THE NURSES FLOAT SCHOLARSHIP FUND

THE NURSES FLOAT SCHOLARSHIP FUND Introduction The Nurses Float Scholarship Fund was created by Bare Root, Inc., a not-for-profit 501 (c) 3 organization, from funds remaining from the Nurses Float which appeared in the 2013 Rose Parade. The impetus for this historic event was the presidency of Sally Bixby, RN who was the first nurse and only the second woman to hold the office of President of the Tournament of Roses. The 5 nurses, who founded Bare Root Inc., worked to make the Nurses Float a reality setting a goal that if any funds remained a scholarship would be established. Through the generous donations of many nurses, lay people, health systems, organizations, and associations, the Nurses Float Scholarship Fund is a reality. To learn more about this historic event we invite you to visit www.flowers4thefloat.org. At the completion of the Nurses Float project the Association of California Nurse Leaders (ACNL) was selected, by Bare Root Inc., to be the administrator of the Nurse s Float Scholarship Fund. The Nurses Float Scholarship Fund is an academic scholarship. One scholarship will be awarded annually to a registered nurse pursuing either an ADN to BSN or BSN to MSN degree. For the ADN to BSN Candidate: A successful candidate for the ADN to BSN will receive one $5,000 scholarship annually with the previous year s winner being given priority, if they reapply, and they have achieved a minimum of a 3.0 GPA in their first year while maintaining a full time school schedule for a maximum of 2 years. If this student chooses to pursue a MSN, the student must reapply and be considered with all other candidates for the scholarship and must achieve a minimum of a 3.0 GPA while maintaining a full time school schedule for a maximum of 2 years. For the BSN to MSN Candidate: The successful BSN to MSN candidate will receive one $5,000 scholarship annually, with the previous year s winner being given priority, if they re-apply, and they have achieved a minimum of a 3.0 GPA in their first year while maintaining a full time school schedule for a maximum of 2 years. Transcripts will be required so place your request as soon as possible. Include GPA. The application is due Tuesday December 15, 2015. The recipient selection is determined through a committee process and is based upon the applicant meeting the eligibility criteria and completion of the application documents. The recipient will be announced and recognized at the ACNL Annual Conference. Applicants need not be a member of ACNL or reside in the State of California to apply. 1

THE APPLICATION Please type the application. The application must be complete to be considered for a scholarship. Please indicate which scholarship for which you are applying. Check the appropriate box. ADN to BSN BSN to MSN 1. PERSONAL INFORMATION Name: Home Address: City/State/Zip: Phone: Work: Home: Cell: E-mail: 2. EDUCATION INFORMATION Please provide us with the name of the education institution you will attend to obtain your degree. Name of School: Address: Address: Anticipated Date of Completion 3. Have you received a Nurses Float Scholarship before? Please circle the correct answer. Yes or No If yes, please provide the year the scholarship was awarded. Please proceed to the PERSONAL STATEMENT Section 2

PERSONAL STATEMENT In 500 words share why you are seeking a scholarship from the Nurses Float Scholarship Fund. Describe the following: 1. Your current position 2. Your future career goals 3. What you feel is your biggest contribution to the profession of nursing to date Please include information about: 1. How you vision your future 2. How you work in collaboration with others 3. Your comfort level with risk taking 4. Your entrepreneurial spirit. Place this information in the context of your leadership abilities. You can use this space for your statement or you may attach a separate sheet of paper. If you choose to attach a separate sheet of paper please make sure it is titled PERSONAL STATEMENT and include your name. After you have completed the PERSONAL STATEMENT proceed to the BIO SKETCH 3

BIO SKETCH Please provide the following information. If an area does not apply please indicate by using NA in that space. Name: Position/Title: Work Address: Address: Phone: Email: EDUCATION List the most recent degree first. INSTITUTION LOCATION FIELD OF STUDY DEGREE MM/YY Indicate current GPA: Please list current Certifications/Credentialing: Please list recent authored/co-authored publications: Please list recent professional speaking engagements: 4

Please list recent Community Service Activities: Your signature implies that this application is honest and truthful. Signature: Date: You are almost complete, please proceed to the RECOMMENDATION LETTER. 5

RECOMMENDATION LETTER To the applicant: Please provide these pages to the person you select to provide a letter of recommendation. Include your name in the space below. You may want to keep a copy of these pages for your own file. The person you select should be someone that you currently work with in a collegial or administrative capacity. They should be able to address your potential to be a successful student demonstrating the qualities listed below. They should also comment on your willingness to be a role model for the profession of nursing. The recommendation letter must be typewritten. Name of applicant TO THE RECOMMENDER To the person writing the letter of recommendation, please address how the applicant demonstrates the qualities listed below. You may use a separate sheet of paper. The instructions for sending this letter are listed below. Please return these pages with your recommendation letter. SUGGESTED QUALITIES The 5 nurses who founded Bare Root Inc.-The Nurses Float, realized the qualities listed below were required to complete this historic project. We would like the Nurses Float Scholarship Fund to support a nurse who would like to strengthen and demonstrate these qualities during their educational process and beyond. If you are not familiar with the Nurses Float project please visit www.flowers4thefloat.org to learn more. Vision: describe how this individual creates a vision for their future, the future of a project, organization, association and/or the profession. Collaboration: provide insight into how this individual uses the quality of collaboration to facilitate teamwork and bring a project to completion. Risk Taking: provide at least one example where this individual stepped out of their comfort zone and took a risk to accomplish a goal or fulfill a vision. What was the impact on the profession of nursing? Entrepreneurial Spirit: describe how this individual demonstrates the entrepreneurial spirit to accomplish a goal; make a dream come true, or fulfill a vision. What was the impact on the profession of nursing? 6

Leadership Ability: provide one example of this individual s ability to provide direction, guidance, and visionary thinking. What was the impact on the profession of nursing? Please indicate the strength of your overall endorsement of this applicant: Highly Recommended Recommended Recommended with reservations Not Recommended Recommender s Name: Position: Organization: Address: Address: Phone: Email: Signature: Date: Please mail, email or fax your recommendation letter and the parts of this form that were completed by Tuesday, December 15, 2015 to: Wendy Smolich, ACNL Administrative Manager Email: wendy@acnl.org Fax: 916.779.6945 Office Number: 916-779-6949 Mailing Address: 2520 Venture Oaks Way #210 Sacramento, CA 95833 One last item to check before you are finished. Proceed to the CHECKLIST. 7

CHECKLIST Due by Tuesday, December 15, 2015 Use this checklist to ensure that you have completed the process correctly. Please submit the following Nurses Scholarship Fund documents. Completed APPLICATION. Completed PERSONAL STATEMENT. Completed BIO SKETCH. Provided information about the RECOMMENDATION LETTER portion to the person who have selected. Attached transcripts of the most recent educational program attached. Include current GPA. Verified Recommendation letter along with accompanying forms has been sent to ACNL according to the instructions in the application. Completed CHECKLIST Please mail, email or fax the application to: Wendy Smolich ACNL Administrative Manager Email: wendy@acnl.org Phone: 916-779-6949 Fax: 916-779-6945 Mailing Address: 2520 Venture Oaks Way #210 Sacramento, CA 95833 8