PHILIPPINE NURSES ASSOCIATION OF NORTHERN CALIFORNIA, INC.



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PHILIPPINE NURSES ASSOCIATION OF NORTHERN CALIFORNIA, INC. PNANC NURSING STUDENT SCHOLARSHIP The Philippine Nurses Association of Northern California, Inc. (PNANC) promotes fellowship and unity among Filipino nurses, to foster a positive image and to provide activities that assist in the professional development of the Filipino nurse. PNANC offers two (2) scholarship awards to Filipino-American nursing students who are currently enrolled in an accredited school of nursing in Northern California. There are two categories of scholarship awards: Undergraduate (Bachelor degree) Graduate (Master, Doctorate or Post-Doctorate degree) Amount for each awardee: 1) $1000 2) 1-year free PNANC membership Deadline for applications: October 31, 2015. The scholarship award will be announced online on our PNANC website & facebook by November 30, 2015. The criteria for the application are: Must have a biological parent or grandparent who is Filipino. Undergraduates: Student must be enrolled in the 3 rd year or higher of a San Francisco Bay Area accredited undergraduate nursing program (Holy Names University; Samuel Merritt University; University of California, San Francisco; San Francisco State University; San Jose State University; California State University East Bay; University of San Francisco; Dominican University of California). Graduates: Student must be enrolled in the 2 nd year or higher, or a student of a postdoctorate program must be enrolled in the 1 st year or higher of a San Francisco Bay Area accredited graduate nursing program.

Must demonstrate superior record of academic achievement with a cumulative grade point average (GPA) of 3.0 or higher. If you are a doctorate or post-doctorate student, you must demonstrate that your previous GPA was 3.0 or higher. Must provide letters of recommendation Undergraduate: One letter must be from student's clinical instructor from enrolled nursing program 2 nd letter from student's nursing program instructor (academic or clinical instructor) or from an employer that you have worked for more than 2 years Graduates One letter from student's program instructor from the enrolled nursing program 2 nd letter from an employer you have worked with for 2 or more years. For Post-Doctorate Graduates one confirmation letter from the institution's faculty to confirm your admission. 2 Nd letter is not required. Must complete application packet (general information, list activity involvement and complete an essay). Must provide verification of community involvement - A letter from the organization verifying community involvement, a certificate of participation or recognition, or a time sheet are all acceptable Must submit an official transcript from the accredited nursing program. If an official transcript will not arrive by the deadline, an unofficial transcript can be temporarily submitted. A temporary unofficial transcript needs to be signed off by one of the institution's faculty members (includes their title, name printed, signature and contact phone number) to verify your grades, and a receipt copy of the official transcript request. An official transcript must still be submitted and must arrive within 3 weeks after the deadline in order to be considered. Awardee commitment (once the undergraduate and graduate is awarded the scholarship): Be a member of the PNANC for 2-years, in which 1-year is free membership. Participate in at least 4 PNANC activities within 2014 through 2016 to promote the goals and activities of the organization. Examples of activities are PNANC organized events such as attending member meetings, health fairs, educational conferences, fundraisers, being involved in a committee, community outreach events, medical missions, recruitment of at least 5 PNANC members. One of the 4 PNANC activities required must be to attend a meeting or conference to meet members of PNANC. Submit photo and agree for PNANC to publicly announce awardee's accomplishments

Provide PNANC the address of school and department to where scholarship award will be sent. Scholarship award recipient will claim said award from that department.

2015 PNANC NURSING STUDENT SCHOLARSHIP APPLICATION I. GENERAL INFORMATION (INCOMPLETE INFORMATION WILL NOT BE PROCESSED) FULL NAME: STREET ADDRESS: CITY, STATE, ZIP: PHONE NUMBER (Day): PHONE NUMBER (Evening): EMAIL ADDRESS: DATE OF BIRTH: List if parent &/or grandparent is Filipino Nursing School in SF Bay Area: Nursing School Street Address: Nursing School City, State, Zip: Year in Nursing School enrolled in: Expected Date of Graduation: Employer: Employer Street Address: Employer City, State, Zip: Current Job Title I certify that all the information in this application to be true and correct. I agree to allow the Philippine Nurses Association of Northern California to ask for personal and academic information concerning my application from my college and references. Signature Date

II. ACTIVITIES Student Government Clubs / Organizations Sports / Athletics Theater / Drama / Arts Volunteer Work (verification letter, certification, or timesheet from organization must also be included in application) Employment III. SPECIAL ACHIEVEMENTS: HONORS AND AWARDS (LIST IF ANY OR N/A) Name of Award/Achievement Date Brief Description

