Scholarship Application Form
ELIGIBILITY:
The Royal Columbian Hospital (RCH) Nurses Alumnae Society Scholarship will annually providefinancialassistance for a nursing student registered in the second or third year of a Full Time Registered Nurse Baccalaureate Program located within the province of British Columbia.
APPLICATION PROCEDURE:
Students wishing to be considered for this Scholarship opportunity and who meet the eligibility requirements must complete and forward the scholarship application by June 30th to:
RCH School of Nursing Alumnae Society
c/o: # 168 – 45900 South Sumas Road
Chilliwack, B.C. V2R 0S9, or
Email:
Section A: Personal Information
Last Name:
First Name:
Street Address:
City:
Province:
Postal Code:
E-mail address:
Contact Number:
Page 2 / Cel phone: Home:
Section B: Personal Letter
Enclose a letter including your personal goals and expected learning outcomes of your nursing program accompanied by a current professional photograph.
Section C: Letter of Reference
A current letter of reference must accompany your Application form in order to evaluate the suitability of your application for this scholarship.The Referee must provide contact information and indicate the period of time they have known you and in what capacity.
The reference lettermust bear the original hand-written signature of the Referee, be contained in a sealed envelope with the referee’s signature written across the back of the envelope,and either accompany your application or be mailed directly to the address indicated in the ‘Application Procedure’ section.
Section D: Study Information
University or College you are attending:
Length of Program: / (Years)
Graduation Date:
Proof of Enrolment containing your current GPAmust be attached to this application.
Section E: Signature and Declaration
Successful applicants will be asked to submit a brief Bio and picture for publication in the annual newsletter.
I have fully read and completed the application form. I have met the eligibility requirements and I declare that I have submitted completed and true information on the application form.
I authorize the RCH School of Nursing Alumnae Society to includethe Bio, picture, city of residence, and the name of the University/College that I am attending in their annual Newsletter.
Date signed:
Signature of Applicant:
Page 3
Before submitting your application, please ensure that youenclosed/attached the following Information:
___ Completed application form.
___ A personal letter identifying your goals and learning outcomes.
___Letter of reference.
___Proof of enrolment in your nursing program.
___Read, dated and signed the declaration requirement.
___ Submitted your application before the deadline date of June 30th.
**Please Note:
Only successful scholarship recipients will be notified in September or early October in the calendar year of application.
Revised: February 2017.