Trinity Regional Medical Center Caring for Our Future Scholarship

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With over 100,000 vacant positions an ever-growing need for healthcare workers, the career outlook is excellent for the nursing field. Statistics on Registered Nurses. Nursing is a highly regarded profession. A 2013 Gallup Poll announced that the public again voted nurses number one for honesty and ethical standards of various professions. The purpose of this scholarship is to assist candidates into the nursing profession and those already in the profession, to further their nursing education. The goal of this scholarship is to foster entry level nursing education, as well as, advanced degrees. Applicants for the scholarship need to be accepted or enrolled in a nursing education program. The scholarship is based upon: 1. Professional goals and career plans 2. Three written references 3. Academic standing (2.8 grade point minimum) with an ACT of 21, if no ACT then a college GPA or HS GPA of 3. Send Official Transcripts Check if Official Transcripts have been submitted in 2017-2018 to the Trinity Foundation 4. Involvement in professional/community/volunteer activities The amount of the 2018 scholarship will be determined based on available funds. Applications for the current scholarship are due April 9, 2018. A decision will be made and all applicants notified of the decision by May 6, 2018. Please send all application materials to: Diane Anderson The form will be available until April 9, 2018. If you have any questions or want to request materials, please call Diane Anderson at 515-574-6764 or diane.anderson@unitypoint.org. Field Code Changed

Application (Please print or type) Name: Social Security #: (Last) (First) (Middle Initial) Home Address: City: State: Zip Code: Birthdate: Address While In School: Phone Number: (Home) (Work) (School) Best time to contact: a.m. p.m. Place to contact: Home Work School College/University you are currently enrolled/have been accepted for enrollment: (Name) (Address) (Phone Number) Degree working toward (ADN, BSN, MSN, PhD): Present Grade Point Average: (*attach official transcript for present or last recorded GPA) Expected Year of Graduation: Educational History High School: City: Graduated: Yes No Years Attended: GPA: * College: City: Graduated: Yes No Years Attended: GPA: * Major:

Work History s of Employment Employer Type of Work Hours/Week Activities Professional Activities, Memberships and Awards (please list) Community Activities and Awards (please list)

In one or two sentences describe the importance of this scholarship toward your future plans. Why are you seeking assistance from the TRMC Caring for Our Future Scholarship? What are your future goals? (Include career plans, personal growth, educational goals, etc.) Have you applied for other scholarships or loans? Yes No Have you received other scholarships or loans? Yes No Specify Your signature is required below for consideration as an applicant for the TRMC. If I am a recipient of the TRMC and I decide to delay or not attend the nursing education program as described in this application, the full amount of the scholarship will be returned to the TRMC Caring for Our Future Scholarship Fund of the Trinity Health Foundation. Please attach the following references/recommendations: 1. A written recommendation from your present supervisor or employer 2. A written recommendation from a current (if presently in school) or former instructor 3. A written personal recommendation other than a relative TRMC 2/2018

RECOMMENDATION: Name of Applicant Address of Applicant (Street) (City) (State) (Zip Code) Note to writer: Scholarships are awarded based on professional goals, academic merit, interest in promoting healthcare, qualities of good citizenship and high morale value. For this reason the group needs your assistance in evaluating the applicant. Please provide a statement concerning the applicant s general ability, personality and character: Title Position Occupation Please return to: Address Phone Number Deadline: April 9, 2018

RECOMMENDATION: Name of Applicant Address of Applicant (Street) (City) (State) (Zip Code) Note to writer: Scholarships are awarded based on professional goals, academic merit, interest in promoting healthcare, qualities of good citizenship and high morale value. For this reason the group needs your assistance in evaluating the applicant. Please provide a statement concerning the applicant s general ability, personality and character: Title Position Occupation Please return to: Address Phone Number Deadline: April 9, 2018

RECOMMENDATION: Name of Applicant Address of Applicant (Street) (City) (State) (Zip Code) Note to writer: Scholarships are awarded based on professional goals, academic merit, interest in promoting healthcare, qualities of good citizenship and high morale value. For this reason the group needs your assistance in evaluating the applicant. Please provide a statement concerning the applicant s general ability, personality and character: Title Position Occupation Please return to: Address Phone Number Deadline: April 9, 2018