional information below that would be helpful to the BSN program related to your decision to exit the program.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms