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Last NamePhone #First NameW#@my.yosemite.eduMJC Student EmailDateASSOCIATE DEGREE NURSING PROGRAMMULTICRITERIA SCREENING PROCESS ADVISING RECORD (MSPAR) - Assembly Bill 239Applicants must apply for admission to MJC prior to applying to the ADN programYesNo Successful Completion of Math 89 or 989 or equivalent or higher Bachelor’s degree or higherCourse:Location:Semester/Year completed:Previous student in this program. Semester/Year:Previous last name:Advanced Placement: LVN/ LPT/ MilitaryNoIV certification:YesName of LVN or LPT Program:License #:Exp:Active License verified:Probation and/or Restricted license not acceptedRegionally-WASC Accredited:LVNs who challenged the LVN board must complete MJC challenge criteria or apply as an applicant to first semesterTransition course: Nurse 259 – Transition to the RN Role HS 043 – Nursing Synthesis at SJDCTotal Possible Points: 100CRITERIA11A1B1C1D1EAcademic degrees or diplomas, or relevant certificatesheld by an applicant. Any relevant work or volunteerexperience.POINTDISTRIBUTIONMaximum points forCriterion 1Areas A – E 16Academic degree from a regionally accredited college oruniversity - Select oneMaximum points for1A 5BA/BS Degree or higherAA/AS DegreeLicensed/certified healthcare worker - Select one fromeach category if applicableLicensed Vocational Nurse (LVN), Licensed PsychiatricTechnician (LPT), Registered Respiratory Therapist (RRT),Certified Respiratory Therapist (CRT), ParamedicCertified Nurse Assistant (CNA), Certified MedicalAssistant (CMA) - AAMA certification, EmergencyMedical Technician (EMT) - CA certification or nationalregistry53Maximum points for1B 5Relevant Work ExperienceHealthcare work experience (see 1B above) – 1000 hours inthe five years prior to February 14 of application yearVolunteer ExperienceVolunteer work – 200 hours in the five years prior toFebruary 14 of the application yearMilitary healthcare work experienceCorpsman or MedicREQUIRED SUPPORTINGDOCUMENTATIONTo determine college accreditation,search “Accredited Institutions ofPostsecondary Education” and select“Accreditation of PostsecondaryEducation in the United States.”Applicants who completed nursingcoursework at a non-regionallyaccredited institution will have programeligibility determined on a case-by-casebasis.Official transcript.Official transcript.5Copy of current license.Probation and/or Restricted licensenot accepted3Copy of current certificate.Probation and/orRestricted license not acceptedMaximum points for1C 33Maximum points for1D 11Maximum points for1E 22Criterion 1C SupportingDocumentation FormCriterion 1D SupportingDocumentation FormCopy of Defense Department Form DD214. Honorable Discharge RequiredTOTAL POINTS FOR CRITERION 1 AREAS A–EUpdated 11/1/20 MSPAR kwb1

POINTDISTRIBUTIONCRITERIA2Grade Point Average (GPA) in relevant coursework(prerequisite courses). All prerequisites must becompleted for letter grades.Biology course:YesNoMaximum points forCriterion 2Areas A – F 65REQUIRED SUPPORTINGDOCUMENTATIONOfficial transcript with final grades posted bythe application deadline. For all out-of-statecourse work, must provide course descriptionsfrom catalog and copies of catalog coversfor the years the courses were taken.Applicants who completed nursing courseworkat a non-regionally accredited institution willhave program eligibility determined on a caseby-case basis.Semester/year completed:Chemistry course:YesNo Semester/year completed:Natural Sciences GPA (Anatomy 125 or equivalent,Maximum points forMicrobiology 101 or equivalent, Physiology 101 or2A 27equivalent). All courses must be completed with a gradeof C or better AND a minimum combined GPA of 2.5 isrequired.MJC uses semester units. If you have transferred quarterunits from another school, they must be converted tosemester units before calculating the GPA. *Semester/yearcompleted:A 4 grade pts, B 3 grade pts, C 2 grade ptsAnat Grade pts x Units Micro Grade pts x Units Physio Grade pts x Units 2ATotal points Total Units Combined GPADid you check to ensure that each course was a semester unit or converted to a semester unit?Yes See conversion chart below if necessary.