USC University of Southern California

General Information

• First Name First Name is required.
• Middle Name
• Last Name Last Name is required.
• Other Name(s)

Contact Information

Current Mailing Address

• Mailing Address Mailing Address is required.
• City City is required.
• State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State is required.State is required.
• Zip Code Zip Code is required.
• Contact Phone No Contact Phone No is required.
• Email Email is required.

Emergency Contact Mailing Address

Please provide a secondary point of contact. The address should be different from the one provided above.

• Contact Name Contact Name is required.
• Mailing Address Permanent mailing address is required. Permanent mailing address must be different than current address.
• City Permanent city is required.
• State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Permanent state is required.Permanent state is required.
• Zip Code Permanent zip code is required.
• Contact Phone No Permanent contact phone is required.

Colleges / Universities Attended

Please click on the Edit link to enter your first college experience. Click on the Add link to enter additional colleges.

All fields are required for each school

Professional Nursing Experience

Applicants need ONE completed year in critical care to apply and TWO completed years by the time of program matriculation.

Please click on the Edit link to enter your first nursing experience. Click on the Add link to enter additional experiences.

All fields are required for each experience

Add

• Have you ever attended or been dismissed from another Program of Nurse Anesthesia? YesNo Program dismissal response is required.
• If yes, please explain. Dismissal explanation is required.
• Did you attend the USC Program of Nurse Anesthesia information session? YesNo Information session response is required.

References

These references can match the references from the university's application. You must provide exactly three references.

All fields are required for each reference. Exactly three references are required.

Course Work Completed

Please click on the Edit link to the right of each row to enter course details. Click the Save link to save each line of changes.

Statements of Purpose

Please address the following inquiries (maximum of 500 words for EACH question). Both statements are required.

Reflect on a moment when you recognized the limits of your current role and felt compelled to pursue nurse anesthesia. What specifically prepared you for this transition?

0 / 500 words This statement of purpose is required. This statement of purpose must be 500 words or fewer.

Provide an example of when you advocated for a patient or safety concern, particularly when doing so challenged existing practice or hierarchy.

0 / 500 words This statement of purpose is required. This statement of purpose must be 500 words or fewer.

Application Procedures

Upload Documents for Supplemental Application (Upload a file less than 50 MB)

Please upload the following with this supplemental application:

1. Copy of current CA RN license
2. Resume
3. Unofficial transcripts if available
4. Transcript request receipts must be submitted for each institution entered under colleges/universities attended.

Select a file for each document type below; it will upload automatically. You may upload multiple documents per type. Files must be less than 50 MB.

Pending items can be emailed or faxed directly to the Program of Nurse Anesthesia at 323-442-1701.

Transcripts

Official university transcripts from ALL institutions must be emailed to etrans@usc.edu.

Criminal History

Have you ever been convicted of a crime or subject to regulatory disciplinary sanctions, including but not limited to:

• Driving under the influence
• Chemical dependency
• Drug diversion
• Exclusion from a federal or state healthcare program, such as Medicare or Medicaid

• Your response (Yes or No): YesNo Criminal history response is required.
• If yes, please explain. Criminal explanation is required.

Failure to provide accurate information may result in revocation of admission or dismissal from the program.

Verification

Data in this document reflects current, accurate information; the Program reserves the right to revise the information at their discretion and to make reasonable changes in content/requirements to enhance the quality of the academic program. All elements of the applicant data are considered in invitation for interview and admission to the Program.

I have read the entire supplemental application for the USC Program of Nurse Anesthesia/Department of Anesthesiology and certify that the information I have given is complete and correct to the best of my knowledge.

• I accept Certification acceptance is required.

Application Fee

After submitting your application you will be presented with a link to pay a $75 USD program application fee (separate from the university application fee).

I understand that my application will not be considered complete until the application fee is paid.

• I accept Application fee acceptance is required.