MARGARET GODFREY SCHOLARSHIP APPLICATION

MARGARET GODFREY SCHOLARSHIP APPLICATION
In order to promote the educational pursuits of our members in LTC nursing, and support the facilities where they work, the Board of Directors and the Scholarship Committee are pleased to announce the awarding of three scholarships each year to qualified persons who wish to further their education in the Long Term Care Nursing profession. The amount of each scholarship will range from $500 to $1,000. This educational opportunity is available to Michigan licensed nurses, CNAs and PCAs who aspire to advance their studies in the Nursing profession. Please see full criteria on our website.
Criteria for scholarship application includes:
1. Submission of a completed application. NOTE: The completed application has three sections:
  1. The applicant’s information and essay section,
  2. TWO (2) REFERENCES and
  3. Proof of enrollment in an accredited LPN, RN or post graduate nursing program.
2. Applicants must be nominated by a MI/NADONA member. (The nomination will be verified. Accurate contact info for the nominating member is the applicant’s responsibility.)
3. MI/NADONA members may self-nominate.
4. Commitment to work in a Michigan Long Term Care Facility (nursing home or assisted living) for at least one (1) year after completion of the nursing program.
5. The completed application must be completely filled out online and submitted by September 1.
6. Applications will be accepted year round. Submitted applications will be reviewed after Sept. 1st each year.
7. If any of the required documents are missing or incomplete, your application will be disqualified and you will not be considered for the scholarship award.
8. You will be notified of the status of your application by Oct. 1.
9. If you are selected to receive this scholarship, in the future we may contact you in order to secure a brief note describing how the award helped you to reach your educational goals.
10. Scholarship winners will be invited to the Annual Michigan NADONA/ LTC conference to receive their award. Each recipient will be allowed to invite one guest to the scholarship awards presentation. If the recipient is unable to attend the annual MI/NADONA conference to receive their award, the MI/NADONA Area coordinator will present the scholarship award at a mutually agreeable later date.
APPLICANTS DETAILS
Applicant's Name

First NameLast Name
Applicant's Cell Phone
Please enter a valid phone number.
Personal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Facility of Employment
Type of Facility

SNFAL
Facility Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Facility Phone Number
Please enter a valid phone number.
Length of Employment
Employment Start Date

MonthDayYear
Date
Employment End Date (select today if currently employed)

MonthDayYear
Date
Current Position
Area of Study

MastersRNLPNOther
Place of Enrollment
School Phone Number
Please enter a valid phone number.
Date of Enrollment in Nursing Program

MonthDayYear
Date
Prospective Graduation Date

MonthDayYear
Date
Active Membership in Michigan Chapter NADONA?

YesNo
Number of Years of Membership (if applicable)
NOMINATING MEMBER'S DETAILS
Name of MI-NADONA Member Nominating Applicant for Consideration

First NameLast Name
Phone Number for Nominating Member
Please enter a valid phone number.
Email for Nominating Member
example@example.com
APPLICANT'S PERSONAL ESSAY
Please discuss the following: 1) Any pertinent experiences you have had in Long Term Care, either personal or professionally that have influenced you in choosing a career in nursing. 2)Your interest in LTC nursing as a profession. 3) What challenges you believe the LTC nursing profession holds for you, your future plans and 4) the reason you should be the recipient of this scholarship award.
REFERENCES

All applicants must include TWO references, following the format required, in order to be considered for the scholarship.
Criteria for references:
1. Must include the full name, title, phone number, email, relationship to applicant of the referrer.
2. Applicant shall be rated Low, Average, High or No Opinion in the following categories
  1. Maturity
  2. Sensitivity to Residents
  3. Commitment
  4. Academic Abilities
  5. Ability to Communicate
  6. Leadership Skills
3. Referrer shall describe why they believe this applicant is a deserving candidate for the scholarship.
Upload Recommendation #1 Here

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Upload Recommendation #2 Here

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PROOF OF ENROLLMENT
Upload proof of enrollment in an accredited LPN, RN or post graduate nursing program.

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MARGARET GODFREY SCHOLARSHIP APPLICATION

APPLICANTS DETAILS

NOMINATING MEMBER'S DETAILS

APPLICANT'S PERSONAL ESSAY

REFERENCES

PROOF OF ENROLLMENT