Leadership Nursing Grant Program

Leadership Nursing Grant Program
Below are the items you will need before you begin.
For details view the Upload Section at the
end of this application.
1. Detailed and itemized budget. Tips and incidentals are not included in this grant.
2. Your letters of support (up to three) from employers and members of the Tennessee Nurses Association (TNA).
3. If a website URL is not available for the program details, upload a copy of
  the program's brochure or information.
Submission of this application must be
ten (10) weeks in advance of the program's event date.
Program Purpose

The Tennessee Nurses Foundation (TNF) Leadership Nursing Program is a grant program designed to enhance nursing leadership abilities by:
- Developing current and emerging professional nurse leaders from
  across the state.
- Establishing a statewide network of nurse leaders.
- Expanding the nurse's knowledge of the community, focusing on
  socio-cultural, economic, political, and ethical issues.
- Motivating nurses to serve as role models of increased involvement
  in the community.
Eligibility Process

TNF recognizes that additional training may be required in order for nurses to participate in public policy development. This program provides an opportunity for RNs to choose a local, regional, state, or national program to develop these skills.

Participation is limited to registered nurses who are members of the Tennessee Nurses Association (TNA). You must be practicing in Tennessee and demonstrating leadership qualities, with a commitment to professional growth and a larger role in community leadership.

Submission of this application must be ten (10) weeks
in advance of the program's event date.

Your Responsibilities
Upon completion of the leadership program, you will be required to submit a:
- certificate of attendance
- written report on the program
to the Tennessee Nurses Foundation Board of Trustees, the Foundation's governing body. In addition, you may have the opportunity to make an oral presentation to the Board.

Please note that grant funding will be distributed to recipients upon completion of the program and receipt of all required documentation listed in the above responsibilities. No funds will be distributed to the recipient before the date of the program.
Name*

First NameLast Name
Credentials*
Applicant's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cellphone Number*
Please enter a valid phone number.
Email*
example@example.com
Are you a member of TNA?*

YesNo
Provide your TNA/ANA membership number*
Are you registered to vote in your community?*

YesNo
Education Section
Degree*
Certification(s)
Employment Information
Employer*
Employer's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work phone number
Please enter a valid phone number.
Work email (if different than above)
example@example.com
Position*
Years with employer*
Immediate supervisor's name
Has your employer agreed to pay your tuition?*

YesNo
If your employer has agreed to pay partial tuition, indicate the amount.
As a participant in the leadership program, you will be expected to attend all of the planned sessions for their entirety. Do you and your employer support this expectation?
Applicant?*

YesNo
Employer?*

YesNo
Program Details and Specifics

Locating a program is the responsibility of the applicant. This portion of the application deals with the details of the program. To be considered for a grant, all of the questions must be answered. In addition, if a website for the program you will be attending is unavailable, upload a copy of the program's brochure or information at the bottom of this application.
Program title*
Program sponsor*
Program Date(s)*
Program website. If a website is unavailable, upload a copy of the program's brochure or information in the Upload Section at the bottom of this application.
Enter the URL for the program details if available.
Program's registration fee.*
Enter the amount of your grant request. *
This must match the total in your uploaded budget (see below Upload Section).
Enter any additional comments about the program here.
Community Involvement
List in order of importance up to five community, civic, professional, religious, social, athletic and/or other organizations in which you are an active member and how you have demonstrated leadership in these organizations. 1 = most important.
Approximately how many hours per month do you devote to volunteer work?
Leadership Aspirations
What characteristics do you have that suggest you will be a leader in an organization which plays a significant role in the community?*
List at least two personal goals that you hope to achieve after participating in this leadership program.*
What ideas do you have for future community service? (e.g., seeking public office, volunteer leadership, serving on boards/commissions, etc.)*
What do you consider your highest career/volunteer achievement or responsibility?*
Upload Section
The documents listed below must be uploaded in their entirety.
Incidentals, meals, and tips are not covered in this grant.

*Detailed and itemized budget, including if applicable:
1. Program's registration fee.
2. Ground transportation from your home to the event location. Include the number of miles and total cost for ground transportation. Ground transportation can include transportation to and from the airport (such as Uber.)
3. Airfare. Any additional costs other than airfare to and from the event location, such as additional luggage, are not covered in this grant.
4. Hotel/Lodging.
*Letters of support (up to three) from employers and members of the
Tennessee Nurses Association (TNA).

*If a website URL is not available for the program details, upload a copy of
the program's brochure or information.
Upload your budget (see above instructions)*

Cancelof
Upload up to three letters of support from employers and members of the Tennessee Nurses Association (TNA).*

Cancelof
If a website URL is not available for the program details, upload a copy of the program's brochure or information.

Cancelof
Tennessee Nurses Foundation
545 Mainstream Drive, Suite 401
Nashville, TN 37228-1296
Phone: 615-254-0350 ext. 3

Questions: Contact Kathryn Denton at 615-254-0350 Ext. 3 or email TNF@TNurses.care.
Should be Empty:

Education Section

Employment Information

Program Details and Specifics

Community Involvement

Leadership Aspirations

Upload Section