New York Black Nurses Association, Inc. Scholarship Application

New York Black Nurses Association, Inc. Scholarship Application
SCHOLARSHIP INFORMATION

The New York Black Nurses Association Inc. offers The Vivian Leslie Memorial, Majorie Anita Andrews, and Laura Cooper Doe Scholarships on a yearly basis.

Eligibility:
1. Candidate currently enrolled in a nursing program (LPN/LVN,
AD, Diploma, B.S.N, entry into nursing graduate programs, graduate nursing program and in good academic standing at the time of application.
2. Actively involved in local health programs/projects.
3. Application may be made at any level of the student’s program.

Deadline for application submission is September 15th each year.
Application Procedure:
Each candidate will submit a complete NYBNA Scholarship
Application form.

Each application MUST be accompanied by
a) Nursing School Transcript with a minimum cumulative GPA of 3.0
b) Two (2) letters of recommendation (one from applicant’s school of nursing: Dean, Instructor, Counselor, etc.) on school letterhead.
c) A maximum of 500 words typed statement about yourself, your future goals in nursing and your particular qualifications for this award.
Evidence of involvement in health programs/projects (letters,
certificates, awards, etc.).
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you hold a nursing license?

YesNo
Phone Number
Email
example@example.com
Name of Current Nursing School
Dean/Director/Chairperson
School Phone Number
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Classification
If accelerated student, indicate program length

11-18 months18+ months
Expected Graduation Date
Please read scholarship details in it's entirety before selecting scholarships.
Which scholarship are you applying for? (Select all that apply)

Vivian Leslie Memorial ScholarshipMarjorie Anita Andrews ScholarshipLaura Cooper Doe Scholarship
Upload Transcript from school of nursing with a minimum cumulative GPA of 3.0

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Letter of recommendation #1 (from applicant’s school of nursing: Dean, Instructor, Counselor, etcetera) on school letterhead

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Recommendation #2

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A maximum of 500 words typed statement about yourself, your future, goals in nursing and your particular qualifications for this award

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Extracurricular/community activities
Are you an NBNA member

YesNo
If Yes List Local Chapter
Member ID #
Date

MonthDayYear
Date
I hereby affirm that all information is true. Any false statement will forfeit the award. Please enter Initials below.
Should be Empty: