LIVING LEGENDS ADVANCED LEADERSHIP SCHOLARSHIP APPLICATION

Application must be typed or reproduced by computer.

SECTION 1:

NAME
MAILING ADDRESS
CITY/STATE/ZIP
Are you currently licensed as a
Registered Nurse in New Jersey?

SECTION 2 – CURRENT SCHOOL

Name of College/University
Please provide your
student identification number
Type of Program /  MSN  DNP  PhD
Approximate GPA (using 4.0 scale) / Date of anticipated graduation
Dean/Professor
Title & Credentials
Mailing Address
City/State/Zip
Phone No.

SECTION 3– ESSAY:

Please explain in 250 words or less why you merit consideration for this scholarship award. Be specific regarding leadership qualities, goals as they relate to the profession and your financial needs.

ESSAY: (Please limit your essay to 250 words) Place cursor in box to type.

SECTION 4 – APPLICANT’S CERTIFICATION:

I believe I am eligible for and hereby make application to received one of the Living LegendsAdvanced Leadership scholarships. I certify that all statements made in my application are complete and accurate. I understand the Scholarship Committee and ultimately the Organization of Nurse Executives, New Jersey Board of Directors will select scholarship winners and its decision will be final.

SignatureDate

CONTINUE TO PAGE 4 – APPLICANT CHECK LIST

LIVING LEGENDS ADVANCED LEADERSHIP

Scholarship Application

Checklist for Individual Scholarship Packet

Directions: Complete this checklist. Put a check mark in column marked “applicant” opposite each question if your answer is YES. If your answer is NO, please review the application and complete all required areas and include any requested documentation. DO NOT email application packet if you have answered NO to any of the questions in the checklist. Leave the last column “Checked by ONE NJ staff” blank.

Applicant’s Name in Print: ______

Signature of Applicant Completing this Checklist: ______

SignatureDate

ITEM / Checked by
Applicant / ONE NJ Staff
  1. Did you complete the scholarship application form?

  1. Are a licensed registered nurse in New Jersey?

  1. Are you currently enrolled (not waiting to hear) in a Baccalaureate, Masters Nursing or Doctoral program?

  1. Have you included the dean or designee support letter?

  1. Have you included your unofficial transcript of your most recent college transcript?

  1. Have you included a letter of recommendation from a professional colleague or your supervisor?

  1. Are you a member of ONE NJ?

  1. Have you included your resume?

  1. Have you included a completed checklist for the scholarship packet?

  1. Have you included your Student ID number?

  1. Are you emailing the complete scholarship packet to

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