2017-2018 Sanford Health/Northwest Technical College LPN Forgivable Loan Application
Sanford Health is an equal opportunity employer and will not discriminate against applicants because of race, color, creed, religion, national origin, gender, age, sexual orientation, genetic information, marital status, disability, military or veteran status, and status in regard to public assistance or any other basis prohibited by applicable federal, state or local law.
Name______
Address:______State______Zip______
Phone # ______
EmailAddress ______
Past Education (high school, college or vocational school):
Name of School, City/State, Year Attended, GPA/Degree
1.______
2.______
Are you currently employed at Sanford Health? □ Yes □ No
Region □ Sioux Falls □ Fargo □Bismarck □Bemidji
Job Title ______
Department ______
Date of Hire______Status □ Full-time □ Part-time □ PRN/UPT
List Your Recent Past Employment (Employer/Position/Dates):
______
______
Have you applied for the 2017-2018 Northwest Technical College LPN program? □ Yes □ No
Have you been accepted into the 2017-2018 Northwest Technical College LPN program? □ Yes □ No
______
Essay (on separate sheet of paper): (1) Describe your reasons for becoming an LPN and your desire to work at Sanford; and, (2) Describe your career goals.
Submission of this application does not guarantee award of the $5000 forgivable loan.
To be considered, applicants must meet the entrance requirements and have been accepted to the LPN program at Northwest Technical College.
Upon successful completion of this application, the applicant will be notified if she/he has been selected for an interview.
Based on the interview, candidates shall be selected for the $5000 forgivable loan.. The forgivable loan will be paid directly to the student enrolled in the Northwest Technical College LPN program.
Upon acceptance of the $5000 forgivable loan, the student shall enter into an agreement with Sanford Health of Northern Minnesota whereby the student agrees to work in an LPN position for 2 years in order to receive the full loan forgiveness. Receipt of a forgivable loan does not guarantee employment with Sanford Health of Northern Minnesota.
The Loan principle shall be amortized and forgiven in equal per pay period amounts.
If the student fails to complete 2 years of employment with Sanford Health of Northern Minnesota, the student shall repay the remainder of the loan.
All terms and conditions in the Agreement will be solely as specified by Sanford Health of Northern Minnesota and will exist only between Sanford and the Northwest TechnicalCollege LPN student selected to receive a loan.
APPLICANT SIGNATURE ______
DATE ______
BY MAY 1, 2017, RETURN BY MAIL OR EMAIL TO:
Michelle Lindom
Center for Learning
Sanford Health
1300 Anne St. NW
Bemidji, MN 56601
Route 10035
218-333-6038
Submission Deadline May1, 2017