2009 Northern Virginia ONS Scholarship Application 1

At Least Two Northern Virginia ONS Chapter Members Will Each Receive a $500 Scholarship to Attend Congress in San Antonio (April 28-May 3, 2009). Will You Be One of Them?

Scholarship Application Released: Monday, February 23, 2009

Electronic (via e-mail) Application Due: Friday, March 6, 2009

For an electronic copy of this document, please send an email to .

Signed Hard Copy to be Mailed Once Electronic Application Due:Postmarked by March 9, 2009

Northern VA ONS Board Reviews Applications:March 7, 2009 – March 14, 2009

Awardees Notified by Email: Monday, March 16, 2009

National ONS Early Bird Registration Deadline:Thursday, March 19, 2009

Application Requirements:

  1. Agree to the terms of Page 2 of this application.
  2. Complete Page 2 of this application. Don’t forget to sign the document.
  3. Complete Page 3 of this application by writing a 350 word essay.
  4. Email and mail signed application per deadlines above. For details, see Page 3.
  5. Failure to comply with the specified instructions will result in forfeiting your application.

Good luck!

Northern Virginia Oncology Nursing Society
2009 Scholarship Application

Applicant’s Name and Credentials / Applicant’s Email Address / Date of This Northern VA ONS Scholarship Application
Name of Conference / Dates of Conference / Early Bird Registration Deadline
Registration Fee / Estimated Airline Fee / Anticipated Date of You Will Register for Conference
Applicant’s Mailing Address / Applicant’s Phone Number / Do You Receive Compensation From Your Employer? If so, how much do you receive?

To the best of my knowledge, I have not received a scholarship from the Chapter within the past two years. Also, to the best of my knowledge, I have attended 50% of Chapter meetings within the past twelve months. If awarded this scholarship, I agree to provide confirmation of conference attendance and to continue or increase my participation in the Chapter by participating in the work of a Chapter Committee (Newsletter, Special Projects, Programs, Membership, Nominating, or Scholarship) within four months from the date of this application. I understand that my name will be forwarded to the Coordinator of the Committee that I designate below.

______
Signature and Printed NameDatePreferred Committee

For Chapter Use Only:

Chapter Meeting Attendance? / Date Issued / Amount Issued / Conference Attendance Verification / Repayment Activity / Date Activity Completed

In 350 words or less, describe:

  1. Your role as an oncology nurse.
  2. How attending this conference will impact your practice.
  3. How attending this conference will impact the patients for whom you care.
  4. How you plan to share the information from this conference with your colleagues.

Please email an electronic copy of this scholarship application to Carlin Callaway, Scholarship Chair, at . Then, please mail a signed copy of this scholarship to Carlin Callaway, 310 Fourth Street SE #33, Charlottesville, VA, 22902. For any questions, please call 303-506-7727.