NER-WOCN Scholarship Application

NER WOCN Scholarship Application

(WOCNEP Students)
Please submit the completed application and necessary documents.
One submission per person, per year.

If you have any questions, please direct them to the Membership Committee Contact Person Vashti Livingston (vashtiner@aol.com) .

The Application Submission Deadline is AUGUST 1, 2018.
Incomplete applications will not be accepted.

Scholarship Awards are announced at the NER WOCN® Region Fall Conference. Awardees not present will receive their scholarship via mail after the conference.
Name*

First NameLast Name
Credentials*
Home Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number/Mobile
Phone Number/Work
E-mail*
Are you a member of the WOCN national organization?*

YesNo
IF you are a member of the WOCN, please provide your membership #:
How long have you been a member of the WOCN Society?
Your WOCNEP Program?*

Cleveland ClinicRutgersSan Jose StateUW WMEPWeb WOCEmory
What is your status?*

Accepted to this WOCNEP/not yet matriculatingCurrently attending this WOCNEPGraduated
Dates of expected/current/completed attendance:
Start Date*

MonthDayYear
Date
End Date

MonthDayYear
Date
Content Focus (click all that apply)*

WoundOstomyContinenceFoot Care
Please attach the following documents to your application:

A. 2 Letters of Recommendation

B. Letter of WOCNEP Acceptance or current enrollment, OR proof of Graduation from a WOCN-accredited WOCNEP program within the last 6-12 months

C. Your Personal Statement of 100 -150 words describing your interest in the WOCN discipline.
A. 2 Letters of Recommendation*

Upload
1 MB size limit Cancelof
B. Letter of WOCNEP Acceptance/Graduation*

Upload
1 MB size limit Cancelof
C. Personal Statement*

Upload
1 MB size limit Cancelof
I hereby certify that the information on the application and additional documents are true and accurate.*
Type, "I agree" in the box above
Should be Empty:

NER WOCN Scholarship Application