IV. ESSAY: Please use a separate sheet of paper, double-spaced and write your response to the following statements: Briefly provide a self-reflection that describes your strengths and areas for improvement. 200+ words Briefly describe your career goals. 100+ words Explain your need for a scholarship. 100+ words Describe how you can contribute to the goals of the PNANC. Be specific. 100+ words Describe an accomplishment or activity as a nursing student or as a nurse that has impacted your life or the life of another person. 200+ words

V. APPLICANT RESPONSIBILILTIES Completed application must be received by exact deadline or as posted date in envelope. The following documents are required with the application (refer to CRITERIA for more details): General Information sheet List of activities involved in Verification of community involvement Letters of Recommendation (2 for undergraduates & graduates. 1 for post-doc) An official transcript Essay NOTE: If necessary, you will be notified of a date/time/location for a Personal Interview Applicant will be contacted via email after the process of selection is completed Any questions or completed applications are to be mailed to: Rowena Patel PNANC Scholarship Committee Chair C/O Teresita Baluyut 845 Mt. Vernon Ave., San Francisco, CA 94112 rowenapatell@gmail.com APPLICATION DEADLINE October 31, 2015

LETTER OF REFERENCE Name of Applicant: The applicant above is applying for the 2015 UNDERGRADUATE OR GRADUATE NURSING STUDENT SCHOLARSHIP from the Philippine Nurses Association of Northern California, Inc (PNANC). The mission of the organization is to promote fellowship and unity among Filipino nurses, to foster a positive image and to participate in activities that assist in the professional development of the Filipino nurse. PNANC awards a thousand-dollars ($1,000.00) scholarship every year to a Filipino undergraduate or graduate nursing student of an accredited program in Northern California. PNANC seeks candidates based on community service, leadership activities and financial need. We would like you to address in your letter of reference: nature of your relationship with the applicant and the length of time you have known the applicant. applicant s character, including enthusiasm and motivation needed to complete nursing program evaluation of applicant's leadership ability, strengths, weaknesses, and potential within and outside the clinical setting academic achievement(s) in nursing school Participation in extra-curricular or community activities that show evidence to serve the needs of others Your evaluation of this applicant will be appreciated. Information provided will be kept CONFIDENTIAL.

Name of Applicant: PHILIPPINE NURSES ASSOCIATION OF NORTHERN CALIFORNIA, INC. (PNANC) 2015 NURSING STUDENT SCHOLARSHIP APPLICATION LETTER OF REFERENCE Name of Reference Signature of Reference Date Title Must be submitted to PNANC by October 31, 2015 to: Rowena Patel PNANC Scholarship Committee Chair C/O Teresita Baluyut 845 Mt. Vernon Ave., San Francisco, CA 94112 Reference Employment Name & Address

Name of Applicant: PHILIPPINE NURSES ASSOCIATION OF NORTHERN CALIFORNIA, INC. (PNANC) 2015 NURSING STUDENT SCHOLARSHIP APPLICATION LETTER OF REFERENCE Name of Reference Signature of Reference Date Title Must be submitted to PNANC by October 31, 2015 to: Rowena Patel PNANC Scholarship Committee Chair C/O Teresita Baluyut 845 Mt. Vernon Ave., San Francisco, CA 94112 Reference Employment Name & Address

2014 2015 MEMBERSHIP INFORMATION PHILIPPINE NURSES ASSOCIATION OF NORTHERN CALIFORNIA, INC. (PNANC) As of September 2014, any membership fee paid now, will include a membership year that encompasses 2014 through December 2015. The next annual membership fees due will be for a membership year that is from January through December there after. What Your Membership Offers: Activities that unify Filipino-American nurses in Northern California Programs to promote professional growth and development of its members Networking opportunities with professional organizations and agencies to develop and implement educational programs relevant to nursing practice, education and research Participation in community activities and programs that foster health education. Scholarships to qualified nursing students of Philippine ancestry Mentorship and fellowship among nurses of Philippine ancestry Information regarding legislation and public policy which affect nursing and health care (CHECK ONE BELOW) I am already a member of PNANC I am an undergraduate student and paying for PNANC membership ($10/year) I am a nurse and attending graduate school and paying for PNANC membership ($80/year) I am not a member at this time but may be interested in the future PAYMENT CAN BE DONE: 1. ONLINE: http://www.pnanorthcal.org/registration.html Check if paid online. 2. Download membership application from above online address and mail with your scholarship application to: Rowena Patel PNANC Scholarship Committee Chair C/O Teresita Baluyut 845 Mt. Vernon Ave., San Francisco, CA 94112