The Florence Nightingale Foundation / Chief Nursing Office for England Leadership scholarship
APPLICATION FORM 2017-2018
PERSONAL DETAILSSurname / family name
First name(s)
Title (e.g.Mr/Mrs/Ms/Miss/Dr)
NMC Registration Number
Home address (full including postcode)
Home telephone number
Mobile telephone number
Home email address
How did you hear about these scholarships? e.g. word of mouth, CNO Bulletin, publication or direct email, etc.
PROFESSIONAL AND HIGHER EDUCATION (undergraduate and post-graduate of 1 year’s length or more)
Qualification / Institution (name, city, country) / Date
commenced / Major field of study / Year completed
EMPLOYMENT DETAILS
Current job title and Band / Grade
Length of time in this role
Organisation name
Work address (full)
Work telephone number
Work email address
Chief Executive or equivalent head of organisation:
Name:
Email address:
Please remember to provide with your application a letter of support agreeing to the grant of study leave and the commitment to provide 10% of the award that the scholarship requires.
KEY RESPONSIBILITIES IN CURRENT ROLE list briefly:
1.
2.
3.
4.
5.
EMPLOYMENT & LEADERSHIP EXPERIENCE (after qualification) – begin with position prior to current and include any voluntary appointments and trusteeships etc.
Position /Title / Organisation / Number of years / Main areas of responsibility
IN SUPPORT OF YOUR APPLICATION please complete the questions below. Use the space provided and the word count suggested.
1. Please describe any leadership development which you are currently undertaking or have completed in the last two years:
(up to 200 words only)2. Please give three examples of what you see as your key achievements to date in the development of nursing and health and social care services:
(up to 300 words only)3. Please outline your plans for the bespoke element of the scholarship and the reasons for your choices (this may include reference to leadership diagnostics such as a recent 360° assessment and your personal development plan):
(up to 300 words only)4. Please indicate the amount of funding required:
5. Please outline your personal immediate and long term goals in health and social care and how obtaining a Leadership Scholarship might contribute to achieving these:
Immediate:(up to 200 words only)
Long Term:
(up to 200 words only)
6. Please set out your vision of what you would like health and social care services to look like in 5 years’ time:
(up to 100 words only)7. Please provide details of any other leadership development funding for which you have applied:
The quality, not quantity, of this information and its presentation will be an important part of the selection process.
Have You … / Tick üFully completed the application form
Provided with your application the letter of support required for your scholarship
Please email your completed application to:
The Florence Nightingale Foundation
Email:
The closing date for receipt of applications is Monday 12th February 2018.
Applications will be acknowledged upon receipt and you will be notified whether you have been shortlisted for interview or not by Monday 19th February 2018.
INTERVIEWS FOR LEADERSHIPS SCHOLARSHIPS WILL BE HELD EARLY MARCH 2018.
Any candidate who is unable to attend for interview on one of these dates cannot be considered.
Travel costs are not reimbursed to successful candidates but a contribution can be negotiated by candidates who are unsuccessful at interview.
Please note, The Foundation cannot pay for secretarial assistance, IT equipment, stationery, replacement staff costs or study leave while the Scholar is undertaking the scholarship. This application can only be considered for funding for the year 2017-18. A scholarship cannot be awarded retrospectively.
The Foundation complies with the provisions of the Data Protection Act 1998.
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