HOAG PATIENT CARE SERVICES Advanced Nursing Degree (BSN, MSN, DNP, PhD, Ed.D) SCHOLARSHIP APPLICATION BACKGROUND PURPOSE

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HOAG PATIENT CARE SERVICES Advanced Nursing Degree (BSN, MSN, DNP, PhD, Ed.D) SCHOLARSHIP APPLICATION BACKGROUND As an answer to the critical nursing shortage, the Foundation task force Choose Nursing, Choose Hoag was formed to promote awareness that nursing education is a viable component to the solution. It is comprised of a group of community leaders dedicated to supporting nursing education in order to attract and develop the best and brightest new nurses, and to providing career-advancing education for established nurses. The groups on-going efforts include the construction of the Marion Knott Nursing Education Center that offers continuing education programs, funding nursing professorships at local colleges and universities and provide funding for nursing scholarships. PURPOSE The Hoag Hospital Patient Care Services Advanced Nursing Degree Scholarship Program for nursing has been established to provide supplemental financial support to Hoag Registered Nurses who actively pursue education in nursing at the Bachelor s, Master s or Doctoral degree level. This program recognizes the vital contribution nurses make to healthcare and is therefore designed for RNs seeking further education in nursing science who demonstrate financial need to meet tuition requirements. CRITERIA FOR AWARD Qualified candidates are Registered Nurses at Hoag Hospital who are currently enrolled or have confirmation of acceptance in a Bachelor s, Master s or Doctoral Program in Nursing. Qualified candidates must meet the following minimum criteria: Full time, scheduled part time, or per-diem employee. Evidence of enrollment or letter of acceptance in an accredited Bachelor s, Master s or Doctoral Program in Nursing. Verification of having worked one year at Hoag Hospital in good standing with no written/verbal counseling within the past six months. Demonstration of scholastic and professional excellence. APPLICATION PROCESS The following items should be submitted to Rick Martin, MSN, RN, Senior Vice President, Clinical Operations & Chief Nursing Officer, for consideration. The completed scholarship application. Three letters of recommendation: 1) one from a member of Hoag Medical Staff, 2) one from immediate supervisor, and 3) one from a colleague. The letters must address the candidate s knowledge, skill, motivation and commitment to patient care. Curriculum vitae. SELECTION PROCESS

ADVANCED NURSING DEGREE SCHOLARSHIP APPLICATION Page 1 of 5 Selection of recipients will be based on a review of the completed application, three (3) letters of recommendation, evidence of eligibility requirements, and may include a panel interview. 1

ADVANCED NURSING DEGREE SCHOLARSHIP APPLICATION Page 2 of 5 I. PERSONNEL INFORMATION (Please type or print) Name Address City State Zip RN License Number State Permanent mailing address (if different from above) Address City State Zip Home phone Work II. DEMOGRAPHIC DATA Current job title Unit Current Job status Full Time Scheduled part time Per-diem Date of hire Education History LVN Associate Degree (AA, AD, AS) Bachelor s Degree Master s Degree Doctorate Degree Field Year Completed School GPA 1. Please explain why you are pursuing this degree. 2. Please describe your financial need 2

ADVANCED NURSING DEGREE SCHOLARSHIP APPLICATION Page 3 of 5 3. Have you received Hoag scholarship funds in the past? Yes No If yes, date and amount for each previous scholarship. 4. Describe your professional goals for the next three years. III. HONORS/AWARDS/CERTIFICATIONS 1. Please list all that apply: IV. PROFESSIONAL APPLICATION 1. Describe how you see this degree enhancing our professional growth. 2. Describe how you will utilize the degree to impact patient care at Hoag and support the Forces of Magnetism. 3. Describe what you have done to date to enhance patient care at Hoag. 3

ADVANCED NURSING DEGREE SCHOLARSHIP APPLICATION Page 4 of 5 4. Give an example of how you utilize evidence-based-practice. V. ENROLLMENT INFORMATION School of Nursing Date of Acceptance Anticipated Date of Graduation Academic Advisor required approvals Supervisor name: Signature Date Extension # Department head name: Signature Date Extension # The above information is true to the best of my knowledge. I understand that my education expenses and receipts submitted and reimbursed by any available tuition reimbursement or scholarship program offered by Hoag Hospital or Hoag Hospital Foundation are ineligible for reimbursement by any other Hoag Hospital or Hoag Hospital Foundation programs. Employee signature Date 4