To receive an application, please contact the following:
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1 The Association of Kern County Nurse Leaders (AKCNL) is pleased to announce our Nightingale Nursing Scholarship Award. This scholarship is available to assist in undergraduate and graduate preparation of nurses in Kern County. Flier There are 10 undergraduate and/or graduate scholarships available in the amount of $ each. These funds have been raised by the Association of Kern County Nurse Leaders (AKCNL). Undergraduate and graduate students with nursing leadership qualities are eligible and are strongly encouraged to apply. To receive an application, please contact the following: All applications must be postmarked no later than March 11, 2016
2 February 2016 The Association of Kern County Nurse Leaders (AKCNL) is pleased to announce our Nightingale Nursing Scholarship Award. This scholarship is available to assist in undergraduate and graduate preparation of nurses in Kern County. There are 10 undergraduate and/or graduate scholarships available in the amount of $ each. These funds have been raised by the Association of Kern County Nurse Leaders (AKCNL). Undergraduate and graduate students with nursing leadership qualities are eligible and are strongly encouraged to apply. Information concerning eligibility and application instructions are delineated in the enclosed application. Individuals who meet the following criteria are eligible to apply: Must include a written recommendation from your immediate supervisor or instructor (please refer to the attached recommendation form and instructions.) Currently enrolled in an accredited entry level or graduate RN Program. Plan on staying in Kern County after graduation. Undergraduate student must maintain at least a 3.0 GPA. Graduate student must maintain at least a 3.5 GPA. Completed packet for an AKCNL Nightingale Scholarship must be completed and postmarked by Monday, March 11, Send packet to: Association of California Nurse Leaders Kern Chapter ATTN: Professional Practice/Education Committee PO Box Bakersfield, CA Please contact Diane Biswanger at Diane.Biswanger@DignityHealth.org if you have any questions. Qualified candidates will be selected through an application review process. Scholarships will be awarded at our April 21, 2016 RN of the Year Dinner. 2
3 Completed Application Must Include: Complete application Transcript of program courses to date including GPA Current Recommendation Letter Must use enclosed 3 page Supervisor/Instructor Scholarship Recommendation Form Essay (no longer than 500 words) 3
4 Scholarship Application Name: Telephone Number: Address: City and Zip Code: Current Semester or quarter: Name of school and program attending: Degree to be obtained: Projected month/year to graduate: GPA (verified by school document): Would you be willing to attend the Annual A Night to Honor Our Nurses event on April 21, 2016 at 6 pm? Yes No Please write a comprehensive 500 word essay that clearly answers the following questions. The essay must be typewritten and double-spaced. Use your own voice and writing style. *Include your complete name in the upper right-hand corner of each page. Incomplete, missing or unmarked essays will disqualify your application. 1. Please describe how courage, self-reliance and/or determination have affected your life to this point, and how you feel your life experiences have helped prepare you for a career in nursing. 2. Describe the values you bring to the nursing profession. 3. Describe how you plan to use your education to enhance the way you deliver patient-centered care as well as assure a professional practice in nursing. 4. Describe how you plan to use your profession to contribute to and/or give back to our community. 4
5 Supervisor/Instructor Recommendation Form AKCNL Nightingale Scholarship To the applicant: Please complete the following before distributing the form. Name of applicant: Last First Middle NOTE: This form is to be filled out by your immediate supervisor or one of your nursing instructors. Name of Supervisor/Instructor Department To the applicant: I understand this letter of evaluation is to be received and maintained in confidence by the Association of Kern County Nurse Leaders (AKCNL) for consideration of their Nightingale Scholarship award. I hereby waive any and all rights I have of access to this evaluation under the Family Education Rights and Privacy Acts of 1974 and any/or all other laws, regulations and policies. I understand that the rights I am waiving include, but are not limited to, the right to inspect and review this letter; the right to have a copy of this letter made for my use; and the right to request an amendment of this letter. I agree to waive access to this statement. Applicant signature: I do not agree Date: Please give this form and the Assessment of Applicant s Abilities form to your supervisor/instructor to complete Supervisor/Instructor Instructions: The above named student has applied for the AKCNL s Nightingale Scholarship and is required to provide a written recommendation from his/her supervisor or instructor. We would be grateful if you would give your frank evaluation of the applicant by responding to the following questions. Please return this form directly to the applicant in a sealed envelope or mail to: AKCNL, P.O. Box 13188, Bakersfield, CA or to Diane.Biswanger@DignityHealth.org. Once you have completed the recommendation please notify the applicant. To avoid delays in processing your employee s scholarship application, your prompt attention is greatly appreciated. 5
6 Supervisor/Instructor Recommendation Form Continued Assessment of Applicant s Abilities Please check which of the following descriptions applies to the candidate. Check Unknown if you are unable to judge. Social Appropriateness Emotional Stability Leadership Qualities Responsibility Unknown Inadequate Adequate Strong Outstanding Cooperation Teamwork Communication Personal Maturity Articulateness Professional Ability Potential Personal Demeanor Poise Initiative Academic Ability Creative Instinct Critical Thinking Skills Personal Integrity Additionally, for the purposes of our scholarship review committee, if there is any aspect of this candidate s qualifications you would like to highlight or express your concern about, please indicate on the next page on the Personal Evaluation of the Applicant form. 6
7 Supervisor/Instructor Recommendation Form Continued Personal Evaluation of the Applicant 1. How long have you known the applicant? 2. In what capacity? 3. How would you rate this applicant s potential success as a Registered Nurse? Exceptional Very good Good Fair Poor 4. If this candidate receives an ACNL Nightingale Scholarship, his/her chief need for personal development or improvement is: Signature: Date: Thank you for your assistance in our selection process!
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