2016Scholarship Application

Application Deadline: Monday, May 30, 2016

Scholarship recipients will be selected based on the information provided in this form. Incomplete or late applications will not be considered.

Criteria for selection include

  1. Must be a currently admitted/enrolled student at Rutgers -School of Nursing in the BS, MSN, Post-Masters, DNP, or PhDprograms on either campus.
  2. Demonstrates service to Rutgers-School of Nursing and/or the nursing community at large.
  3. Demonstrates service to others through volunteerism.
  4. Demonstrates high academic achievement and humanistic clinical care.
  5. Financial need may be considered as part of the selection process.

*First Name:
*Last Name:
*Student ID#:
Daytime Phone #:
E-mail Address: / Street Address
Apt.
City State: Zip:
County:

Academic Information

Student Status: Yes currently enrolled in Rutgers Nursing Program

Campus (check one): Newark New Brunswick

Cumulative GPA: Expected credit load for the year:Expected Graduation date (month/year):

Degree Program(check one)

BScircle one (full time) (accelerated) (part time) (RN to BS)

MSN POST-MASTERS CERTIFICATE DNP PhD

Gender (check one)MaleFemale

Ethnicity and Race

To help the University comply with a commitment to the U.S. Department of Health, Education and Welfare, you are urged to identify your ethnic background and gender. You may decline to do so without prejudicing the action taken on your application.

Please check one:

Hispanic Asian or Pacific IslanderNon-Hispanic Black

American Indian or Alaskan NativeNon-Hispanic WhiteOther:

Work History

Please list your work history for the past 5 years (or attach your resume with the application)

Service to the Rutgers School of Nursing and/or Healthcare community at large (please list)

Volunteer/Community Service Activities(please list)

Previous Scholarships

Please specify any financial scholarships you have received for your current academic program at Rutgers School of Nursing

Scholarship Essay

Briefly describe how a scholarship would help you to reach your educational and professional goals. Identify yourgoals and needs clearly. This essay is given strong consideration in the decision-making process.

Signature

By typing/signing my name in the signature line, I certify that the above information is accurate to the best of my knowledge. I authorize the Rutgers School of Nursing Enrollment Services to verify my GPA and other information contained in this application to members of the Scholarship Committee. I also agree that Rutgers-Financial Aid may review my financial status and share pertinent information regarding my financial need. If selected to receive a scholarship, I agree to participate in promotional activities to publicize my awards, such as attendance at awards presentations and the use of my photos and other information in print and online publications produced by Rutgers and its affiliates.

Signature:Date:

Save a copy of the completed application for your records.
E-mail it to:

Deadline: Monday, May 30, 2016

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