Minot State University Department of Nursing Scholarship and Awards Application Form

Transcription

1 Minot State University Department of Nursing Scholarship and Awards Application Form Application Deadline: February 1 st Please refer to Department of Nursing Handbook and MSU Undergraduate Catalog for detailed information and criteria about each of the scholarships for which you are applying. Submit this completed application to the Nursing Office, Memorial Hall Complete the Financial Aid scholarship application online by February 1 st 2. To qualify for as many scholarships as possible, complete the following: Student Name Semester in Nursing (in Spring) or Licensed as LPN RN Are you a resident of North Dakota? Yes No What State and County are you from? Are you older than 24? Yes No Do you have financial need? Explain Current GPA Are you a member of NSA? Yes No Have you completed any community service? Explain What area of nursing are you interested in or planning on going into? Medical ICU Surgical ER Pediatrics CRNA Obstetrics Rehab Psychiatric Hospice other/explain Where are you planning on working after you complete your nursing degree? Minot other (include place) 1

2 Please mark box by scholarship for which you are applying. Answer questions and attach essay if applicable. BETSY NOKLEBY SCHOLARSHIP 1. Current S2 or S3, RN-BSN (circle one) 2. Full-time student Part-time student Need not be a North Dakota resident Based on financial need and work output Second semester junior and senior students and faculty may submit names of nominees to be considered by Student-Faculty Affairs Committee. CHAIR S AWARD: The Chair s Scholarship from the Fabricius-Steinle Endowment 1. Do you display innovation, creativity, or leadership? 2. Can you communicate an idea or raise a question? 3. Have you implemented a project? Attach essay explaining 1, 2, and 3 Students are recommended by the faculty. Selection is made by the Chair of the Department. ELIZABETH PROSS SCHOLARSHIP ENDOWMENT - Awarded to Female nursing student 1. Can you show evidence of community service during previous semester (a minimum of 10 hours)? 2. Can you show a dedication to the caring theory of nursing (explanation of how you have or how you plan to implement the theory in your career in the future to improve the quality of nursing)? Attach essay explaining 1 & 2 EMMA MISNER SCHOLARSHIP ENDOWMENT 1. Are you a ND resident/graduate? Yes No 2. Are you in your second nursing semester (junior year, 2 nd half) Yes No Attach one page essay on What is the most important quality of a nurse and why? EVELYN R. NIELSEN SCHOLARSHIP 1. Cumulative GPA (must be 3.0 or higher) 2. Are you an officer or member of the Nursing Student Association- MSU? Yes No 3. Have you made an active contribution to and/or held a leadership position in the NSA, Department of Nursing, nursing profession, or community service? Yes No If Yes, explain: FRANCIS SVEE SCHOLARSHIP 1. Are you a ND resident? Yes No 2. Full-time student Part-time student 3. Current S2 or S3, RN-BSN (circle one) Students and faculty may submit names of eligible nominees in writing to SFA Committee that meet psychosocial criteria: o Caring o Unconditional acceptance o GRACE FISHER 1. Are you a full-time student? Yes No 2. Are you a Sophomore Junior Senior 2

3 GUNNAR SOLBERG SCOLARSHIP 1. Are you eligible for junior or senior year? Yes No 2. Are you a citizen or eligible non-citizen? Yes No 3. Are you maintaining satisfactory progress? Yes No 4. Are you a full-time student? Yes No HALVOR AND ORMA NESHEIM SCHOLARSHIP 1. Are you a resident of Mountrail or Ward County? Yes No 2. Do you have a GPA of 3.0 or higher? Yes No 3. Are you planning to stay in ND following graduation? Yes No HELEN CHATFIELD SHURR ENDOWMENT SCHOLARSHIP 1. Cumulative GPA 2. Do you plan to be enrolled in 4 to 6 credits of nursing courses toward BSN degree? Yes No 3. Are you eligible to enroll in 400 level nursing courses at Minot State University? Yes No (Current S3 or S4 or RN-BSN) 4. Have you completed at least 30 semester hours in nursing courses? Yes No 5. Are you a ND resident? Yes No Preference is given to an RN or LPN pursuing a BSN degree Attach one page on Describe your professional growth since your decision to obtain a BSN. IRENE ELLA AND OTTO JOHNSON ENDOWMENT SCHOLARSHIP 1. Are you 24 years old or older? Yes No 2. Cumulative GPA 3. Have you completed the first group of nursing courses that include a clinical "hands-on" nursing care component? Yes No Recommendations will be made by Nursing Foundations faculty at the completion of each Foundations course; the names are then submitted to Student-Faculty Affairs Committee. Nursing Foundations faculty will submit potential recipient names at the end of each spring and fall Nursing Foundations course to ensure fair representation of all sophomore level students. Awards will be allotted to a student from each spring and fall semester group of Nursing Foundations students (two monetary awards per year). JANICE SMITH NURSING SCHOLARSHIP ENDOWMENT 1. Are you a full time nursing student? Yes No JIM AND KAREN JENSEN NURSING SCHOLARSHIP ENDOWMENT 1. Are you a full time nursing student? Yes No JOAN LOVE CHRISTIANSON SCHOLARSHIP 1. Cumulative GPA Must meet minimum requirements set by MSU Department of Nursing 2. Are you a full time student? Yes No KEITH AND ELEMA CUNNINGHAM ENDOWMENT 1. Is there a financial need? Yes No Awarded through Financial Aid Office LOIS BELLET WILLIAMS NURSING SCHOLARSHIP ENDOWMENT 1. Are you from Williams, McKenzie, Burke or Divide counties? Yes No If no applicants are from the above mentioned counties the chair of the department will first consider other ND students. 3

