MSN Culminating Activity Registration

*We are asking for personal email and employer information because our accrediting body requires that we do post-graduation surveys of students and employers. The data will be protected.

1. Which Term/Year are you requesting to do the Culminating Activity? (ex. Fall 202X or Spring 202X) *This question is required.

2. Student ID Number *This question is required.

3. First and Last Name *This question is required.

5. Phone Number *This question is required. This question requires a valid number format.

6. Address (ex. 123 Nursing Lane) *This question is required.

7. City *This question is required.

8. State *This question is required.

9. Zip Code *This question is required.

10. Personal Email Address *This question is required. This question requires a valid email address.

11. Employer Name *This question is required.

12. Current Position and Unit *This question is required.

13. Employer Address *This question is required.

14. City *This question is required.

15. State *This question is required.

16. Zip Code *This question is required.

17. Name and Title of Supervisor *This question is required.

18. Supervisor's Email *This question is required. This question requires a valid email address.

19. CSUDH Nursing Graduate Student Exit Survey (required for our accreditation).

Please take about 5 minutes to complete the survey https://survey.alchemer.com/s3/7035499/Graduate-Exit-Survey-Assessment
Take a screen shot of the completion screen at the end or print to a PDF.
After you complete the survey, return to this question and upload evidence of survey completion (screen shot or PDF print out)
Continue with the Culminating Activity registration form to the end and submit

*This question is required.

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20. List graduate courses transferred from another University (including course substitutions, Open University, and Extended Education). If none, please write in n/a or none. *This question is required.

21. Will any MSN course(s) be over 5 years at the graduation term? *This question is required.

22. Have you applied for graduation (degree application)? *This question is required.

23. Attach a copy of your CSUDH Academic Profile.

To Print out the Academic Advisement Report in MyCSUDH to show completion of your degree requirements and graduation status:

Log into MyCSUDH. Click Student Center > click My Academics > click View My Advisement Report.
Click on the “Expand All” button before printing; that will open up all sections to show the courses completed, dates, and grades.
Print to PDF to upload here.

*This question is required.

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