PITTSBURGH FOUNDATION NURSING SCHOLARSHIPS QUALIFICATIONS SPECIFIC

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1 PITTSBURGH FOUNDATION NURSING SCHOLARSHIPS QUALIFICATIONS SPECIFIC Edward and Dorothy Livingston Fund Scholarship Female Preference will be given to minority students Resident of Allegheny County, Pennsylvania Attend a School of Nursing in Allegheny County William Henry Fitch Memorial Trust Fund Scholarship Preference will be given to minority students Resident of Allegheny County, Pennsylvania Economically disadvantaged Disadvantaged educational background Sheena M. Taylor Scholarship Legal resident of Western Pennsylvania, West Virginia; attend a School of Nursing in Allegheny County Legal resident of the United Kingdom of Great Britain or Northern Ireland attending a School of Nursing in the United States Economically disadvantaged Disadvantaged educational background QUALIFICATIONS GENERAL Nursing School QPA minimum 2.0 (on a 4.0 scale) Attend an accredited School of Nursing (Diploma, Associate Degree or BSN) which prepares the individual to become a registered nurse Priority will be given to junior or senior level students in a BSN program or second year students in diploma / associate degree programs

2 PITTSBURGH FOUNDATION NURSING SCHOLARSHIP APPLICATION PROCESS: 1. Complete Scholarship Application and Personal Statement. 2. Obtain verification from your school s financial aid officer using the Financial Aid Verification Worksheet (must have completed FAFSA and have EFC) Student Aid Report (SAR) must be attached. 3. Submit three signed Recommendation Forms. One must be from a faculty member in the School of Nursing. 4. Official copy of School of Nursing Transcript. 5. Collect all of the required documents and submit the entire package to: Kathy Mayle, Scholarship Administrator Dean of Nursing 800 Allegheny Avenue, Room 402 Pittsburgh, PA Scholarship recipients will be selected based on a variety of criteria including: Compliance with established criteria Financial need Academic achievement Personal commitment to nursing Contribution to the school and to the community Leadership potential Completeness of application Adherence to published application deadline Packet must be postmarked by July 15. No or faxed transmissions will be accepted.

3 CONSOLIDATED NURSING SCHOLARSHIP APPLICATION (OF THE PITTSBURGH FOUNDATION) Edward and Dorothy Livingston Fund (limited to females) William Henry Fitch Memorial Trust Sheena M. Taylor Scholarship Select all that apply Name Address Last First Middle (School) City County State Zip (Permanent) City County State Zip Phone Home Work Cell Address: High School: Date of High School Graduation: School of Nursing: Year in Nursing School: Anticipated Graduation Date: I am a member of a minority group: Yes No Gender: Male Female I am a resident of: Northern Ireland Great Britain Western Pennsylvania West Virginia

4 Please attach a 500 word personal statement describing your: Economic need / economic disadvantage * Educational disadvantage * Theoretical and clinical achievement Contributions to school Contributions to the community Personal commitment to nursing Other factors relevant to your situation 1. I hereby apply for a Pittsburgh Foundation Scholarship. I understand that if I am awarded a Scholarship the monies must be used for tuition, books and or educational fees. If I withdraw or am terminated from the program, I must return all unused monies immediately to the Pittsburgh Foundation. 2. I grant the Scholarship Administrator of the Pittsburgh Foundation to monitor my academic progress in nursing school. 3. I understand that only the final Scholarship recipients will be notified. 4. I certify the information herein is true and correct to the best of my knowledge. Print Name Signature Date *As defined by Health Resources and Services Administration (HRSA) disadvantaged background is a student who: Comes from an environment that inhibited the individual from obtaining the knowledge, skills and abilities required to enroll in and graduate from a health professions or nursing school or Comes from a family with an annual income below a level based on low-income thresholds according to family size published by the US Bureau of Census adjusted annually for changes in the Consumer Price Index, and adjusted by the Secretary US Department of Health and Human Services, for use in health professions and nursing programs.

5 THE PITTSBURGH FOUNDATION SCHOLARSHIP APPLICATION PERSONAL STATEMENT (approximately 500 words) Print Name Signature Date

6 PITTSBURGH FOUNDATION NURSING SCHOLARSHIP FINANCIAL AID VERIFICATION WORKSHEET ACADEMIC YEAR This must be completed by the School of Nursing Financial Aid Officer. Name: Address: Phone: School of Nursing: Educational Expenses * Tuition $ Books $ Supplies $ Other $ (Please specify) Total $ *Do not include living expenses. Program Type: BSN ADN Diploma Year: Freshman Sophomore Junior Senior Second Degree Year 1 Year 2 Other

7 Financial Aid (Other Resources) PHEAA Grants $ PELL Grants $ FSEOG Grants $ Direct Subsidized Loans $ Direct Unsubsidized Loans $ Work Study $ Tuition Loan Forgiveness $ Employee Tuition Benefits $ Other Scholarships $ Other $ Other $ Other $ Total Resources $ Unmet need $ EFC (application will not be considered without EFC) Please attach Student Aid Report I certify the above information is true and correct. Signature of School Financial Aid officials Print Name Title School Phone

8 School Seal Please return completed form to student. THE PITTSBURGH FOUNDATION NURSING SCHOLARSHIP REFERENCE FORM This Section to be completed by the applicant. Name First Last MI Print the name of the person completing the reference. Do not use friends or family as references. Name: Relationship to applicant: The above individual has applied for a Pittsburgh Foundation Scholarship. Your comments will be used by the Selection Committee to assist in making an award decision. Applicants to Reference: Public Law grants a student access to his/her records as maintained by the Pittsburgh Foundation. This law grants the student/applicant the right to relinquish access to the reference to assure that your records are held in compliance with the law, check one: I relinquish my right of access to this reference* I do not relinquish my right of access to this reference Signed Date *If the applicant chooses to relinquish, the person supplying this reference should mail this form to: Kathy Mayle, Scholarship Administrator Dean of Nursing 800 Allegheny Avenue, Room 402 Pittsburgh, PA Reference must be postmarked by in order for the applicant to be considered for an award. No or fax transmissions will be accepted.

9 How long have you known the applicant and in what capacity? Please comment on the applicant s academic ability (if you are a faculty member please provide evidence of the applicants academic achievement theoretical and clinical). Please describe the applicant s contribution to the school or the community. What is your estimate of the applicant s leadership potential? Please comment on the applicant s commitment to nursing. Other comments: Name (print): Name (signature): Title: Date: Address: Phone:

10 PITTSBURGH FOUNDATION NURSING SCHOLARSHIP Applicant Checklist: Application Personal Statement Official transcript from School of Nursing 3 completed reference forms Financial Aid Verification Sheet Student Aid Report (SAR) Mail to: Kathy Mayle, Scholarship Administrator Dean of Nursing 800 Allegheny Avenue, Room 402 Pittsburgh, PA Complete application packet must be postmarked by. NO FAXED or transmissions will be accepted.

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