SCHOOL OF NURSING BETTY WHITE HEALTH CENTER

Graduate Nursing Program Student Acknowledgment of Receipt of Graduate Nursing Handbook

My signature below indicates that I have received and read the Graduate Nursing Handbook.

I understand that the policies contained within these documents apply directly to me and to all students in the Graduate Nursing Program. I agree to abide by these policies, and recognize that not abiding by these policies could result in dismissal from the Graduate Nursing Program and/or affect my standing as a student at Kentucky State University.

Name (please print): ___

CWID (Student ID): ___

Signature: ___

Date: ___

Contact information (please PRINT clearly):

Local Address: ___

Local Phone: ___

KSU E-Mail: ___