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!
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1. First Name
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2. Last Name
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3. Street Address
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4. City
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5. Zip Code
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6. Email address
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7. Phone number
Please enter in the format (123) 456-7890 or 123-456-7890.
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8. Are you a US Citizen or Permanent Resident?
 Yes No |
9. Race
American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander White Other |
10. Are you of Hispanic or Latino origin?
Yes No |
11. Gender
Female Male Non-binary Prefer not to say Other |
12. What is your current status regarding a BSN program?
Currently enrolled in a BSN program Planning to enroll in a BSN program Not sure yet |
13. Have you graduated or recently graduated from an ADN program?
Yes No Currently enrolled in an ADN program |
14. Have you passed the NCLEX-RN licensure exam?
Yes No Scheduled to take it |
15. Have you completed the required Core Curriculum for the Bachelor's program?
Yes No Unsure |
16. What is your current GPA?
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17. What institution are you interested in attending for your BSN training?
University of Houston - Downtown San Jacinto College Lone Star College Lamar University Sam Houston - Woodlands Prairie View A&M University Texas Woman’s University UT Health Houston - Cizik School of Nursing Other |
18. If "Other," please specify:
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19. How did you hear about this opportunity?
School/Educational Institution Former students of CIH Online/social media/Google Word of mouth (friend/family) Community organization or business |
