Award & Scholarship Application Packet

The deadline for all applications is November 15

Incomplete applications will be not considered

Available Awards, Grants, Scholarship

Education Scholarship – One $1,000 scholarship annually to assist with tuition, books, academic supplies to pursue nursing education.

Research/Evidence Based Practice Project Award – One $1,000 award annually to conduct research or an EBP project.

Candia Baker Laughlin Certification Scholarship – One $1,000 scholarship annually to one member to cover the exam fee, study materials, and other expenses related to achieving certification.

Conference Scholarship for Nursing Students (NEW!) – One $1,000 scholarship and complimentary conference registration annually to a student seeking initial nursing licensure only – ADN, RN, BSN.

Conference Scholarship for New Nurses (NEW!) – One $1,000 scholarship annually (Members in nursing less than 2 yrs.)

Conference Scholarship– One $1,000 scholarship annually (Members in nursing 2 yrs. or more)

Excellence Awards Sponsored by the Anthony J. Jannetti, Inc. Nursing Economic$ Foundation (Two $500 awards annually)

Administrative Excellence award recognizes a member’s unique ability to lead others toward the successful completion of their organization’s/work place’s mission and goals.

Clinical Excellence award recognize a member’s excellence in nursing skills, knowledge, expertise and personal attributes that contribute to the delivery of quality patient care.

Visit aaacn.org/awards to obtain separate Excellence award application.


Award & Scholarship Application - Part 1 Demographics

To be completed by all applicants

Note: You must be a member of AAACN for a minimum of two continuous years

at time of application.*

Instructions:

Complete the portions of this packet that apply to the award/scholarship/grant you are applying for by the deadline to . Insert “Award/Scholarship Application” in the subject line. Or, mail the application to: AAACN Scholarships, P.O. Box 56, Pitman, New Jersey, 08071-0056. Applications receive a blind review by the Nominating Committee.

Awards, scholarships, and grants are presented annually at the conference following the year in which the application was submitted. The application deadline for all awards/grants/scholarships is November 15. All applicants should complete pages 2, 3, and 12 of this packet, respond to questions in the appropriate section based on the award you are applying for, and submit a copy of your resume/CV. You may apply for more than one award or scholarship but only one will be awarded.

I am applying for:

[ ] Education Scholarship

[ ] Research Grant

[ ] Evidence Based Practice Project Award

[ ] Candia Baker Laughlin Certification Scholarship

[ ] Conference Scholarship for Nursing Students (NEW!)*

[ ] Conference Scholarship for New Nurses (NEW!)

[ ] Conference Scholarship for Members (2 years or more in nursing)

Demographic Section:

Name: Credentials:

Job Title:

Employer:

Mailing Address:

E-Mail Address:

Phone Numbers: Home Work

*Applicants for Nursing Student scholarship do not need to be members of AAACN. But, they must be recommended by a current member via a letter of recommendation.

AAACN Award & Scholarship Application Part 1 (continued)

To be completed by all applicants

How long have you been a member of AAACN?

Are you Nursing certified?

If yes, which one?

Ambulatory Care Coordination Other______

What volunteer committees, task force, etc., have you participated in for AAACN?

How do you promote AAACN?

Number of AAACN Conferences attended in the past?

Number of presentations given at AAACN Conference(s), including poster presentations?

What is your highest level of education?

ADN_____ RN_ ___ BSN Masters __ Doctorate ___ Other___

What is your degree in?

Nursing ___ Business __Health Related Other (please describe):_

Are you a member of any other professional organizations? [ ] Yes [ ] No

If yes, which organizations?

Note: Please include your resume/CV for all applications.


Award & Scholarship Application Packet

Part 2

Complete ONLY the Section that applies to the award or scholarship you are applying for.

Use this checklist to make sure your application is complete.

