Ohio State University



The Ohio State University College of Nursing Graduate ProgramRequest for Dual DNP / Specialty Certification (PM) Status – Current StudentsThis petition requires review by the appropriate Specialty Program Director and must be approved by the Graduate Studies Committee. You must be a currently enrolled student in the DNP degree program. Dual status will begin 48 hours after approval. Petition should be made at least one term prior to anticipated enrollment in any specialty related course and should include:1. A personal statement detailing the reasons for the request and how the specialty complements your current DNP plan of study.2. This form, with all required signatures. Emails acknowledging approval may be submitted in place of the required signatures.Submit one copy (per petition) electronically as a single scanned pdf or MS Word document, with all supporting materials, to CON-gradrecords@osu.edu Name__________________________________________________________________________________ DateRequested Specialty: _____________________________________________________________________Please note that not all specialties currently offered may be an option for online enrollment.DNP Adviser____________________________________________________________________________ DNP Adviser Signature:_________________________________________________________________ Email may be submitted in place of the required signatures.DateSpecialty Director’s Signature ___________________________________________________________ Email may be submitted in place of the required signatures.Date Can accommodate at this time Unable to accommodate at this time Post Masters (Specialty) adviser __________________________________________________________ Assigned by Specialty DirectorOnce approved, the Specialty Director and the student must complete a gap analysis for completion of the Post Masters (Specialty) component. Graduate Studies Committee / Records Office Use OnlyGSC approval____________________________________________________________________________ Graduate Studies Committee Chair DateNotify: student, DNP advisor, new PM advisor, future SPD, Records Office ................
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