Scholarship Sponsor Commitment Form

2021 Scholarship Sponsorship Commitment Form
By completing this form, you/organization agrees to participate in the FNSNA Scholarship Program. Note that the minimum scholarship amount is $2,500 with an additional 10% administrative fee.

Thank you for supporting our future RN's!
Organization Name
As you wish it to appear in publicity materials
Contact Name *

First Name Last Name
Contact Title
Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Contact Phone *

Area Code Phone Number
Contact Email *
example@example.com
Indicate the number of scholarships you would like to support. *
Indicate the total scholarship dollars *
The minimum donation to establish a scholarship is $2,500.00.
Indicate the total dollar amount of the 10% administrative fee *
The minimum administrative fee to establish a scholarship is $250.
Should be Empty:

2021 Scholarship Sponsorship Commitment Form