SGNA First Time Attendee Annual Course Scholarship Application
All information is due to SGNA Headquarters no later than March 1. Applicants will be informed of the Committee’s decision in mid-april
Please submit to:
SGNA Awards Committee
330 N Wabash Avenue, Suite 2000
Chicago, IL 60611-4267
Email:ax: 312.369.6694
Type or clearly print the information requested below
Name and Credentials:_____Malia Currie RN______
Email:______Phone:____(812)584-6629______
Home address:__9544 Mt Tabor Road______
City:_Aurora______State:__IN______ZIP:__47001______
Employer:__St. Elizabeth Hospital______
Employer’s Address:__4900 Turfway Road, Florence, KY 41042______
Provide the name and phone number of your immediate supervisor:
______Debra Payne (859)212-7329______
May we contact him/her for information if needed? YesxNo☐
1.Membership:
1a. How long have you been a member of SGNA?_Just joined last week______
1b. Name and/or number of your Regional Society:___Kentucky Regional Society (22)
2.When did you begin working in a GI/Endoscopy facility?___January 2013______
3.List any SGNA-related (regional/local) activities you attended in the past two years:
____None______
4.Have you served as an officer or on a committee for your regional or local SGNA? Please list.
____No______
5. Essay: In 300 words or less (typed and double-spaced), explain your goals in attending the Annual Course and how you will share your experience with others.
I have become the teamleader of St. Elizabeth Florence Endoscopy this year. Our endoscopy department in small, with an average of seven employees. This year we have started doing several new procedures and our staff is growing. As the team leader, I would like to be as knowledgable as possible to make
our department the best that it can be. Any education that I can get will be dispersed amongst the staff to help in their education and increase their knowledge in our department. This information will be sharedthrougheducational meetings withpower points, as well as general discussion throughout the work
day.The more we know, the better we will be!
We are hoping to have all our nurses become certified over the next fewyears and I would like to be the first nurse to this. I have enrolled in the certification review classes to start this process, and will continue to study after the SGNA Annual Course until I become certified. I have been appointed Team Lead
and plan to do just that.
The newest procedures in the department include Endobronchial Ultrasound with fine needle aspiration and Navigation Bronchoscopy with Veran technology. I am highly excited to take the session on Pulmonary Endoscopy and will leave the conference with information to share with our team. I am also
excited about the Advanced Hands-on ERCP course, the more ERCP information the better.
Becoming a member of SGNA makes me feel like a true Endoscopy Nurse. Being a part of this specialized field is an honor. Allowing our department to grow into a good, strong endoscopy department is our goal.
6. References: Please submit two references from a supervisor, certified nurse, or physician with whom you work on a regular basis.
1.Name:Debra Payne______Email:______Phone:_(859)212-7329___
2.Name:Camille Hornsby____Email:______Phone:_(513)462-8676___
ApplicationsmustbereceivedbyMarch1st.
Completethisformandreturnto SGNA
Email:
Fax:312.673.6694
Mail:330 N Wabash Avenue Suite 2000,Chicago,IL60611
I understand that, if I receive an SGNA Novice Nurse/Associate Scholarship I am required to apply funds received toward expenses related to attending this annual course. I agree to return to the SGNA any unused portion of the scholarship.
Signature______Malia Currie, RN______