Degree of Interest
Program
A copy of your RN license is needed for admission to the RN to BSN program. Please scan and email to admissions@charteroak.edu
Legal First Name
Legal Last Name
Do you have any previous names?
Please list all previous names that may appear on a transcript.
SSN
Date of Birth
Street Address
Zip
City / Town
State
Country
Email
Phone
Have you served in the U.S. Military or are you a military spouse?
Select Military Branch
Select a Military Status
Citizenship
Please select your Gender
Please indicate how you identify yourself (choose one or more)
Please identify ALL prior academic history
SELECT LOCATION, COLLEGE, then CLICK “ADD COLLEGE” BUTTON TO SAVE
Repeat steps to add ALL prior colleges where you previously took courses.
Location
College
Name and Location of Institution
You will need to have your official High School or GED transcript sent directly to Charter Oak.
Please indicate if you have any non-college credit credit from any of the areas below.
Have you earned any credentials?
Credential
Add another credential?
Are you currently employed?
Employer Name
Please specify employer and location
When you click “Apply Now”, you will be directed to CASHNet to submit the $50 non-refundable application fee. If you have a waiver code, please enter the code and click “Apply Now” to submit your application.
Waiver Code:
By submitting this form, I confirm that the information provided on this form is accurate and complete, and subject to the policies and procedures of Charter Oak State College and the Connecticut Board of Regents.