4 LORETTA F. HOLUB SCHOLARSHIP Award based on financial need. MALONEY SCHOLARSHIP: Awarded to ND residents on basis of financial need, academic excellence, character and citizenship. MARGARET BRUCE NURSING SCHOLARSHIP 1. Are you from one of the following counties: Divide, Williams, McKenzie, Burke, Mountrail, Renville, Ward, Bottineau, McHenry, Sheridan, Wells, Rolette, Pierce, and McLean? Yes No If yes, which county? Student must demonstrate a financial need. Must demonstrate good character, citizenship and academic promise. MARK RONDE MEMORIAL SCHOLARSHIP 1. Are you an RN to BSN student? Yes No 2. Is your GPA at least 3.0? Yes No 3. Is there financial need? Yes No Students and faculty may submit names of nominees to be considered. MINOT MOOSE LODGE SCHOLARSHIP Based on financial need, academic performance, character, and citizenship. MSU DEPARTMENT OF NURSING ALUMNI SCHOLARSHIP 1. Have you received a formal letter of acceptance for admission by the Department of Nursing and begun the nursing major? Yes No 2. Attach 1 or 2 page essay about Why you chose nursing as a career? SFA will evaluate essays by selecting committee to review essays and make selections using established criteria. o Clear articulation of personal factors that came to bear on your choice of nursing as a career o Collegiate level communication abilities should be demonstrated in essay o Rank essay based on these criteria and make recommendation NELS T AND OLINE BLIKRE SCHOLARSHIP 1. Are you from Mountrail County? Yes No 2. Do you demonstrate financial need? Yes No PBC SCHOLARSHIP Students from the College of Business, College of Education and Human Services or the Department of Nursing. PATRICK KELLY MUUS NURSING SCHOLARSHIP 1. Are you a full time student? Yes No 2. Are you a ND resident? Yes No 3. Are you planning a career as a CRNA? Yes No Students and faculty may submit names of nominees to be considered to the Student Faculty Affairs Committee, who will then make a recommendation to the Faculty Committee. PATTY LOU PIETSCH TRZPUC MEMORIAL SCHOLARSHIP: 1. Are you a regularly enrolled, full-time, MSU Nursing student? Yes No 2. Cumulative GPA The Junior (Semester 2 or Semester 3) with the highest GPA at the time of selection will be awarded. Student-Faculty Affairs Committee will determine eligibility and bring names forward to Faculty Committee. 4

5 DR. RICHARD DORMONT NURSING SCHOLARSHIP ENDOWMENT 1. Do you have an interest in pediatrics? Yes No 2. Are you from NW ND? Yes No 3. Attach essay covering the topic of history of involvement and achievement that benefits the community. Selection also based on: Financial need and Excellent scholastic record ROGER DROBASH NURSING EDUCATION SCHOLARSHIP 1. Are you a relative of a current or former member of either Trench Rat Dugout No. 436 or Disabled American Veterans Chapter No. 4? Yes No RUBBELKE SCHOLARSHIP: 1. Are you a relative of Leona Rubbelke? Yes No Preference will be given to any of Leona s nieces, nephews, grandnieces, grandnephews, etc. who may apply for scholarship ST JOSEPH S COMMUNITY FOUNDATION SCHOLARSHIP Apply through Department of Nursing 1. Are you from one of the following counties? Please circle Bottineau Renville Burke Rolette McHenry Sheridan McLean Ward Mountrail Wells Pierce Selection will be based on academic performance, financial need (not based on federal guidelines), financial circumstance, family status, and other factors determined by the department to affect the ability of a student to attain a nursing degree. TRACY PETERSEN SNYDER ENDOWED SCHOLARSHIP 1. Are you a Junior or Senior in the nursing program? Yes No Students and faculty may submit names for consideration to the SFA. o Demonstrates excellence in scholarship. o The scholarship is not to be given solely on the basis of need. o o Display attributes of being a dedicated, qualified student of professional nursing. Consideration may be given to attributes reflecting Tracy s professional skill and interest in the nursing care of children. William N. Skip Shirley Memorial Nursing Scholarship Endowment 1. Are you a ND High School graduate? Yes No 2. Nursing major? Yes No YVONNE FALSTAD HOOVER Allocation is based solely on financial need. Awarded through Financial Aid Office. 5

6 **Other awards and scholarships available. AMVET SAD SACKS OF ND: Application is scanned and ed to all students in the Nursing Program. NURSING STUDENT LOAN (NSL): Apply at Financial Aid Office. ND NURSING SCHOLARSHIP LOAN PROGRAM: Apply to the ND Board of Nursing. ND NURSES ASSOCIATION: Apply to NDNA. TRINITY HEALTH EDUCATIONAL SCHOLARSHIP: Complete the appropriate application form provided by Trinity Health Foundation. Contact the Foundation at TRINITY ALUMNI SCHOLARSHIP: Offered through Trinity Alumni Association. Application due by December 1 st. Contact nursing faculty (Linda Schaefer or Linda Haider) or SFA. By signing this document you state that the information provided is true and correct. Signature Date 6