Award/Scholarship you are applying for / Be sure to complete these pages
Education Scholarship – attach:
●CV/resume
●Proof of acceptance in course or enrollment in accredited nursing program.
●Narrative / 2, 3, 5, 12
Research Grant – attach:
●CV/resume
●Copy of Research abstract
●Proof of acceptance by IRB or academic institution
●Narrative / 2, 3, 6, 12
EBP Award – attach:
●CV/resume
●Copy of EBP abstract
●Proof of acceptance by employer or sponsoring institution
●Narrative / 2, 3, 7, 12
Candia Baker Laughlin Scholarship for Certification – attach:
●CV/resume
● Three 100-150 word narratives as requested / 2, 3, 8, 12
Conference Scholarship for Nursing Students (NEW) – attach:
●A CV/resume is not required
●Proof of student status
●Letter of recommendation from current AAACN member
●Narrative – response to one of four statements / 2, 3, 9, 12
Conference Scholarship for New Nurses (NEW) – attach:
●CV/resume
●Narrative / 2, 3, 10, 12
Scholarship for Conference Attendance – attach:
●CV/resume
●Narrative / 2, 3, 11, 12

AAACN Education Scholarship

$1000 for assistance with tuition, books, academic supplies to pursue nursing education.

Please describe your need for the program/course by checking one:

__ Employer does not offer reimbursement for tuition, books, academic supplies

Employer pays [ ] tuition only

Employer pays percentage of [ ] expenses [ ] tuition

Employer pays a flat rate in the amount of $______

___other: describe ______

Are you currently enrolled in an academic institution? Yes No

[ ] ***Please submit proof of acceptance in course, or current enrollment in an accredited school of nursing program***

How do you plan to utilize this scholarship award if selected? (please select all that apply)

Payment of tuition

__ Books

__ Academic supplies

__ Other: ______

Name and address of Academic Institution:

What degree are you seeking?

ADN___ BSN____ Masters ___ Doctorate __ Other ______

Will your degree be in:

Nursing ____ Business ____ Health Related ____ Other _____

[ ] Narrative (100-150 words)::

Write a brief narrative describing why you are applying for this scholarship award and why you should be considered a candidate.

If advancing your degree, what do you intend to do with your degree or the education obtained once completed?

How will this course or degree program help you give back to AAACN and/or ambulatory care nursing?

(Use separate sheet if necessary)

AAACN Research Grant

NOTE: ONLY one award will be granted annually

($1000 to assist with conducting either nursing research or EBP project.)

Complete applicable page – Research or EBP

Does the research apply to ambulatory care nursing and supports the AAACN Mission of advancing the art and science of ambulatory nursing?

Yes No

[ ] Attach copy of Research Abstract that contains the following information:

o  Title of Research/ EBP Project

o  Primary investigators name and credentials

o  Co-investigators name and credentials

o  Body of Abstract to include:

Identification of problem/overview

EP question/purpose

Methods/Evidence

Significance of findings/outcomes

Implications for ambulatory nursing

[ ] Proof of acceptance of research study by academic institution or by Investigational Review Board of employer or sponsoring institution is attached:

Yes No

Are you willing to publish article in ViewPoint or present via a poster or presentation at the conference describing the research study/EBP project and its outcomes within one year of receipt of the award.

Yes No

[ ] Narrative (100-150 words):

Write a brief narrative describing why you are applying for this research grant including why you should be considered a candidate. Include how your research applies to ambulatory care nursing (e.g., how will you be giving back to ambulatory care nursing)? Also include how this will assist you in supporting the mission of AAACN by promoting the art and science of ambulatory care nursing.

(Use separate sheet if necessary)

AAACN Evidence Based Practice (EBP) Project

NOTE: ONLY one award will be granted annually

($1000 to assist with conducting either nursing research or EBP project.)

Complete applicable page – Research or EBP

Name of EBP Project:

Names and titles of co-researchers, if any:

[ ] Copy of EBP Abstract attached to this application:

Yes No

o  Body of Abstract to include:

Identification of problem/overview

EP question/purpose

Implications for ambulatory nursing

Root cause that stimulated EBP Project? Briefly describe what motivated the action to conduct this EBP Project.

[ ] Acceptance of EBP Project by employer or sponsoring institution is attached:

Yes No

Are you willing to publish article in ViewPoint or present via a poster or presentation at the conference describing the research study/EBP project and its outcomes within one year of receipt of the award.

