SUMMER IMMERSION APPLICATION 2016 – Deadline July 1, 2016

BEST 4.0 is a free program designed to increase diversity in the nursing workforce and promote academic excellence. The project targets Hunter college students who are enrolled in nursing pre-requisite courses.

Identification / Answer in this column
Name
Date of Birth
Gender
Cell Phone Number
Hunter College Email
Full Address
City
State
ZIP
GPA
Social Security Number (For Stipends)
Education / Answer in this column
Pre-requisite courses you are enrolled in
and # credits completed
Name of High School/Previous College
Current School Name
CUNY ID
Eligibility / Answer in this column
Are you a U.S. Citizen
Please indicate which ethnic group/s you identify with: Hispanic/Latino or Non-Hispanic Latino
What is your country of birth?
Have you been accepted into Hunter College?
How did you hear about the best program?
Have you submitted a 2015/2016 FAFSA?
Do you receive financial support from a parent or guardian? Please specify
Are you receiving financial aid? Please specify
Do you consider yourself economically or environmentally disadvantaged?
Are you a veteran?
Please choose one of the following areas you are most interested in:
Service/Writing for Publication/ResearchAssistance
Voluntary Self – Identification:
Pg. 251 of “Performance Report for Grants and Cooperative Agreements” -
Race according to standards for the classification of federal data on race and ethnicity from OMB, five minimum categories on race exist: American Indian or Alaska Native, Asian, Black or African-American, Native Hawaiian or Other Pacific Islander, and White. The minimum categories for data on race and ethnicity for Federal statistics, program administrative reporting, and civil rights compliance reporting are defined as follows:
Please indicatewith which of the following groups you would identify yourself:
American Indian or Alaska Native. A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Please Specify Country:______
Black or African-American. A person having origins in any of the Black racial groups of Africa. Terms such as “Haitian” or “Negro” can be used in addition to “Black or African-American.”
Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White. A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Other (Please specify):______
The provision of this information is on a strictly voluntary basis.If you prefer not to answer, please write N/A
Describe why you would like to be a part of the BEST 4.0 Program (150 words). Please attach a copy of your latest transcript to this application.

Barbara Singletary - BEST 4.0 Advisor

Hunter-Bellevue School of Nursing - 425 East 25th Street New York, NY 10010

(212) 481-7574

In order to participate in the BEST 4.0 program, students must be from economically or environmentally disadvantaged backgrounds.

CRITERIA FOR DISADVANTAGED BACKGROUND STATUS:

1. Come from an environment that has inhibited them from obtaining the knowledge, skills, and abilities required

to enroll in and graduate from a health professions or nursing school (Environmentally Disadvantaged). The

following are provided as examples of “Environmental Disadvantages” for guidance only and are not intended

to be all-inclusive.

Examples:

• Person from high school with low average SAT/ACT scores or below the average State test results.

• Person from a school district where 50 percent or less of graduates go to college.

• Person who has a diagnosed physical or mental impairment that substantially limits participation in educational experiences.

• Person for who English is not his or her primary language and for whom language is still a barrier to academic performance.

• Person who is first generation to attend college.

• Person from a high school where at least 30 percent of enrolled students are eligible for free or reduced price lunches.

– OR –

2. Come from a family with an annual income below a level based on low-income thresholds established by the U.S. Census

Bureau, adjusted annually for changes in the Consumer Price Index (Economically Disadvantaged).

The Secretary defines a ‘‘low income family’’ for various health professions and nursing programs included in Titles III,

VII and VIII of the Public Health Service Act as having an annual income that does not exceed 200 percent of the

Department’s poverty guidelines. A family is a group of two or more individuals related by birth, marriage, or adoption

who live together or an individual who is not living with any relatives.

I, (print name) ______come from an economically and/or environmentally disadvantaged background.

(Signature)______