Request for Information

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Request for Information

PLEASE NOTE: Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your response to this form to: msn@capital.edu.

Please take a moment to fill out the following information!

Surname or Last Name:		First Name:
Street Address:
City:	State:	Zip/Postal Code:	Country:
FAX:		e-mail:

Check all of the following that apply to you:

High School Diploma	LPN or LVN License	Associate Degree in Nursing	Baccaluareate Degree in Nursing
RN or RGN License	Associate Degree in another field	Baccalaureate Degree in another field	Some Graduate Work in Nursing

Indicate the program about which you would like more information:

BSN in Nursing (Begin as a Freshman)	BSN in Nursing (Transfer Student)	BSN Completion Program (for RNs)	Fast Track Information
MSN in Nursing (single degree)	MSN and MBA	MSN and JD	MSN and MA in Lay Ministry

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