Kent State University
College of Nursing
Psychiatric Mental Health Nursing (PMHN) Graduate Program
Application for Margaret Clark Morgan Foundation and/or
Ohio Department of Mental Health Traineeship
Graduate PMHN students may apply for a Margaret Clark Morgan Foundation/Ohio Department of Mental Health traineeship. These traineeships will be available for the following semesters: Fall 2012 and Spring 2013. Students must complete and submit an application for each semester he/she is seeking traineeship funds. Eligibility criteria must be met and maintained. The amount of the traineeship will depend on the number of qualified students who apply for these funds.
Eligibility criteria are:
1. Full acceptance into the MSN Program in one of the following three concentrations: PMH Adult CNS, PMH Child/Adolescent CNS, PMH Adult or Family NP;
or,
Full acceptance into one of the following post-master’s certificate programs: PMH CNS Adult, PMH CNS Child/Adolescent, or PMH Adult or Family NP.
2. GPA 3.0 or above at the time of application
3. No outstanding incomplete grades on transcript at time of application.
4. Enrolled in full-time (minimum of 8 semester hours) or half-time (minimum of 4 semester hours) graduate coursework.
5. Commitment to participate in volunteer mental health activities during the semester that the traineeship is awarded.
6. Commitment to work in the Ohio mental health system after graduation.
Deadlines for completed applications are:
§ August 17, 2012 for the Fall 2012 Semester
§ January 4, 2013 for the Spring 2013 Semester
Kent State University
College of Nursing
Psychiatric Mental Health Nursing (PMHN) Graduate Program
Application for Margaret Clark Morgan Foundation Traineeship
NameBanner ID
Address (street)
(city, state, zip)
Phone (home)
Phone (work)
Phone (mobile)
Undergraduate GPA
Current Graduate GPA
RN License Number / Expiration date: State:
Indicate semester/academic year you are seeking funding for:
Fall 2012
Spring 2013
Indicate your program concentration:
Psychiatric Mental Health Clinical Nurse Specialist (Adult)
Psychiatric Mental Health Clinical Nurse Specialist (Child/Adolescent)
Psychiatric Mental Health Nurse Practitioner (Adult or Family)
Post-Master’s Certificate
Psychiatric Mental Health Clinical Nurse Specialist (Adult)
Psychiatric Mental Health Clinical Nurse Specialist (Child/Adolescent)
Psychiatric Mental Health Nurse Practitioner (Adult or Family)
Indicate all sources of financial aid (grants, scholarships, employer reimbursement) you are currently receiving:
Type of Aid / Amount / Renewable (Y/N)Indicate the courses you plan to take during semester for which you are seeking funding:
N60002 PMH APN Adult II: Group, Organization, Community
N60005 PMH APN Child/Adolescent II: Group, Organization, Community
N60007 Advanced Assessment Across the Lifespan
N60012 Advanced Mental Health Assessment and Psychopathology
N60013 Advanced Health and Physical Assessment Lab
N60042 Primary Care I
N60045 Pathophysiology for Advanced Practice Nurses
N60051 Neurobiology and Psychopharmacology Across the Lifespan
N60101 Theoretical Basis for Nursing Practice
N60151 PMH APN I: Individual Psychotherapy Across the Lifespan
N60206 Ambulatory Diagnostics for APN
N60332 CNS Role Practicum in PMNH
N60441 APN Pharmacology
N60450 Ethical and Cultural Issues
N60401 Research Methods I
N60402 Nursing Research II
N60451 Health Policy and Delivery System
N61592 PMH APN Practicum I
N65692 PMH Practicum III
Indicate your projected graduation date: ______
Briefly describe the type of mental health volunteer activities you are interested in. Formulate goals for your participation in these volunteer activities:
______
______
If you receive traineeship funds, are you willing to:
practice in a mental health setting in Ohio for at least two (2) years following graduation?
serve as a preceptor for students in the PMHN graduate program at Kent State University?
serve as a guest lecturer on special clinical topics in courses offered in the PMHN graduate program at Kent State University?
CERTIFICATION In the event I am awarded support, I hereby certify that:
1. I am enrolled full-time (8 semester hours) or part-time (4 semester hours) in the PMHN graduate program at Kent State University
2. If my enrollment status changes due to dropping a course, I have until the end of the semester to pay back the traineeship monies I received for the semester.
3. I know I must maintain a 3.0 GPA.
4. I consent to provide information regarding professional activity for 3 years following graduation from the PMHN graduate program at Kent State University.
5. I know this is taxable income.
My signature demonstrates that all the information contained in this application is accurate and current.
______
Signature Date
Mail completed application to:
Wendy Umberger PhD PMHCNS-BC
Program Director, PMHN Graduate Concentration
Kent State University
College of Nursing
113 Henderson Hall
Kent, OH 44242
or
Fax to:
330-672-2433
Attention: Dr. Wendy Umberger
or
Email to:
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