2023_BTLLF_Nursing_Scholarship

Nursing Scholarship Application
If you are filling out this application, you have already been accepted into or are awaiting acceptance into an accredited nursing program that leads to a RN Certification. We are eager to partner with students to advance them in their goals toward becoming a Registered Nurse.

Before completing this application, please read all of the application instructions to be prepared to supply the information required for this application. All applicants will be considered for a Trinity Lutheran Hospital School of Nursing Scholarship and, if you are pursuing a BSN, you may also apply for a L.A. Hollinger, MD Scholarship by submitting an additional essay.

Complete application criteria and instructions may be found and downloaded by clicking here.

1. Basic Information

Provide the information requested below.
Scholarship(s) being applied for (Check ALL that apply):*

Trinity Lutheran Hospital School of Nursing Alumnae ScholarshipL. A. Hollinger, MD Scholarship
Full Name*

PrefixFirst NameMiddle Initial Last NameSuffix
Student ID # for Nursing School
E-mail-Personal*
E-mail-School*
example@example.com
Cell Number*
Alternate Phone Number
Home Address*

Street Address

Apt/Suite #

CityState

Postal / Zip CodeCountry
Check ALL that apply:*

I am reapplying for a second time.I am not a registered nurse yet.I have a relationship to AcruxKC, Baptist Medical Center, Trinity Lutheran Hospital or Trinity Lutheran Hospital School of Nursing or any of their employees, board members or alumnae current or past.*
*If checked, please explain your relationship:
Tell us who, where, and about the time and details of your relationship.

2. School Information

Please provide the requested information.
College you currently attend:*
Choose One
*If you chose other, please list your current college here:
College you will attend for nursing school:*
Choose One
*If you chose other, please list the college you will attend for nursing school:
Address for your college/university to which scholarship payments are to be mailed if awarded:*

Street Address Line 1 or Attn:

Street Address Line 2

CityState / Province

Postal / Zip Code
Semester(s) you will be enrolled during the 2025-2026 academic year:*
Choose One
Anticipated date of graduation:*
Choose One
Degree program enrolled in:*
Choose One
*If you chose other, please name the degree program enrolled in:
Name degree program here.
Cumulative GPA
Cumulative GPA /First-time applicants must provide added transcripts if transfer grades are not included at current school.

3. Financial Information

Please provide the requested information.
If awarded, the scholarship(s) will be distributed in two payments—one per semester—unless the recipient is only enrolled for the fall semester, in which case a single payment will be made. The scholarship is exclusively for tuition costs and cannot be used for fees, books, living expenses, or other non-tuition expenses.

We will cover tuition needs not already addressed by other grants, loans, scholarships, or service agreements. However, if those sources also apply to tuition, their contributions will be deducted from your calculated need.

Please provide your best estimate of your anticipated tuition need per semester for the 2025–2026 academic year, minus other funding for tuition only.
My anticipated need per semester for the 2025-2026 academic year.

4. Work History

List your work experience.
Employer #1

Employer Name

Street Address Line 2

CityState
Start Date of Employment:

MonthDayYear
Start Date
End Date of Employment:

MonthDayYear
End Date
Phone Number:
Position Title/Specialty:
Employer #2

Employer Name

Street Address Line 2

CityState
Start Date of Employment:

MonthDayYear
Start Date
End Date of Employment:

MonthDayYear
End Date
Phone Number:
Position Title/Specialty:
Employer #3

Employer Name

Street Address Line 2

CityState
Start Date of Employment:

MonthDayYear
Start Date
End Date of Employment

MonthDayYear
End Date
Phone Number:
Position Title/Specialty:
Employer #4

Employer Name

Street Address Line 2

CityState
Start Date of Employment:

MonthDayYear
Start Date
End Date of Employment:

MonthDayYear
End Date
Phone Number:
Position Title/Specialty:
Employer #5

Employer Name

Street Address Line 2

CityState
Start Date of Employment:

MonthDayYear
Start Date
End Date of Employment

MonthDayYear
End Date
Phone Number:
Position Title/Specialty:

5. Professional or Community Membership/Activities

Particularly list activities that support your pursuit of a nursing career.
Activity #1
Organization Name
Position/Activity
Position Title or Activity Name
Start Date of Activity

MonthDayYear
Date
End Date of Activity

MonthDayYear
Date
Activity #2
Organization Name
Position/Activity
Position Title or Activity Name
Start Date of Activity

MonthDayYear
Date
End Date of Activity

MonthDayYear
Date
Activity #3
Organization Name
Position/Activity
Position Title or Activity Name
Start Date of Activity

MonthDayYear
Date
End Date of Activity

MonthDayYear
Date

6. Recommendation Letters to be Expected

Please follow the instructions below.
Per the application instructions found online, request two individuals to serve as a reference. Recommendations are valued by individuals in order of educator/counselor, employer, and community/non-academic. Each reference will receive an e-mail upon your submission of this application with a questionnaire link through which they will be asked to provide a recommendation. Please verify that you have the correct e-mail address.
Reference #1*

First NameLast Name
Their Title
Title of the individuals holds at their organization.
Their E-mail*
example@example.com
Relationship to Applicant*
Years of Relation*
Reference #2*

First NameLast Name
Their Title
Title of the individuals holds at their organization.
Their E-mail*
example@example.com
Relationship to Applicant*
Years of Relation*

7. Application Essays

Paste or Complete Your Essay(s) below following the instructions listed here and on the application instructions.
All applications are required to submit an equivalent to a one page, single-spaced personal essay in the space provided below.
Required Personal Essay*

0/500
Applicants that are pursuing a BSN degree are eligible for consideration of a L. A. Hollinger, MD Scholarship award. Please select the topic under which you are applying and complete the second essay. Remember that you must choose a different topic from your first application if you are applying for a second year.
Hollinger Essay Category under which you are applying for a Hollinger Scholarship.
Please indicate the chosen topic.
Optional Hollinger Essay

0/500

8. Demographic Information

We request the following information to help us understand who we are serving better. Nothing recorded here will be included on your application.
Check ALL that apply:

My home is within 200 miles of the Kansas City Metropolitan Area. (This is not a qualification.)My college/university is within 200 miles of the Kansas City Metropolitan Area. (This is not a qualification.)
Gender*
Race*
Ethnicity*

Almost Done!
Confirm the following (check all that apply):

I understand that I cannot be considered if I do not have a 3.0 GPA, will not be a full-time (12 credit hours) student, or am not enrolled in an accredited nursing program which will lead to certification as registered nurse as described in the instructions provided online.I will request an official transcript(s) to be mailed or e-mailed per the application guidelines for completion of my application packet. I understand that an official transcript is one that has been certified by direct mail or through transcript service by my college/university and will not be sent by me, but by my request from my college.I understand that it is my responsibility to follow-up with my references to confirm receipt of the reference form link (they may need to check their junk mail folder). I will contact nursingscholarships@acruxkc.org with any difficulties regarding my references.I understand that this scholarship(s), if awarded, is for tuition only that will be equally split to be paid in fall (August-December) and Spring (January-May) and does not cover summer or J-terms. If you are only applying for one semester, your award will be made in one payment.I confirm that my college/university is accredited by the ACEN or CCNE.

Acknowledgements

Please thoroughly read the statement below and sign upon agreement. After signing do not forget to go to the next section and press submit.
Date of Signature*

MonthDayYear
Date
I certify that the statements on this application and in my essays are correct to the best of my knowledge. I understand that additional information may be requested at a later date per the discretion of the scholarship committee or AcruxKC staff. The scholarship award(s) will be made without regard to race, color, religion, sex, or national origin. I also understand that should I not maintain a 3.0 GPA, be a full-time student status (12 credit hours) in a formal nursing curriculum, or drop out of school, I will be obligated to reimburse all or part of the scholarship monies awarded.
Signature

Clear
Printed Name

First NameLast Name

Submitting!
We look forward to reviewing your application in consideration of a scholarship award for the 2025-2026 academic year. Click submit below to release your information to us.
Should be Empty:

Nursing Scholarship Application

1. Basic Information

2. School Information

3. Financial Information

4. Work History

5. Professional or Community Membership/Activities

6. Recommendation Letters to be Expected

7. Application Essays

8. Demographic Information

Almost Done!

Acknowledgements

Submitting!