Thank you for your interest in the Mission-Aligned Admissions Process Workshop for your school AACN. We ask you to complete the following intake survey to help us better understand your needs and tailor the workshop to best meet the needs and goals of your school. This request should be completed by the person/designee who requested a workshop for your school. It should take approximately 15 minutes to complete this form.
Once we receive your request we will contact you within 5-7 business days.

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1. The following are all of the topics that can be addressed during an AACN Mission-Aligned Admissions Process Workshop. Please rank the topics in order of priority, keeping in mind how the topic matter for the achievement of your school's goals and objectives associated with access, connection, and engagement, and for your admissions committee's training needs.

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2. What is the most important outcome for this workshop?
(e.g., What do you hope the audience will learn?) (Required.)

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3. Workshop Format: (Required.)

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4. What is your total student enrollment in your nursing school?

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5. What is the full-time enrollment of students at your college or university?

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6. Indicate the type of nursing program where Mission-Aligned Admissions Process will be utilized. Please select all that apply.

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7. Have you used any strategies associated with Mission-Aligned Admissions Process in your admission practices?

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8. Do you have an admissions committee?

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9. If so, how is your admission committee comprised? Please select all that apply.

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10. The number of individuals on my college/school's admissions committee, including myself, is:

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11. Does your school require the admissions committee to undergo training related to admissions goals? (Required.)

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12. Is the training provided annually?

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13. Is there anything else you would like to tell us about what your office of admissions, faculty and admissions committee needs to know in order to make progress toward your school's admission goals?

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14. Does your school have a minimum GPA requirement to be eligible for admission? (Required.)

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15. Does your school have minimum standardized test score requirement to be eligible for admission? (Required.)

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16. Does your application/admission process include any of the following? Please select all that apply (Required.)

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17. Which of the following are currently concerns or challenges, with regard to Mission-Aligned review of candidates for admission, at your school: (Required.)

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18. What metrics have you used to evaluate outcomes of your diversity efforts? Please mark all that apply.

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19. What is the percentage by race/ethnicity of your student body?

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20. What is the percentage, by gender, of your full-time student enrollment?

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21. Approximately what is the percentage of your faculty by race/ethnicity?

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22. Approximately what is the percentage, by gender, of your faculty?

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23. Approximately what is the percentage, by race/ethnicity, of your administrative leadership (deans, department chairs, and executive-level administrators)?

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24. Approximately what is the percentage, by gender, of your administrative leadership (deans, department chairs, and executive-level administrators)?

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25. Survey Respondent Information (Required.)

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26. Are you primarily responsible for admissions (e.g., director or dean of admissions) at your school for the nursing degree program?

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27. Provide contact information for the primary point of contact for this service request. (Required.)

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