March 15, 2007

Dear Nursing Student:

Since December 1981, the Department of Nursing, Community College of Philadelphia, has received gifts from the Arronson-Lavine and Independence Foundations of approximately $370,000 to establish and support Nursing Scholarship awards. The purpose of these gifts is to generate revenues, which will be used to provide scholarships to nursing students. There will be 8-10 scholarship awards for the next academic year of $2,400 each ($300 per month for 8 months). In addition, one Harold E. Kohn Memorial Scholarship will be awarded.

These awards will be made to nursing students entering the second year of the nursing curriculum who complete an application and meet the following criteria:

  1. Achieve a grade point average of 3.0 or higher (B) with a minimum grade of C in N132 or a grade point average of 2.8 or higher with a minimum grade of B in N132 (including Spring 2007 grades.)
  1. File an application for financial aid no later than April 15th regardless of your economic status. You can apply for financial aid at the FAFSA (Free Application for Federal Student Aid) website at http://www.fafsa.ed.gov/. The FAFSA form can also be obtained from the Financial Aid Office. Please note that this application must be submitted to the federal government. If you have already applied to FAFSA for academic year 2006-2007, you do not need to complete another application. You must complete and submit all pages of your SAR (Student Aid Report) with your application. Students with incomplete applications will not be considered for this scholarship. Students are advised to check for completeness of their FAFSA form.
  1. Complete the application process.
  1. Sign the attached intent to work for one year following graduation at a health care facility in Philadelphia County.
  1. Sign the attached consent to release information.

Application packets will be distributed in class. In addition, this application is available on the Nursing 132 webpage. The deadline for applications to be returned to the nursing office is Tuesday, May 8, 2007 by 12 noon. Applications submitted after that date and time will not be considered. All applications must include the following six items and those six items must be submitted to Gail Crawford, W2-5, in an envelope. You will need to obtain two references from faculty. Be sure to request that the faculty member write the reference and place it in a sealed envelope with his/her signature across the seal. These references must be included in the completed packet. A complete application must be typed and includes:

  1. Scholarship application form.
  1. Responses to essay questions.
  1. Photocopy of all pages of your SAR (Student Aid Report).
  1. Signed Intent to Work Statement.
  1. Signed Consent to Release Information.
  1. Two written nursing faculty references in envelopes with the faculty signature across the seal.

It is the student's responsibility to insure that the application is complete. Incomplete applications will not be considered for the award. An interview with the Scholarship Committee may be requested at the Committee's discretion. Awards will be announced by letter in late June.

All nursing students entering the second year of the nursing program who feel they meet the criteria are invited to apply. All awards will be made without regard to race, color, ancestry, creed, national or ethnic origin, age, sexual orientation/preference, religion, sex, disability or status as a disabled veteran or veteran of the Vietnam era.

Applications will be reviewed by the Scholarship Committee which, in the past, has paid close attention to grades, faculty references, activities, and responses to essay questions.

Sincerely,

Andrea Mengel, PhD, RN

Head, Department of Nursing

Rev 2/07

AM/Arronson and IF letter

COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF NURSING

SCHOLARSHIP APPLICATION

Return to Ms. Gail Crawford, Office W2-5H by May 8th at 12 noon

Name______Social Security # ______

J#______Email Address______

Address______

______

Telephone # Daytime______Evening______

References are included from the following nursing faculty:

  1. ______
  1. ______

List all of your activities over the past five years:

Student/academic life______

______

______

Volunteer activities in community ______

______

Work Experience ______

______

Iherebypromisethatalloftheinformationenteredonthisapplicationisaccurateand truthful tothebestofmyknowledge.Iunderstandthatanyfalsestatementcaninvalidatemy

candidacyforscholarshipassistance.

Signature ______Date______

COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF NURSING

SCHOLARSHIP APPLICATION

Intent to Work Statement

I understand that one of the conditions attached to the nursing scholarship is a commitment on my part to secure employment for one year at a health care facility in Philadelphia County.

If I choose not to work at one of these facilities, I understand that I have a commitment to return to the Fund, in full, within two years, all monies I received.

Print Name______

SS# ______J#______

Signature______Date______

Consent to Release Information

To whom it may concern:

As a recipient of a Community College of Philadelphia scholarship for nursing students, I give my consent to Community College of Philadelphia and the Department of Nursing to release any personal information, including name, home address, telephone number, grade point average, and all of the information submitted as part of my application, including my essay, in any form or publication for the purpose of announcing and/or acknowledging my receipt of this scholarship.

Sincerely,

Signature______Date______

SS#______J#______

My signature below confirms that I agree to permit the sharing of my directory and academic history with the scholarship donor.

Signature______Date______

AM/Arronson and IF scholarship application

COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF NURSING

SCHOLARSHIP APPLICATION ESSAY QUESTIONS

Please note: If you choose to provide your typed responses on additional pages, please sign each page.

Tell us about your life prior to entering the nursing program. (200 words or less).

Describe a difficult situation or challenge that you faced (at school, at work, or in volunteer activities). What did you do? What did you learn? (200 words or less).

Please describe any special circumstances which you feel might assist the Committee in reaching a positive decision about your application. (100 words or less).

Signature ______Date______

COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF NURSING

SCHOLARSHIP APPLICATION FACULTY REFERENCE

To be completed by the applicant

Name______

Social Security # ______J#______

Agreement respecting confidentiality

Please read carefully the statement below regarding your rights. If you wish to waive your rights according to Federal Law, you must sign each recommendation form.

I request that this recommendation be treated as confidential by the officers and faculty members of Community College of Philadelphia. I understand that it will be used solely for the decision on my application for scholarships. I therefore agree that the contents of this appraisal shall not be made known to anyone else, including myself.

______

Signature of Applicant Date

Please give this recommendation form to each of the faculty you have listed on page one of this application. Include this reference (in a sealed envelope) with your application packet.

To be completed by the nursing faculty member

Please complete the reverse side. You may also choose to write a brief (no more than 200 words) recommendation for the above named person. Your recommendation should include your assessment of the candidate's character and clinical skills, as well as any other information you feel would be pertinent to the committee deliberations. You should return the completed form to the student in a sealed envelope with your signature across the seal. The student will submit the reference as part of

a completed packet. All completed application packets must be submitted by May 8th.

COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF NURSING

FACULTY REFERENCE

Re: Student’s Name: ______

To whom it may concern:

I am a nursing faculty member at Community College of Philadelphia and I was the

___clinical teacher ___seminar teacher ___classroom teacher ___skills lab teacher

for this nursing student in the following nursing course: ___N 101 __ N 132 __N 915

This reference is based on my assessment of the student during this course.

Outstanding / Above Average / Average / Below Average
Nursing knowledge
Nursing judgment
Intellectual curiosity
Initiative
Communication skills
Collaboration skills
Punctuality and attendance

Additional comments:

Recommendation:

____Highly recommend ____Recommend ____Do not recommend

Faculty (signature)______Date______

Faculty (print name)______

Department of Nursing