UNAC/UHCP. Kathy Sackman Member Scholarship Program. Putting Patients First Since 1972 PLEASE POSTMARK BY DECEMBER 31 OFFICIAL APPLICATION FORM

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1 UNAC/UHCP Associations o fc ia Unit rn ifo ed al OFFICIAL APPLICATION FORM ls n of on a io Un PLEASE POSTMARK BY DECEMBER 31 s se ur Putting Patients First Since 1972 N Kathy Sackman Member Scholarship Program He alth Care Prof si es

2 United Nurses Associations of California INTRODUCTION 2 In 2014, UNAC/UHCP renamed our member scholarship program in honor of Kathy Sackman, RN, and her decades of leading nurses and other health care professionals to advocate for their patients. Along with a small group of nurses from Kaiser Fontana, Kathy Sackman, RN, built UNAC/UHCP from her kitchen table. While working as an ICU nurse, she realized that nurses should represent other nurses, and shortly thereafter, UNAC/UHCP was born. For thirty three years, Sackman grew the union to 20,000 members strong, adding physician assistants, optometrists, physical and occupational therapists and many more health care professionals to the mix. Sackman s UNAC/UHCP also took a case to the US Supreme Court--and won! UNAC/UHCP created three scholarship programs in 2012 and began awarding scholarship recipients in The Kathy Sackman Scholarship Program offers scholarship prizes for full dues-paying UNAC/UHCP members. The Sonia Moseley Scholarship Program awards scholarships to family members of UNAC/UHCP members. Finally, the Delima MacDonald Community Scholarship Program gives scholarships to community members pursuing a health care degree. UNAC/UHCP is proud to offer 10 scholarships of $3,000 each this year for any full dues-paying member to continue his/her education. Turn the page to review the guidelines and fill out an application. All applications must be postmarked by December 31, In solidarity, Ken Deitz, RN, BSN UNAC/UHCP President Denise Duncan, RN UNAC/UHCP Executive Vice President Jettie Deden-Castillo, NP UNAC/UHCP Treasurer Charmaine Morales, RN UNAC/UHCP Secretary Union of Health Care Professionals United Nurses Associations of California / Union of Health Care Professionals 955 Overland Court, Ste. 150 San Dimas CA

3 ELIGIBILITY 3 This is a competitive scholarship, and applicants are evaluated according to academic ability, social awareness, and appreciation of the labor movement. A GPA of 3.0 or higher is recommended. These one-time awards are for study beginning in the Fall Term. Students may re-apply each year. The UNAC/UHCP Kathy Sackman Member Scholarship Program is an ongoing program of scholarships available to full dues-paying UNAC/UHCP members to continue their education in the health care field. Ten scholarships of $3,000 each will be awarded to the winners selected from applicants who meet the eligibility requirements and submit complete applications. To be eligible for a scholarship the member must: Be a full dues-paying UNAC/UHCP member at the time when the application is submitted; Be enrolled for the upcoming Fall Term in a degree program or continued education courses in a health care field at an accredited college, university, trade or technical school; and Be available to attend an awards banquet on Saturday, May 2, 2015 at 7 p.m. in San Diego, if selected as a scholarship recipient. The scholarship may be used for study in a health care field only. SELECTION The UNAC/UHCP Scholarship Committee, consisting of impartial health care professionals who are members of UNAC/UHCP, will thoroughly examine all application materials submitted by each scholarship applicant. The application materials include the application form, essay, transcript (if applicable), recommendation letter, and contributions to or appreciation of the labor movement. The Scholarship Committee will use a blind selection process, and the applicants names or contact information will be redacted before the application materials are reviewed by the Committee. Based on the record of each applicant, the Scholarship Committee will then choose ten scholarship recipients and announce the winners by MARCH 15. Every applicant will be notified by a letter sent to the address provided on the application form the outcome of the selection process. UNAC/UHCP cannot provide any information on the status of an application before March 15. The Scholarship Committee s decision is final and cannot be appealed.

4 INSTRUCTIONS 4 For UNAC/UHCP Kathy Sackman Member Scholarship Program: 1. Complete the application form on pages 5-6 (enclosed). 2. Compose an essay, typed and double-spaced, not to exceed 500 words, on the subject: What UNAC/UHCP has meant to me. 3. As a 3.0 GPA is recommended, please attach an official copy of your transcript from your most recent degree program or undergraduate transcript. 4. Include a letter of recommendation from another UNAC/UHCP member, not to exceed one page, explaining why he/she believes you should receive the scholarship. 5. Please make sure your complete application and all supporting documentation (essay, transcript, letter of recommendation, proof of union membership) are mailed together in one envelope, POSTMARKED NO LATER THAN DECEMBER 31, to: 6. Please do not send photos. UNAC/UHCP Member Scholarship Program Attn: Scholarship Committee 955 Overland Court, Suite #150 San Dimas, CA

5 APPLICATION (Please print in ink or type.) 5 Applicant s Name Address City State Zip Code Phone ( ) address What activities did/do you participate in at your work site? List any offices held or honors received during your employment. List any academic honors that you have received. List all community service or social justice activities or awards you have received. List all accredited college, university, trade or technical schools you have been accepted to, attend, or applied to for acceptance for the upcoming Fall Term. All essays written as part of the UNAC/UHCP Scholarship application process become the property of UNAC/UHCP. UNAC/UHCP retains the right to reprint some or all of the winning essays in UNAC/UHCP s The Voice Newsletter, on UNAC/UHCP s website or social media accounts, or in other union publications and to identify the authors of the winning essays. UNAC/UHCP also reserves the right to reprint, describe or except theses essays in other publications or to assign that right to others. Signature Date

6 APPLICATION (continued) (Please print in ink or type.) 6 Membership Information (attach proof of membership such as a copy of UNAC/UHCP Membership Card) Employer Affiliate Work Phone Number ( ) How did you hear about the UNAC/UHCP Scholarship Program?: (website, , letter, union member, union leader, school financial aid department, other): High School Information Name of High School from which you graduated: High School Grade Point Average (Average/Scale): [Enter showing Average/Scale, e.g. 3.9/4.0 or 4.1/5.0] High School Class Rank/Class Size (skip if not applicable): [Enter showing Rank/Size, e.g. 1/400 or 100/250] Post-High School Education Information Attendance dates at College (from Month/Year to Month/Year): Major/Field of Study at College: Date (Month/Year) you received your degree/diploma at this College (skip if not applicable): [Use this format: 05/2011] College Grade Point Average Average/Scale (skip if not applicable): [Enter showing Average/Scale, e.g. 3.9/4.0 or 4.1/5.0] If you have attended more than one College, add additional explanation with College names, location, dates of attendance, degrees (sought or earned): Signature Date