SC ENA Professional Development Scholarship Application

SC ENA Professional Development Scholarship Application

South Carolina Emergency Nurses Association
The South Carolina Emergency Nurses Association will award two recipients a $500 scholarship to cover certifications (initial), conference fees, and tuition reimbursement expenses. The recipient must be an active ENA member. The recipient is required to submit an invoice showing the amount owed by the ENA member. The amount awarded cannot be more than the ENA member owes.
- Applications for the Spring Scholarship are open from January 1st to May 15th of each year. The award recipient will be notified by email in May of the same year.
- Applications for the Fall Scholarship are open from August 1st to October 15th of each year. The award recipient will be notified by email in December of the same year.
Name*

First NameLast Name
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Credentials (select all that apply):*

DiplomaAssociatesBachelorsMastersDoctorateCENCPENCFRNCTRNTCRNOther
ENA Membership Number*
Chapter affiliate:*

CentralCoastalFoothillsLow CountryPee Dee
Date of Original ENA Membership*

MonthDayYear
Date
Have you maintained continuous EMA membership?

YesNo
Attended # Chapter Attended of# Chapter Held chapter meetings in the previous 12 months.
Attended # State Attended of # State Held State meeting in the previous 12 moths.
Date of Event*

MonthDayYear
List date of the educational activity / event or class start date you are requesting support
Title of Event / Class / Program*
Purpose of Event / Class / Program*
i.e., Obtain Bachelor's degree, Preparation for CEN exam, continuing education credits, etc.)
Amount requested*

$100$200$300$400$500Other
List any membership for committees / positions held with the local or state chapter for the South Carolina Nurses Association. Must include dates, chapter, duties / responsibilities. *
i.e., Chapter secretary, fundraising committee, golf tournament committee, etc.
Please select any ENA activities that you have attended in the last 2 years.

SESSEnlightenment DayGlobal ENA ConferenceOther - Please list specifics below
Other - Must be Specific in the "other" event attended - the type of event and date of event *
i.e., Attended SESS in 2020, Participated in Enlightenment Day in 2020, etc.
List any current memberships in professional organizations other than ENA*
Attach proof of any memberships listed above*

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List any activities that you have participated in related to the profession of Emergency Nursing outside of your regular job duties*
i.e., Injury prevention, government legislation, etc.
What activities have you participated in to further the profession of emergency nurses within your current job? Be specific about your contributions.
i.e. SANE training. starting forensic programs, EMS outreach.
List any community service activities you have participated in within the past year. Must include date and location of each event / activity. *
i.e., serve at the soup kitchen every other Saturday morning, coordinated a local food drive, etc.
Write an essay explaining why you deserve to be awarded a financial scholarship from the South Carolina Emergency Nurses Association. If awarded funds, what are your plans for continued involvement in SC-ENA? How do you plan to give back to SC-ENA? (minimum of 250 / maximum of 500 words)*
Upload proof of payment by ENA member*

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Signature of Applicant*

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