KING COUNTY NURSES ASSOCIATION 2018 SCHOLARSHIP INFORMATION SHEET & APPLICATION

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KING COUNTY NURSES ASSOCIATION 2018 SCHOLARSHIP INFORMATION SHEET & APPLICATION PURPOSE 1. Provide financial assistance to qualified students who have a permanent address in King County, or are currently enrolled in a nursing program in King County and are preparing for a career as a registered nurse, or to RNs returning for an advanced degree in nursing or a related field. 2. Encourage and provide for increasing diversity within the nursing profession that reflects the population as a whole. 3. Support nurses to be change agents in creating a healthier community in King County. TYPES OF SCHOLARSHIPS AVAILABLE Eighteen scholarships of $3,000 each will be awarded in the spring of 2018 for summer 2018 through spring 2019 school terms. Applicants must be accepted into or currently enrolled in a nursing program for the summer 2018 through spring 2019 school year. If you have applied to a nursing program but have not been accepted yet, you are ineligible and should wait until the following year to apply for the scholarship. Applicants can only receive an award once from KCNA. If you previously received an award, you are not eligible to apply. Basic Program: General scholarships will be awarded to students enrolled in associate or baccalaureate degree programs preparing for a career as a registered nurse. Graduate Entry Program: Scholarships will be awarded to students currently enrolled in a graduate entry program in nursing. The student may be in the pre-licensure or the advanced degree portion of the program. RN Baccalaureate (RNB) Program: Scholarships will be awarded to a registered nurse in a program leading to a bachelor s degree in nursing. Advance Degree Program: Valerie Weiss, ARNP, MN, MA, Memorial Scholarship Award is for a current RN working toward an advanced degree in nursing or a related field. The award is given as a lasting legacy to an outstanding nurse whose professional commitment was an inspiration to her colleagues and patients alike. KCNA reserves the right to distribute the scholarships among these categories depending on applications received. ELIGIBILITY REQUIREMENTS All Scholarships: Be currently enrolled in nursing program as described in the categories above. Maintain a minimum B average (3.0 grade point average). Maintain a permanent address in King County or be enrolled in a nursing program located in King County. Note: KCNA members are automatically eligible. Valerie Weiss Memorial Scholarship: Meet the above criteria and demonstrate an exemplary commitment to the nursing profession through extracurricular professional activities. continued

AWARD CRITERIA Scholarships will be awarded on the basis of: Commitment to social justice Commitment to King County community Community/School Involvement SUBMISSION REQUIREMENTS A. Application materials must be postmarked or hand-delivered by Thursday, March 1, 2018 to: King County Nurses Association, 4649 Sunnyside Avenue N. #352, Seattle, WA 98103. If hand delivered, drop off between 9 am and 3 pm. B. Scholarship application materials must include the following: 1. Completed KCNA Scholarship Application (3 pages). 2. Current college transcripts that include nursing courses and any prerequisites (an unofficial copy of the transcript is acceptable). 3. Two signed letters of recommendation one from an instructor (of nursing, if applicable) and one from a non-relative, such as a volunteer or work supervisor. If a nursing program director or dean is used as a reference, that person must provide a letter of recommendation in addition to completing application page 2, Statement of Eligibility. We do not use a form for the references, they must submit letters. 4. Current resume or curriculum vitae C. General: Please have pages single-sided and do not use staples. GENERAL INFORMATION A. The KCNA Scholarship Committee will select scholarship recipients. All information will be held in strict confidence. B. This scholarship is a one-time award. New recipients will be selected yearly. C. Scholarship recipients will be notified by mail and will be honored at the KCNA Spring Banquet/Annual Meeting May 10, 2018. D. Awards will be paid by KCNA directly to the school of nursing attended by the recipient for application to his/her account. KING COUNTY NURSES ASSOCIATION King County Nurses Association is a professional organization of registered nurses, promoting healthy communities since 1903 through education, advocacy, and outreach. Questions?? Call us at 206/545-0603, or email kcnurses@kcnurses.org. 2