Yes No

[ ] Narrative (100-150 words): Write a brief paragraph describing why you are applying for this EBP award including why you should be considered a candidate. Include how your project applies to ambulatory care nursing (e.g., how will you be giving back to ambulatory care nursing)? Also include how this will assist you in supporting the mission of AAACN by promoting the art and science of ambulatory care nursing. (Use separate sheet if necessary)

American Academy of Ambulatory Care Nursing Awards/Scholarship Packet 12

AAACN Candia Baker Laughlin Scholarship for Certification

($1000 for assistance with exam fee and preparation materials)

Please describe your financial need for the certification scholarship by checking one:

___Employer does not offer reimbursement for exam fee or preparatory materials

___Employer pays exam fee only but does not pay for preparatory materials

___Employer pays _percentage of [ ] exam fee [ ] preparatory materials

Employer pays a flat rate in the amount of $

___other: describe

1. I am currently eligible to sit for the exam? ____Yes ____No

2. I agree to become certified in Ambulatory Care Nursing through ANCC within one year of receiving award?

____Yes _____No

3. I am willing to write an article for the ViewPoint newsletter within one year of

receipt of the award describing my journey to certification and the professional benefits I have derived from this award. ____Yes ____No

[ ] Narrative:

Please provide written description of why certification is important to you (50-100 words).

Please describe your motivation for attaining this certification (50-100 words).

Describe any benefits from your employer such as pay or promotion, requirements of career ladder, professional status, personal/professional satisfaction, or any other motivators. (50-100 words)

Describe how this will help you give back to ambulatory care nursing and AAACN.

(Use separate sheet if necessary)


AAACN Conference Scholarship for Nursing Students

($1000 for assistance with registration, air fare, or lodging to attend the AAACN annual conference) Student must be recommended by a current AAACN member

(Must be in student status during the semester application is submitted. A student is defined as an individual seeking initial nursing licensure only – ADN, RN, BSN)

Name and Address of Academic Institution:

[ ] Please submit proof of your student status.

What degree are you seeking?

ADN_____ RN_____ BSN_____

Name of current AAACN member recommending you for this scholarship?

[ ] Must include letter for recommendation from current AAACN member.

If given a scholarship I am willing to write a brief article in the ViewPoint newsletter describing where I am in my nursing journey and how I feel my attendance at the conference will help me move forward to achieve my goals.

____Yes _____No

[ ] Narrative:

As a nursing student, please respond to one of the four statements below (in 50-100 words) to include as part of your application: (Use separate sheet if necessary)

1.  State how you expect ambulatory practice to be part of your career.

2.  State how you expect the benefits of attending the AAACN annual conference will assist you in your career.

3.  State your vision of promoting the art and science of ambulatory care nursing.

4.  State your goals for your professional nursing career and broadly describe how you plan to meet those goals.

NOTE: A CV/resume is not required for Nursing Student applications.


AAACN Conference Scholarship for New Nurses

($1000 for assistance with registration, air fare or lodging to attend the AAACN annual conference for a new nurse practicing 2 years or less)

I graduated from nursing school and have been a Registered Nurse no longer than 2 years at time of submission of application. ____Yes ____No

I am willing to write an article for the ViewPoint newsletter within one year of receipt of the award describing my journey from nursing school graduation to competence in the profession of nursing. Additionally, will include a description of the professional benefits I have derived from this award. ____Yes ____No

What nursing degree did you obtain?

ADN_____ RN_____ BSN_____ Other_____

Did you participate in a nurse residency program? ____Yes ____No

If Yes, was it ______Inpatient Residency? ____Outpatient Residency?

Narrative (50-100 words):

As you begin your career in nursing, please respond to one of the four statements below to be included as part of your application. (Use separate sheet if necessary)

1.  State how you expect ambulatory practice to be part of your career.

2.  State how you expect the benefits of attending the AAACN annual conference will assist you in your career.

3.  State your vision of promoting the art and science of ambulatory care nursing.

4.  State your goals for your professional nursing career and broadly describe how you plan to meet those goals.


AAACN Scholarship for Conference Attendance

($1000 for assistance with registration, air fare, or lodging to attend the

AAACN annual conference)

Please describe your need for the scholarship by checking one:

Employer does not offer reimbursement for registration or expenses

Employer pays registration only

Employer pays expenses only

Employer pays _____percentage of registration

Employer pays ___percentage of expenses

Employer pays a flat rate in the amount of $

Other: describe

I have been asked to present at this AAACN Conference ___Yes _ No

I am willing to write an article for the ViewPoint newsletter within one year of receipt of the award describing the professional benefits I have derived from this award.

Yes No

[ ] Narrative (50-150 words):

Describe why you are applying for this scholarship and why you should be considered a candidate. State how you expect the benefits of attending the AAACN annual conference will assist you in your career. Include past contribution or plan for future contribution to AAACN and/or ambulatory care nursing.