APPLICATION DEADLINE IS JUNE

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1 F N F Florida Nurses Foundation Future P.O. Box Orlando, FL (407) Phone (407) Fax foundation@floridanurse.org SCHOLARSHIP GUIDELINES Investing in Nursing s 1. To qualify for an FNF scholarship, you must be: Enrolled in a nationally accredited nursing program. Eligible students include those in associate, baccalaureate, and masters degree nursing programs or doctoral programs. Nurses enrolled in doctoral programs are not restricted to nursing specialties. To be eligible for a scholarship, a student in an initial nursing education program (associate or baccalaureate degree) and not yet licensed as an RN, must have completed at least one (1) semester of a nursing program in the State of Florida and must reside in Florida throughout the term of the scholarship. The one semester requirement must be completed by the June 1 st deadline. A resident of Florida for at least one (1) year. 2. Criteria used by the FNF Board of Trustee to select candidates: Criteria designated by individual scholarship fund requirements. For further information, refer to our website at or call the FNF office at the number listed above. Unless otherwise designated by an individual fund, GPA requirements are as follows: Undergraduate: 2.5 minimum GPA Graduate: 3.0 minimum GPA Potential for contribution to the nursing profession and society. 3. Only completed applications will be reviewed. Refer to section G of application form for the required documentation. Applicants will be notified by if application is incomplete and will be considered only if applicant resubmits before the June 1 st deadline. If official transcripts are not received by June 1 st, the application will be considered incomplete. 4. Funds will be awarded and names of recipients will be announced in September of the award year. Presentation of the awards will be made at the FNA Biennial Convention/Professional Nurses Summit. 5. Recipients who withdraw from the nursing program before completing the semester/year for which this scholarship applies agree to repay to the Florida Nurses Foundation the sum advanced. 6. Recipients agree to participate in follow-up surveys related to the Scholarship Program. The APPLICATION DEADLINE IS JUNE 1 st of the current application year. No exceptions will be made for late applications. FNF Scholarship Application

2 The Florida Nurses Foundation is a non-profit 501(c)(3) organization F N F FLORIDA NURSES FOUNDATION SCHOLARSHIP APPLICATION Directions: Please type (preferred) or print the following information. A. PERSONAL INFORMATION Name First MI or Maiden Last Address (Street) (City) (State) (Zip) Permanent Address (If different from above) (Street) (City) (State) (Zip) Home Phone ( ) Work Phone ( ) Date of Birth Resident of County in Florida for years If already licensed as an RN, Florida please give license number: Other Who depends on you for financial support? Explain (including ages of dependents): Dependent Relationship Age Annual Income (Sources and Amounts): Applicant Spouse Other Source Total Annual Income Amount B. PLANS FOR STUDY College or University of Attendance: Beginning Date: Expected Graduation Date: Attendance: Part-time Full-time FNF Scholarship Application

3 What nursing degree are you pursuing? Associate degree BSN (basic student; not yet licensed as RN) BSN (RN to BSN) Master s Doctorate (Candidate: Yes No) C. EDUCATIONAL HISTORY SCHOOL CITY/STATE DATES ATTENDED DEGREE/ DIPLOMA D. EXPERIENCE List employment for the past 5 years, beginning with the most recent EMPLOYER (CITY/STATE) MAJOR RESPONSIBILITIES DATES E. FUNDING List any fellowships, scholarships or loan funds from other sources for which you have applied and/or received funds NAME SOURCE AMOUNT F. PROFESSIONAL ACTIVITIES List professional organizations of which you are currently a member, any offices held, and extent of your involvement ORGANIZATION OFFICE INVOLVEMENT List honor societies, civic organizations, or charitable/community groups of which you are currently a member and state type and extent of your involvement ORGANIZATION OFFICE INVOLVEMENT FNF Scholarship Application

4 List books, publications (e.g., articles or pamphlets) you have authored (attach if possible) Title Where Published Date G. APPLICATION CHECKLIST Attach the following additional items to complete the application. ITEM SPECIFICATIONS ATTACHED (Y/N) Statement indicating necessity for scholarship Statement indicating goals and potential for contributing to nursing 2 letters of reference on FNF Reference forms Current OFFICIAL Transcript Validation of Florida residency Copy of Florida nursing license, if RN. Validation of enrollment in accredited school of nursing Attach a typed statement not exceeding one single-spaced page, stating why it is necessary for you to receive an FNF scholarship Attach a typed statement not exceeding one single-spaced page, stating your goals and your assessment of your potential for making a contribution to nursing and society Attach references from individuals who can address your academic aptitude, scholarship and seriousness of purpose, and/or your clinical expertise. Form is attached. Must be mailed directly from your school or in an envelope signed and sealed by a school official. Attach copy of current driver s license or voter registration card. If issued within the past year, must provide other proof of residency H. APPLICATION SUBMISSION Submit one (1) original application and one (1) copy of the completed application packet: Application Form, Statement of Need, Goal Statement, and References, and one (1) copy of Transcript, Residency Validation, and Copy of License in one packet to: Florida Nurses Foundation, P.O. Box , Orlando, FL Postmark deadline is June 1 st Incomplete applications will not be reviewed. AGREEMENT (please initial) Should I be awarded funds and withdraw from my nursing program before completing the semester/year for which this scholarship applies, I pledge to repay to Florida Nurses Foundation the sum advanced. Should I be awarded funds I agree to participate for up to three years of follow-up allowing the Foundation to check on the status of my educational progress. I agree that my name may be used for public relations purposes (i.e. Florida Nurses Association and Florida Nurses Foundation publications, press releases to news media). This will not affect the scoring of your scholarship application. --OR--- I would prefer that my name not be used for public relations purposes. This will not affect the scoring of your scholarship application. FNF Scholarship Application

5 Signature: Date: You are requested to make a copy of this signed application for your records. The original and all supporting documents are to become the property of FNF and are not returnable. If additional space is necessary to answer any of our questions, please feel free to add pages. F N F FLORIDA NURSES FOUNDATION SCHOLARSHIP APPLICATION Professional Reference Form Section 1 (Completed by applicant) (applicant name) is applying for a scholarship from the Florida Nurses Foundation. These educational funds are sought to assist in completing a program of study towards a degree in nursing at College/University. Section 2 Please provide a reference addressing academic aptitude, scholarship and seriousness of purpose, clinical expertise, and potential for success in the field of nursing. FNF scholarships are competitive, and are awarded on the basis of scholarship, financial need, and the potential for contribution to the profession and society. Please write your comments below or attach a letter that includes the requested information. Return the reference to the applicant who will submit it with the application. How long have you known the candidate? years. In what capacity? Name (please print) Position/Organization FNF Scholarship Application

6 Address Signature Date F N F FLORIDA NURSES FOUNDATION SCHOLARSHIP APPLICATION Professional Reference Form Section 1 (Completed by applicant) (applicant name) is applying for a scholarship from the Florida Nurses Foundation. These educational funds are sought to assist in completing a program of study towards a degree in nursing at College/University. Section 2 Please provide a reference addressing academic aptitude, scholarship and seriousness of purpose, clinical expertise, and potential for success in the field of nursing. FNF scholarships are competitive, and are awarded on the basis of scholarship, financial need, and the potential for contribution to the profession and society. Please write your comments below or attach a letter that includes the requested information. Return the reference to the applicant who will submit it with the application. How long have you known the candidate? years. In what capacity? FNF Scholarship Application

7 Name (please print) Position/Organization Address Signature Date FNF Scholarship Application