* Quarter unit to semester unit conversion information:Quarter UnitsSemester Units1 0.52 1.53 24 2.55 3.56 47 4.58 5.59 610 6.511 7.512 813 8.514 9.515 10Deduction for substandard grades (D, F, NC/NP or W) inNatural Sciences (Anatomy 125 or equivalent, Microbiology 101or equivalent, Physiology 101 or equivalent) in the three yearsprior to the application year.2BGPA4.0273.5-3.99223.0-3.49172.5-2.9912 2.5 notqualifiedMaximum Deductionfor 2B -101 substandard grade-22 substandard grades-53 substandard grades-10Course:Semester/year completed:4 or more substandard grades Not qualifiedUpdated 11/1/20 MSPAR kwb2

CRITERIA2CEnglish 100 or English 101 or ELIC 100 is required forall students entering the ADN program. Points will beawarded for the highest grade for English or ELICcourse, not the average of two combined courses.If an Advanced Placement (AP) score is used to meet the Englishprerequisite, you will only receive credit for a C grade. English 103 maybe taken for letter grade to raise the English score. NOTE: English 102taken prior to Fall 2017 will be accepted to raise the English score.GPA for remaining three prerequisites.Psychology 101 or 141 andSociology 101 or 102 or 125 or 150 or 154 or 156 orAnthropology 102 andCommunication 100 or 102All courses must be completed with a grade of C orbetter AND a minimum combined GPA of 2.5 isrequired. The highest grade for each of the three will be used toPOINTDISTRIBUTIONMaximum points for2C 15GPA15A10BC5 C not qualifiedREQUIRED SUPPORTINGDOCUMENTATIONCourse:Semester/year completed:Maximum points for2D 15Semester/yearcompleted:calculate the GPA. NOTE: Communication 110 taken prior to Fall 2019will be accepted to meet the communication requirement.* MJC uses semester units. If you have transferred quarter units fromanother school, they must be converted to semester units before calculatingthe grade point average (GPA).A 4 grade pts, B 3 grade pts, C 2 grade pts2DPsych Grade pts x Units Socio Grade pts x Units Comm Grade pts x Units Total points Total Units Combined GPADid you check to ensure that each course was a semester unit or converted to a semester unit?Yes See conversion chart below if necessary.*Quarter unit to semester unit conversion information:Quarter Units123456 Semester Units0.51.522.53.54Highly recommended coursework2E 2FGPA4.0153.5-3.99133.0-3.49112.5-2.999 2.5 notqualifiedMaximum points for2E & F 8MFDNTR 219 – Nutrition or equivalent1MNURSE 115: Introduction for Nursing Majors (MJC) orCGUIDE 50: Guidance for Nursing Majors (CGUIDE 150)(Columbia– prior to fall 2020). ONLY.1MDAST 321: Medical Terminology or equivalent1MJC ADN to BSN GE CertificationSigned by a CounselorCompleted all lower division coursework for transfer to aBSN program (refer to page 4 on MSPAR)5All courses MUST becompleted to receive pointsSemester/year completed:Criterion 2F SupportingDocumentation FormTOTAL POINTS FOR CRITERION 2 AREAS A–FUpdated 11/1/20 MSPAR kwb3

Additional Requirements for the MJC ADN to BSN GE Certification: A grade of C- or higher is required in Areas A1, A2,A3, and B4 for admission to the CSU System. Warning: C minus grades may not be accepted when attempting to transferto all institutions.AREAA – ENGLISH LANGUAGE, COMMUNICATION & CRITICAL THINKING: One course from each group: 9 semester or 12-15 quarter unitsAP Advanced Placement IP International BaccalaureateA.1: Oral CommMinimum 3 unitsA.2: Written CommMinimum 3 unitsA.3: Critical ThinkingMinimum 3 unitsYesNoComm 100Semester/year completed:YesNoEng 100Comm 102Course:Eng 101Semester/year completed:YesNoELIC 100Units:APCourse:Units:Semester/year completed:Course:Units:AREA B – SCIENTIFIC INQUIRY & QUANTITATIVE REASONING One course from B1, B2 and B4 required.One course from B1 or B2 must be a laboratory course marked with an asterisk (*) for B3. 