KING COUNTY NURSES ASSOCIATION 4649 Sunnyside Avenue N. #352 Seattle, WA 98103 (206) 545-0603 2018 SCHOLARSHIP APPLICATION Applicant s Name Telephone: Email: Mailing Address: City: State: Zip: Permanent Address (if different): City: State: Zip: SCHOLARSHIP DESIGNATION I would like to apply for the following scholarship for the 2017-18 academic year (see descriptions on the Information Sheet): Basic RN Program Graduate Entry RNB Program Advanced Degree (Valerie Weiss Memorial): Check one: Master s DNP PhD ACADEMIC BACKGROUND Colleges Attended (list most recent first): Cumulative Current College GPA (4.00 scale):. Enclose current college transcripts that include nursing courses and prerequisites. How did you hear about our Scholarship Program? 3

STATEMENT OF APPLICANT: I certify that all information on this application and all enclosures are true and accurate to the best of my knowledge. I understand that any misrepresentations may result in the awarded scholarship being rescinded. If I am awarded a scholarship, it is my intention to complete the educational program outlined and to serve as a member of the nursing profession. I authorize KCNA to contact the Dean or Director or references for additional information as needed. I also agree that this application and all credentials submitted by me and others on my behalf are true to the best of my knowledge, and that these will remain the property of the King County Nurses Association. I agree that KCNA can publish information contained in my application in scholarship publications including info sheets, Advocate newsletter, and website. Print Name Signature and Date STATEMENT OF ELIGIBILITY REQUIREMENTS Applicant: Please have the Dean or School Representative complete this section for the 2018-19 Academic Year: I certify that is currently enrolled in or has been accepted to School of Nursing. This is a (please check one): Basic Program (the School is approved by the Nursing Commission) Graduate Entry Program (the School is approved by the Nursing Commission) RNB Program Master s Program Doctoral Program Date of Entrance: Expected Date of Graduation: In my opinion, is a worthy applicant and I recommend that he/she be considered for a King County Nurses Association Scholarship. His/Her current grade point average is on a point system at the end of the quarter or semester. Comments: Signature of Dean or School Representative Date Print Name Phone Address City State Zip 4

APPLICATION QUESTIONS Please note which questions you are required to complete (see checklist below): To respond to the following questions, please type answers on a separate page (maximum one page per question). Address each question in its entirety, giving the scholarship committee a complete picture of your abilities and commitment to nursing. 1. Are there any issues that you are especially passionate about that you hope to address in your career as a nurse? 2. Some of the most persistent health concerns remain disparities in health outcomes. Discuss your beliefs regarding equity and social justice and how you plan to address health outcome disparities in your career as a nurse. 3. How would receiving this award support the purpose of the KCNA scholarships to increase diversity within the nursing profession that reflects the population as a whole? 4. Why have you chosen your current educational/academic path in nursing? Valerie Weiss applicants will also answer the following question: Valerie Weiss was a school nurse who was very involved in professional nursing organizations and activities including serving on the KCNA Board, Program and Scholarship Committees. She felt strongly that nurses should be actively involved in the nursing community in order to advance the profession. 5. How have you demonstrated a commitment to the nursing profession through extracurricular activities? Application Checklist Return all items by March 1, 2018: Basic, Graduate Entry & RNB Applicants: Return Completed Application with Dean Signature Return Current College Transcript (unofficial is ok) Return Two Signed Letters of Recommendation Complete Questions 1, 2, 3, 4 Attach a Resume or Curriculum Vitae Advance Degree (Valerie Weiss Scholarship): Return Completed Application with Dean Signature Return Current College Transcript (unofficial is ok) Return Two Signed Letters of Recommendation Complete Questions 1, 2, 3, 4, 5 Attach Resume or Curriculum Vitae Return to: King County Nurses Association 4649 Sunnyside Ave N., #352 Seattle, WA 98103 5