Information For

California State University San Marcos

Extended Learning & School of Nursing

Extended Learning Application for the Post Master of Science in Nursing Certificate program

If there are changes to any of the information contained on this application after submission, it is your responsibility to notify Extended Learning at elapps@csusm.edu.

DO NOT SUBMIT UNTIL YOU COMPLETE THE APPLICATION

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Please list all colleges or universities you have attended or are currently attending.
Please type "N/A" for fields in which you do not list a college/univeristy you have attended.
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Clinical Nurse Specialist
Clinical Nurse Leader
Family Psychiatric Mental Health Nurse Practitioner

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If yes, please list date received and major
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If yes, please list your Visa status
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If yes, please list dates of service
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Full Name and Date
Submit and Pay