9 semester or 12-15 quarter unitsChemistry 143B.1: Physical ScienceYesNoAPMinimum 3 unitsSemester/year completed:Course:UnitsAPYesNoAnatomy 125B.2: Life ScienceMinimum 4 unitsSemester/year tory,asindicatedbytheasterisk(*)B.3: Laboratory ActivityYesNoB.4: Math & QualitativeReasoning Minimum 3 unitsYesNoMath 134Soc 105Psych 121IBIBAPSemester/year completed:Course:Units:AREA C – ARTS & HUMANITIES 3 units from C1 and 3 units from C2. Additional 3 units from C1 or C2.9 semester or 12-15 quarter units.C1: ArtsAPYesNoMinimum 3 unitsSemester/year completed:Units:NoC2: HumanitiesYesAPMinimum 3 unitsSemester/year completed:Course:Units:C1 or C2: Arts orYesNoAPHumanitiesSemester/year completed:Course:Units:Minimum 3 unitsAREA D – SOCIAL SCIENCES 9 units from at least two disciplines (D.0 – D.9). 9 semester or 12-15 quarter units.Anthro 102SocioD: Social SciencesPsych 101YesNoAPMinimum 3 unitsBaccalaureateSemester/year completed:Course:Units:AREA E – LIFELONG UNDERSTANDING AND SELF-DEVELOPMENTYesFDNTR 219APNoPsych 141E: Lifelong Understanding &Self-DevelopmentSemester/year completed:Course:Units:Minimum 3 unitsCSU US HISTORY, CONSTITUTION & AMERICAN IDEALS6 units: 3 units from group a, and 3 units from group b, or 6 units from group cAPGroup aYesNoMinimum 3 units(group a and b / or c only)Semester/year completed:Course:Units:Group bYesAPNoMinimum 3 units(group a and b / or c only)Semester/year completed:Course:Units:NoYesHist102Hist 101APGroup cMinimum 6 unitsUnits:Semester/year completed:Course:(group a and b / or c only)Course:Units:Semester/year completed:Link to CSU, Stanislaus:www.csustan.edu/nursing To confirm required BSN coursework at other schools of nursing, please visit www.assist.orgUpdated 11/1/20 MSPAR kwbIB4IBIBIBIBIBIBIBIB

CRITERIA33A3B3C3DLife experiences or special circumstances of anapplicant, including but not necessarily limited to thefollowing. Select only one if applicable.Disabilities.Low family income.First generation of family to attend college.Need to work.3EDisadvantaged social or educational environment.3FDifficult personal and family situations orcircumstances.3GRefugee status.Veteran status.3HPOINTDISTRIBUTIONREQUIRED SUPPORTINGDOCUMENTATIONMaximum points forCriterion 3Areas A-H 22Criterion 3 Supporting DocumentationFormDocumented learning disability or proof ofparticipation in or eligibility for DisabilitySupport Program and Services (DSPS).2Criterion 3 Supporting DocumentationFormProof of eligibility for or proof of receipt offinancial aid, e.g. California College PromiseGrant (CCPG), Cal Grant, Pell Grant or otherfederal grant, or Cal WORKS.222222Criterion 3 Supporting DocumentationFormParagraph explaining the educationalbackground of your parents.Criterion 3D Supporting DocumentationFormPaycheck stub from the period of time youwere enrolled in prerequisite coursework orCriterion 3D Supporting Documentation Formfrom employer verifying employment whilecompleting prerequisite coursework. IfCriterion 1C Supporting Documentation Formwas submitted for the period of time in whichyou were enrolled in prerequisite coursework,the Criterion 1C Supporting DocumentationForm can be used to document Criterion 3D.Criterion 3 Supporting DocumentationFormProof of participation in or eligibility forExtended Opportunity Programs & Services(EOPS).Criterion 3 Supporting DocumentationFormParagraph explaining the situation orcircumstances.Criterion 3 Supporting DocumentationFormDocumentation or letter from U.S. Citizens &Immigration Services (USCIS) verifying yourrefugee status.Criterion 3 Supporting DocumentationFormCopy of Defense Department Form DD-214.Honorable discharge required.TOTAL POINTS FOR CRITERION 3 Areas A-HUpdated 11/1/20 MSPAR kwb5