BSN Forms and Resources

Use the links below to skip to a section:

• Future Student Resources
• BSN Application Forms
• BSN Standard Forms
• Transfer Courses To SJSU
• Health Requirement Forms and Resources
• Current Student Resources
• Program Policies
• CNA Application Instructions
• Public Health Nurse Application Instructions

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Future Student Resources

• BSN Information Packet 2023
• BSN Advising Slides 2023
• BSN FAQs

BSN Application Forms

• Functional Competencies 
• Healthcare Experience form
• DACA/AB540 form
• Military Members Info [pdf]

BSN Standard Forms

• N180 Course Info and Syllabus/Contract
  • N180 for Independent Study
  • N180 for Course Re-take
• Social Media Contract [docx]
• School of Nursing Emergency Loan Application
• Petition [docx]

Transfer Courses To SJSU

See the BSN Transfer Course Agreements page for information on;

• Articulation: courses not listed as a prerequisite or courses taken at other campuses that you wish to gain SJSU credit for 
• International Degrees and/or courses

Health Requirements, Forms and Resources

• Background Check and Drug Screening

  • Prior to beginning the program, students must meet clear drug and background requirements (via Castlebranch; info below). Additionaly, students fill out a signed statement each semester indicating no changes in background clearance violations since entering the program (or the last time it was requested). Agencies and/or the School of Nursing may require additional clearances as deemed necessary.

    Students meet with the program’s Director if their documentation for drug screen or background does not clear or there are issues, discrepancies, or problems.

• CastleBranch

  • - CastleBranch Orientation Video

    - CastleBranch Clinical Documentation Information [2023 UPDATE]

• Health Forms

  • - Health Statement [2018 Update]

    - Flu Shot Declination Form [2022 Update]

    - HIPAA Release of Medical Information Form [pdf]

    - TB Requirements Info [docx]

    - TB: California Tuberculosis Risk Assessment College and University Students [pdf]

• Liability Insurance

  • NSO Liability Insurance Policy and Instructions [pdf]

Current Student Resources

• BSN Student Handbook AY2023-2024 [pdf]
• School of Nursing Emergency Student Loan Information
• SJSU Nursing Scholarships Informaiton [pdf]
  • Federal funding opportunities: Health Resources and Services Administation
  • American Association of Colleges of Nursing grants and scholarships

Program Policies

• BRN Concurrency Notification [pdf]
• Applicants from Other Nursing Programs [docx]
• Military Education Policy [docx]
• Progression and Disqualification [docx]
• Uniform Guidelines
• Professional and Safe Practice Policy [PDF]
• Social Media Policy [pdf]

CNA Application Instructions

Current students who have completed semester 2 in the BSN program are eligible to apply to become a certified nurse assistant (CNA).

• CNA Application Form can be accessed on the California Department of Public Health website.

  • Download CNA Application and complete sections for EQUIVALENT TRAINING.

    CNA Application [pdf]

    The form is also available on the CDPH.CA.GOV website. 

• Submit form and unofficial transcript to Nursing office.

  • Submit the completed form with a copy of your unofficial SJSU transcript to the School of Nursing office to be signed. You can submit in person or by email (nursing@sjsu.edu).

• Complete Live Scan Fingerprinting

  • Complete the Live Scan form and print. 

    Obtain Live Scan finger print (services offered at 7th Street Parking Services by appointment or at locations off-campus, fee required).

    Send a copy of live scan finger prints with your signed CNA Application and unofficial transcript directly to address on CNA Application form. 

    CNA Live Scan Form [pdf] [pdf]

    Sample of Live Scan Form

    Upon completing all of the above requirements, applicants will be sent information regarding the Competency Evaluation examination. Applicants will need to schedule their Equivalency exam via Credentia. 

Public Health Nurse Certification Instructions

Graduates of the BSN program are eligible to apply for Public Health Nurse certification after passing the NCLEX and are licensed as a registered nurse.

Visit the California BRN website for information and to download the application or to apply online. Please note, this process typically takes several weeks to complete. Please plan accordingly.

• How to apply

  • 1. Applicant completes application and pays the fee to the BRN (can be done online).

    Enter the following information into the appropriate fields:

    -Name of Public Health Nurse Academic Program: San Jose State University-Bachelor of Science, Nursing 

    -Child Abuse/Neglect Prevention Training Provider Number/School Name: San Jose State University #13894

    -Child Abuse/Neglect Prevention Training Course Name: Community Health Theory (see transcript for course name, i.e. NURS 172, NURS 127B).

    -Child Abuse/Neglect Prevention Course Number of Hours: 9 hours

• Send REQUEST FOR TRANSCRIPT form to School of Nursing 

  • 2. Applicant completes the top section of the REQUEST FOR TRANSCRIPT form. Then, email or mail the form to the School of Nursing office.

• Transcripts

  • Graduates must ensure that your degree has been posted on your transcript before you apply.

    The nursing department will send your transcript directly to the BRN after receiving the REQUEST FOR TRANSCRIPT form.