Scholarship Application

Scholarship Application

Deadline: April 1st, 2023
General information:

A limited number of scholarships are available yearly for NH School Nurses. The scholarship is not to exceed half the cost of the course or $500.00. Reimbursement will be made after applicant sends verification of successful course completion. First time applicants will have priority.

All three criteria below must be met in order to qualify:

1. A NHSNA member for at least two years.

2. Currently active in the practice of school nursing.

3. Use the scholarship for accredited course work toward a nursing- related degree. OR for the fee for the NCSN exam
Date

MonthDay Year
Date
Name

First Name Last Name
Credentials
Home Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
School Name
Home or Cell Phone Number
Please enter a valid phone number.
Email
example@example.com
RN License Number:
Course Title:
If for NCSN Exam, state so here
Course Location:
Course Start Date

MonthDay Year
Date
Course End Date

MonthDay Year
Date
Course Cost
Amount Requested
Should be Empty: