College of Nursing Co-op Program

University of Cincinnati College of Nursing

Co-op Program Application

Please fill out all information below and submit the form. Deadline for application is March 1.

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Name
Address
	City	State	Zip
Home Phone	(include area code)
Cell Phone	(include area code)
Preferred Email
Date of Birth	mm/dd/yyyy
UC Student ID

Co-op Site Preference

Provide the names of the two clinical faculty from whom you are seeking official recommendations.

Statement of Professional Goals

Reason Seeking Admission

List Work/Volunteer Experience

Cumulative GPA

Schedule Flexibility

The nursing co-op program can be demanding. This program offers a wide variety of learning experiences in various clinical settings. Our preceptors work diligently to offer you diverse learning opportunities. If you are working or volunteering, do you have a flexible schedule?

Health Benefits

The nursing co-op program does not provide health insurance. You will be responsible for your own. Will this be an obstacle for you?

I hereby give Shirley Alsup permission to review my college transcripts.

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