Information Request Form Thank you for your interest in attending the School of Nursing located at the University of Nevada, Las Vegas! Q.1 Today's Date (ex. mmddyyyy) Q2 What programs are you interested in? 4 Year BSN RN to BSN or MSN MSN Family Nurse Practitioner MSN Pediatric Nurse Practitioner MSN Pediatric Certificate MSN Nursing Education FNP Certificate Nursing Education Certificate PhD Q3 Which is your current occupation? High School Graduate College Undergraduate Graduate Student International Student Registered Nurse Q4a Please fill out your name, address, phone, and e-mail so that we can contact you and/or send you information. Prefix (Mr/Ms/Dr)   Last Name   First Name   Address   Apt./Ste./PO Box   City   State/Province   Zip/Postal Code   Country   Phone   E-mail