Nursing Scholarship Application

Name

Address

City

State

ZIP

Have your lived at this address for past 6 months?

Yes

If no, list previous previous address (Address, City, State, Zip)

Phone

High School Attending

GPA

ACT Score

SAT Score

Graduation Date

College/University Planning to Attend

Accepted?

Yes

Enrollment Date

Employment Information

Re-order	Employer (Business) Name	Position	Employer (Business) City	Employer (Business) State	From (Mo/Yr)	To (Mo/Yr)	# Hours/Week	Weight	Operations
	Employer (Business) Name	Position	Employer (Business) City	Employer (Business) State	From (Mo/Yr)	To (Mo/Yr)	# Hours/Week	Item weight

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Volunteer Work

Re-order	Volunteer (Business) Name	Position	Volunteer (Business) City	Volunteer (Business) State	From (Mo/Yr)	To (Mo/Yr)	# Hours/Week	Weight	Operations
	Volunteer (Business) Name	Position	Volunteer (Business) City	Volunteer (Business) State	From (Mo/Yr)	To (Mo/Yr)	# Hours/Week	Item weight

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Activities (School or Civic)

Re-order	Activity	Dates	Weight	Operations
	Activity	Dates	Item weight

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Honors and Awards (School or Civic)

Re-order	Honor or Award	Dates	Weight	Operations
	Honor or Award	Dates	Item weight

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Letters of Recommendation

Letter

Only .pdf files allowed.
Maximum 2 files.
8 MB limit.
Allowed types: pdf.

High School Transcript

Transcript

Only .pdf files allowed.
One file only.
8 MB limit.
Allowed types: pdf.

What has motivated you to pursue a career in nursing? (300-word essay)

I affirm that the information contained in this application is true and accurate and the essay I have submitted is of my own work.