2015 CENTENNIAL EDUCATION SCHOLARSHIP

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1 2015 CENTENNIAL EDUCATION SCHOLARSHIP Description of Fund: The Centennial Education Scholarship Fund was created by the Oregon Nurses Foundation (ONF) in During 2003 and 2004, ONF members were successful in raising these monies because they were specifically designated to address the current and impending nursing shortage in Oregon. Specifically, these funds are intended to support individuals in nursing programs by providing support for tuition costs in the early phases of their nursing program. Eligibility for the Funds: 1. Applicant must be accepted into or enrolled in an accredited nursing program in Oregon. 2. Applicant must provide a Letter of Acceptance into the nursing program. 3. A cumulative Grade Point Average (GPA) in nursing of 3.0 or greater. Applicant must provide a signed GPA form from the Registrar, and obtain OFFICIAL transcripts of all college coursework. 4. The critical elements of the application review are: a) Leadership abilities and experiences (35%) b) Experiences with other cultures, minority groups, and underserved populations (30%) c) Career plans in nursing (30%) d) Reason(s) for needing Centennial Education Scholarship funds (5%) 5. Consideration of geographical location in the state of Oregon will be made when choosing recipients. 6. Submit the completed application, using instructions listed under each section. Amount of the Award: Each award will be for $1,000 and will be made available at the beginning of the Fall and Winter/Spring terms following the application due date. The scholarship will be sent directly to the school in which the student is enrolled and applied toward tuition costs. Award Recognition: Oregon Nurses Association (ONA) will publicly recognize Centennial Education Scholarship recipients on a yearly basis. The recipient must contact ONA to acknowledge receipt of the scholarship (if awarded). Application Postmark Deadlines: June 30, 2015 for August 1, 2015 Award November 30, 2015 for January 1, 2016 Award Where to Send the Application: Via Via postal mail: Oregon Nurses Foundation, SW Boones Ferry Rd., Ste. 200, Tualatin, OR Questions??? Contact ONA Professional Services at FOR OFFICE USE ONLY DATE RECEIVED For Application Deadline of: June 30, 2015 November 30, 2015 Application Letter of acceptance to nursing program Official transcripts with all college coursework Certified statement of cumulative GPA at 3.0 or greater Three (3) letters of recommendation sent directly to ONF by the individuals providing references

2 OREGON NURSES FOUNDATION SW Boones Ferry Road, Suite 200 Tualatin, OR (503) CENTENNIAL EDUCATION SCHOLARSHIP APPLICATION (YOU WILL BE NOTIFIED IF ADDITIONAL FORMS ARE REQUIRED) Applicant's Name Telephone Last First Middle Street/PO Box City State Zip Have you been accepted into a nursing program? YES NO (Attach letter of acceptance) School Program: Baccalaureate Program Associate Degree Program EDUCATION AND TRAINING Institutions Name and of School Graduated Yes No Degree Received Areas of Specialization High School College Graduate School of Nursing Special / Military Training NOTE: Please have the college send a statement of cumulative GPA certified by the Registrar s Office. They must also send Official Transcripts for all college coursework directly to ONF. 2

3 Employment Information Employer Name and (Most recent employer first) Dates Employed Job Title and Description of Duties (If additional space is needed, attach a separate sheet) 3

4 1. Provide a description of honors, awards, and leadership positions you have held. (35%) What you should describe is: Examples of honors and awards may include experiences prior to entry into or while in the nursing program; Examples of leadership positions, whether these were paid, elected or appointed, the length of time, and the contribution to the organization which resulted from the leadership. Name of Honor/Award Awarded By Date Reason for Award Leadership Position Organization Dates of Service Contributions (If additional space is needed, attach a separate sheet) 2. Provide a description of your experiences with other cultures, minority groups, and underserved populations. (30%) What you should describe is: Structured learning opportunities in another culture; Service (paid, volunteer) to an underserved population; Mastery of another language that facilitates work with or understanding of another culture (not English). 4

5 3. What do you envision you will be doing in nursing in 5 years? In 10 years? Do you anticipate practicing nursing in Oregon? (30%) Instruction and clarification: We want to know how you plan to contribute to the nursing and health care needs of Oregonians as well as where you think you will be practicing. 4. What is the reason you are seeking these scholarship funds? (5%) Instruction and clarification: Provide a written statement outlining the reasons you need these scholarship funds and answer parts a) and b) below. a) Have you received scholarship funds from other sources in the last year? YES NO b) If yes, indicate the amount of the scholarship. Less than $1000 $ $3999 $ $6000 Over $6000 5

6 5. Names of persons to whom you have given reference forms. Obtain at least one reference from a nursing faculty member known in the last five years or a current supervisor. References from a personal friend are not accepted. (1) Name/Position Telephone/ (2) Name/Position Telephone/ (3) Name/Position Telephone/ This completes the applicant responsibility portion of the packet. View the instructions on pages 7 9 to complete the remaining application requirements. submit form by submit by postal mail or fax: Nursing program letter of acceptance must be attached with submission. Oregon Nurses Foundation SW Boones Ferry Rd, Ste 200 Tualatin, OR Fax:

7 CERTIFIED STATEMENT OF CUMULATIVE GPA & ALL COLLEGE LEVEL COURSEWORK APPLICANT: This page must be printed and provided to your Registrar s office in order to obtain official SEAL from Registrar. It cannot be filled out online. This certifies that the cumulative GPA for at is. Official college-level coursework transcript is attached / being sent separately. Seal Registrar (please print) Registrar's Signature REGISTRAR OFFICER: Please mail this form directly to: OREGON NURSES FOUNDATION SW Boones Ferry Rd, Suite 200 Tualatin, OR This form must be postmarked by: June 30, 2015 November 30,

8 REFERENCE FORM (page 1 of 2) APPLICANT: Please provide a copy of this form (either by printing or electronically) to each of your three (3) references to complete. This form must be postmarked by: June 30, 2015 November 30, 2015 Applicant's Name The above named applicant is applying for the ONF Centennial Education Scholarship. In addition to the applicant's GPA, we ask each applicant to supply personal references. Your cooperation in completing the questions below would be very valuable to us in considering the applicant for the ONF Centennial Education Scholarship. All references are confidential and are not shared with the applicant by the ONF Review Committee. I. Knowledge of the Applicant 1. How long have you known the applicant? Yr(s) Mo(s) 2. In what capacity have you known the applicant? II. Relative ratings of the applicant: Please use your knowledge of the applicant to rate the characteristics listed below. In rating the applicant, please keep in mind the comparison group you state below (undergraduate students, graduate students, practicing nurses, or other). Comparison group: Specific Characteristics N/A Unable to Judge (0) Low (1) Good (2) Very Good (3) Outstanding (4) 1. Strength of interest/commitment of nursing 2. Motivation/diligence 3. Ability to get along with others 4. Professional integrity 5. Clinical competence 6. Demonstration of leadership skills 7. Ability to organize 8. Critical thinking/analytic abilities 9. Communication skills/ability to articulate ideas 10. Creativity FOR OFFICE USE ONLY TOTAL POINTS 8

9 REFERENCE FORM (page 2 of 2) III. Comments: (Please consider the characteristics rated in Section II) IV. Are you willing to further discuss the applicant's qualifications? YES NO Name Title or Position Phone Signature Please mail this form WITH a reference letter directly to: OREGON NURSES FOUNDATION SW Boones Ferry Rd, Suite 200 Tualatin, OR This form must be postmarked by: June 30, 2015 November 30,

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