NOVA Scholarship Application 2017 – Word Version

The rules for submission of scholarship applications must be followed. Follow the directions found on the online application for completion and submission of the application form.It is recommended that this application be printed before completing it online. Printing out this Word version of the application questionswill assist you in gathering needed information prior to completing the online application form. You should develop your essays in a Word processing program and copy/paste the information into the onlineapplication format. Each question is limited to 350 words.You MUST complete all three essay questions in order to be considered for a scholarship.One application per person will be accepted, and individuals must apply for themselves only. Only one NOVA scholarship will be awarded to an individual.All applications will be considered for all scholarships: the Jesse Brown Memorial Scholarship, Vernice Ferguson Memorial Scholarship, Anthony Principi Scholarship, Catherine Rick Scholarship, theMary Raymer Memorial Scholarship, and other NOVA scholarships.

NOTICE: Applicants who receive notification indicating they have been awarded a scholarship will be required to submitthe following documents by the announced deadline:

  1. Validation of GPA via a copy of an official transcript (paper or electronic).
  2. Copy of current Proficiency or Performance Evaluation.
  3. A letter of acceptance from the academic program for which you are receiving the scholarship.
  4. A letter of endorsement from the Academic Dean/Designee from the academic program for which you are receiving the scholarship.
  5. A letter of endorsement from your current VA Nurse Executive/Designee confirming that you are not on restricted or light duty, LWOP, or FMLA.

* Scholarship funds will not be released until the above documents are received.

*Do not send these documents unless you receive notification of being awarded a scholarship.

  1. First Name:
  1. Middle Initial:
  1. Last Name:
  1. Contact information:

Street address:

City:

State:

ZIP code:

Daytime phone number: Home or cell phone number (with area code):

  1. Evening time phone number (with area code):
  1. VA facilitywhere you work:
  1. Personal email address:
  1. College or university to which you have been admitted:
  1. Current GPA (select the range in which your current GPA would fall. Validation of GPA via

official transcript will be required of applicants selected for the award).

< 2.5

2.5 - 3.0

3.1 - 3.5

3.6 - 4.0

  1. Anticipated graduation date (select your last semester):

2017Fall2020Fall

2018 Spring2021 Spring

2018 Summer2021 Summer

2018Fall 2021 Fall

2019 Spring

2019Summer

2019Fall

2020 Spring

2020Summer

  1. Type of degree

Bachelor of Science Degree in Nursing (BSN)

Master of Science Degree in Nursing (includes Nursing Education, Nursing Leadership, Nursing

Management, Clinical Nurse Leader, etc.)

Master of Science Degree Nurse Practitioner

Master’s Degree (not Nursing)

Post-Master’s Program

Doctoral Degree in Nursing

Doctoral Degree (not Nursing)

  1. Total credit hours required for degree (enter whole numbers using numerical

digits only):

  1. Total number of hours left to complete (enter whole numbers using numerical digits only):

Narrative EssayS

Theessays represent a maximum of 40 points in the application criteria. They represent40% of the total possible points used to determine selection of awarded scholarships.It is recommended that thedevelopment of responses to the following issues be done in a word processing program with use of “copy/paste” into the appropriate text boxes. Eachresponse is to be limited to no more than 350 words.Correct grammar and spelling comprise 10 points of the 40 points.

  1. Identify threecurrent clinical priorities in providing healthcare for veterans at your facility, and describe how you will use your academic program to impact the quality of nursing careprovided to veterans in your facility for one of those clinical priorities.
    350-word limit. (10 Points)
  2. VA’s core values spell out I CARE (integrity, commitment, advocacy, respect, excellence). Select one of these core values and describe how you incorporate it into your daily nursing practice.
    350-word limit. (10 Points)
  3. Identify and describe at least one measurable outcome related to providing healthcare for

veterans that will result from your completion of your academic program.

350-word limit. (10 Points)