November 13, 2017

Dear Student:

The Pennsylvania League for Nursing, Area VI is currently accepting applications for its Nursing Scholarship that is awarded annually in the fall. The amount of this year’s scholarship is $500.

Enclosed are the application form and eligibility criteria.

Competed applications are due December 31st, 2017.

Please submit completed applications to:

Angela Balistrieri DNP RN

Chair, PLN Area VI Scholarship Committee

c/o Mercy Hospital School of Nursing

1401 Blvd of the Allies

Pittsburgh PA 15219

Thank you for your interest in the PLN. We look forward to receiving your application.

Sincerely

Angela M Balistrieri

Angela M Balistrieri RN DNP

Chair, Scholarship Committee

PLN, Area VI

PLN Area VI Scholarship Eligibility

Eligible Applicants

  1. Must be enrolled in an ACEN accredited program within Area VI of the PLN.
  1. Must be in their senior year of a diploma, associate degree or baccalaureate degree program.
  1. Must currently have earned a QPA of 3.0 on a 4.0 scale. Official transcript must be submitted with the application.
  1. Need to submit a completed reference form from a clinical instructor.
  1. Need to complete the attached application. The application can be typed directly into the document. The committee requests all applications be typed. Illegible application will be disqualified.

PLN Area VI Scholarship Application

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Contact Information

Name
Street Address
City ST ZIP Code
Home Phone
CellPhone
E-Mail Address

School Information

Name of Nursing School
Street Address
City ST ZIP Code
Type of Program /  Diploma  ADN  BSN
Name of Dean / Director

Academic Information

Expected Graduation Date
Current QPA *
*must submit an official transcript

Academic Honors

Please list any academic honors you received while enrolled in your current nursing program.

Participation in Professional Organizations, community service, or volunteer activities

Please list any professional organizations, community service or volunteer activities that you have engaged in related to your role as a student nurse.

Personal Essay

Please articulate in approximately a 200 words essay “The Value of Participation in Professional Nursing Organizations”

Scholarship Checklist

Please make sure all areas below are included.

  1. Completed application form with all sections addressed.
  2. Official transcript from the nursing program.
  3. Letter of reference from a clinical instructor.

Please mail completed application package to:

Angela Balistrieri DNP RN

Chair, PLN Area VI Scholarship Committee

c/o Mercy Hospital School of Nursing

1401 Blvd of the Allies

Pittsburgh PA 15219

Agreement and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. Any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate disqualification.

Name (printed)
Signature
Date

PLN Area VI Scholarship Reference Form

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Contact Information

Candidate Name
Faculty Name
School Name
Course in which Faculty Supervised student in clinical

Areas of reference

Please complete the following table based on your clinical evaluation of the student.

Excellent / Good / Fair
Application of the nursing process to critical thinking skills
Communication Skills
Dependability (independent, accountable)
Leadership potential
Professional behavior

Comments

Please list any additional comments about the student that would assist the committee in selecting a recipient.

Agreement and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete.

Name (printed)
Signature
Date