2 0 1 0 N u r s i n g S c h o l a r s h i p s St.Vincent Foundation Nursing Scholarships are available to St.Vincent Indianapolis/Carmel associates who work at St.Vincent Indianapolis and/or St.Vincent Carmel including: St.Vincent Indianapolis Hospital, St.Vincent Stress Center, St.Vincent Center for Cancer Care, St.Vincent Hospice, Peyton Manning Children s Hospital at St.Vincent, St.Vincent Women s Hospital, St.Vincent Joshua Max Simon Primary Care Center, St.Vincent Carmel, St.Vincent Breast Center, St.Vincent Medical Center Northeast. Applicants should be pursuing associate, bachelor, masters or doctoral degrees in nursing at accredited schools of nursing. Previous St.Vincent Foundation nursing scholarship recipients are eligible to apply for a one-time renewal scholarship. The number of scholarships and the award amounts varies annually based upon available funding. Nursing scholarships are made possible by the generous contributions of individuals, corporations and foundations who wish to recognize the outstanding nursing care provided to St.Vincent patients and their families, who value education, and who want to encourage the pursuit of higher degrees in nursing. Application and Renewal Criteria Applicants must have been continually employed in a benefits-eligible FTE position at one of the above named St.Vincent facilities for the past 12 months. Applicants must provide proof of enrollment in an accredited nursing program. (If applicant is in the application process, he/she may apply with explanation. Proof of acceptance must be provided to the St.Vincent Foundation prior to release of scholarship funds.) Documentation can include an official transcript from the last semester of enrollment, a letter of acceptance on school letterhead that includes a start date, or a letter from the school confirming the applicant s current enrollment on letterhead. Application must be complete, include original signatures and meet all other requirements to be eligible for consideration. Applicants will be notified by e-mail when the completed application has been received. Application Timeframe Scholarship applications will be accepted by the St.Vincent Foundation from February 1 to the close of business on March 5, 2010. Applications should be mailed or delivered to the St.Vincent Foundation, Attn: Nancy Frick, 8402 Harcourt Road, Suite 210, Indianapolis, IN 46260. Applications must be complete to be eligible for consideration by the Nursing Scholarship Committee! The applicant is responsible for ensuring that all appropriate evaluation forms have been collected and submitted by the due date. If you have questions about the application or the application process, please contact Wanda Powell (338-6820), Nursing Scholarship Committee Chair or the St.Vincent Foundation (338-2338).
S e c t i o n O n e Complete this scholarship application/renewal form and attach all required documents. Consideration will not be given to incomplete applications, applications without all of the required paperwork, or applications received after the due date. Name of Applicant Home Address Street City State Zip Phone (H) Phone (W) Email S e c t i o n T w o Hire date / / Associate ID# Cost Center # FTE status past 12 months Current job title Name of current manager/director Phone 2008-09 Review Rating Score (1-4) Have you received any disciplinary action within the past 12 months? yes no S e c t i o n T h r e e College/University Attending (if known) Student ID# Bursar s Office Address Street City State Zip Major Degree (check one): ASN BSN MSN PhD Previous Degrees Intended enrollment status for 2010-11: Full Time Part Time (indicate # of hours ) Expected graduation date Estimated annual tuition and fees $ I attest that all information provided in this application is true and accurate to the best of my knowledge. Signature of applicant Date S e c t i o n F o u r Check below to verify that each required document has been included with your completed application: Type of application: First time applicant Renewal applicant Completed and signed evaluation form from your current manager/director in sealed envelope Two Completed and signed evaluation forms from two different peers in sealed envelopes Completed scholarship application For renewal applicants only: Most recent official college transcript showing an overall GPA of 2.5 or above on a 4.0 scale Your application packet should be submitted to the St.Vincent Foundation in its entirety no later than close of business on March 5, 2010.
Applicant s Essays Name of Applicant: Please answer each of the following 3 questions. Be as specific with your answers as possible. Use a maximum of 500 words per question. 1. How do you exemplify all of the Core Values in your daily work? 2. How do you currently impact the advancement of nursing practice? Give specific examples. 3. Describe how this education will enable you to further impact patient care at St.Vincent.
Director/Manager Recommendation Form (Please return completed form to applicant in a sealed envelope) Name of Applicant: 1. How long have you known this individual and in what capacity? 2. Applicant eligibility: Did the applicant receive a minimum of meets expectations on last performance review and has the applicant had no disciplinary action within the last 12 months? Yes No (If no, the applicant is ineligible: you may stop now.) 3. Please place a check in the appropriate box to indicate how well this individual exemplifies each of these elements. Give bulleted examples/ comments of exceeding expectations where appropriate. Almost Always Sometimes Rarely Examples/Comments Leadership Team Work Quality Safety Patient Outcomes 4. How do you envision this person using her/his education to impact patient care at St.Vincent in the future?
Peer Recommendation Form (Please return completed form to applicant in a sealed envelope) Name of Applicant: 1. How long have you known this individual and in what capacity? 2. Please place a check in the appropriate box to indicate how well this individual exemplifies each of these elements. Give bulleted examples/ comments of exceeding expectations where appropriate. Almost Always Sometimes Rarely Examples/Comments Leadership Team Work Quality Safety Patient Outcomes 3. How do you envision this person using her/his education to impact patient care at St.Vincent in the future?
Peer Recommendation Form (Please return completed form to applicant in a sealed envelope) Name of Applicant: 1. How long have you known this individual and in what capacity? 2. Please place a check in the appropriate box to indicate how well this individual exemplifies each of these elements. Give bulleted examples/ comments of exceeding expectations where appropriate. Almost Always Sometimes Rarely Examples/Comments Leadership Team Work Quality Safety Patient Outcomes 3. How do you envision this person using her/his education to impact patient care at St.Vincent in the future?