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Capital IDEA Houston BSN Sponsorship Pre-Screening Form

Pre-screening to help assess readiness to apply for sponsorship.


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1.  Basic Information
Capital IDEA Houston is delighted that you have chosen to apply for sponsorship for your RN to BSN program! Please complete the following pre-screening to help us assess if you are ready to apply for sponsorship.

Tell us about yourself!

1.  First Name   (Required)

2.  Last Name   (Required)

3.  Street Address   (Required)

4.  City   (Required)

5.  Zip Code   (Required)

6.  Email address   (Required)

7.  Phone number

Please enter in the format (123) 456-7890 or 123-456-7890.   (Required)

8.  Are you a US Citizen or Permanent Resident?   (Required)



9.  Race   (Required)







10.  Are you of Hispanic or Latino origin?   (Required)



11.  Gender   (Required)






12.  What is your current status regarding a BSN program?   (Required)




13.  Have you graduated or recently graduated from an ADN program?   (Required)




14.  Have you passed the NCLEX-RN licensure exam?   (Required)




15.  Have you completed the required Core Curriculum for the Bachelor's program?   (Required)




16.  What is your current GPA?   (Required)

17.  What institution are you interested in attending for your BSN training?   (Required)










18.  If "Other," please specify:  

19.  How did you hear about this opportunity?   (Required)






   
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