Aspen University Alumni Preceptor Interest Form
Hello Aspen Graduate! In an effort to assist current students in finding a Preceptor for their MSN Practicum, MPH Internship, or DNP Project, Aspen University is reaching out to our alumni to create a database of graduates who are interested in serving as preceptors. This database will be used by the Office of Field Experience to help connect students with preceptors.

Please click on the corresponding handbooks below for more information. 

Thank you so much for your interest in precepting for an Aspen student! Your guidance and leadership is an essential part of their academic experience. Precepting is also an opportunity for leadership development and a valuable addition to your resume/CV.

By submitting this form, you are consenting to being contacted by Aspen's Office of Field Experience. Your information will not be provided to current students; if you are needed as a preceptor you will be contacted directly by the OFE. Please contact ofe@aspen.edu with any questions. 
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Full Name (First and Last): *
Email address: *
Aspen Learner's ID:
Please include if possible. This is the easiest way to find your file with Aspen University and can be found in the upper left corner of your Student Portal at my.aspen.edu. 
Highest degree program of study completed at Aspen: *
If you continued your education at another institution after Aspen, please list your degrees/certifications earned here: *
City and State/Province: *
States where you are licensed as an RN: *
Please select all the apply. If multistate licensure, please select your license state and the multistate option.
Required
Please list your current employer(s) or organization(s) where you have authorization to precept: *
If you have any affiliations with health organizations outside of your employer where you also have authorization to precept, please list them:
Please list any nursing organizations you are affiliated with or are a member of:
What timeframe are you able to commit to? Check all that apply.

 *
Required
Please briefly describe your nursing background/experience and any specialties: *
Would you be willing to serve as a preceptor virtually for a student who is unable to find someone in their area? *
Please include any additional relevant information regarding your ability to precept a current Aspen student:
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