Foundations Scholarship Application

Faith Community Nurse Network

Foundations of Faith Community Nursing Course

Scholarship Application

The Faith Community Nurse Network is pleased to offer a scholarship up to $435.00* to help defray the cost of the Foundations of Faith Community Nursing course.

* This number is subject to change and could range from $150-$400 based on funds available, location of applicant, and population that the applicant serves.

The Faith Community Nurse Network of the Greater Twin Cities will consider scholarship applications from prospective students. The amounts of the scholarships will vary, depending on the situation. A small percentage of students may be granted a full scholarship.

Criteria:

The student must complete the application and submit to FCNN no later than 14 days prior to the start of the course they wish to attend.
Applications will be reviewed by the Director of Education and Executive Director. Financial need, population served and other factors are considered.
If a scholarship is granted, the student will receive that scholarship and can apply it to the registration fee. The student is responsible for purchasing the participant manual and will be send ordering information for that.
The student must complete the course or return the scholarship money to FCNN.
If the scholarship is granted, the student agrees to be featured in FCNN promotional materials if requested (blog post, email newsletter, fund-raising campaign, annual report, etc.)

Foundation Cohort you wish to be a part of (Fall / Spring Year)

Contact Information

Name:

First NameLast Name

RN License #:

State:

Email

example@example.com

Phone Number

Area CodePhone Number

Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Faith Community/ Organization:

Faith Community/ Organization Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Faith Community/ Organization Phone Number

Area CodePhone Number

Is the community that you are serving in an urban area with a majority of members identifying as BIPOC?

Essay Questions

Why do you want to become a faith community nurse?

Describe 3 skills, gifts, experiences that you feel would contribute to your practice as a faith community nurse.

Please describe the community you plan to serve as a faith community nurse, including whether it is an underserved community (For example: rural, tribal nation, community of color, etc.).

What are the needs of the population you seek to serve?

How do you plan to specifically contribute to a faith community or other community setting with the knowledge and skills you will gain from this course?

Briefly explain your reason for needing a scholarship to attend this course.

Check the appropriate boxes for your proposed FCN position:

By signing below, I agree to the terms of the scholarship as outlined above and understand the payment schedule is dependent on successful completion of these criteria.

Student Signature

Date

For office use only:

Date reviewed:

Reviewer's name:

Date student notified: