Scholarship Application
Year - 2026
Personal Information
Full Name
*
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Professional/Community
Do you belong to any professional nursing organizations?
Yes I do.
No, I do not.
If so, please list the organizations below.
Do you engage in any community service or charitable activities?
Yes I do.
No, I do not.
If so, please provide an explanation below.
School/University
Please provide the name of the school or university you currently attend.
Enter the expected graduation date.
-
Month
-
Day
Year
Date
School/University Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School/University Contact
*
First Name
Last Name
Phone Number
*
E-mail
example@example.com
Please compose an essay outlining why you deserve to be considered for the HVNYBNA 2025 Nursing Scholarship (500-word limit).
Please upload your academic transcript along with two letters of recommendation.
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**Disclaimer:** I certify that all information provided in this application is true and accurate. I understand that any false statements may lead to the rejection of my application.
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