The Florence Nightingale Institute
General Leadership Scholarship
Fundedby
The National Leadership & Innovation Centre, HSE Office for the Nursing and Midwifery Services
August 2017
PERSONAL DETAILS
Surname / family name
First name(s)
Title(e.g.Mr/Mrs/Ms/Miss/Dr)
NMBIRegistration Number
Ethnic origin - Please tick / White
Mixed / Multi ethnic
Asian / Asian British
Black / African / Caribbean / Black British
Other ethnic group
Please describe:
Prefer not to say
Home address
(full including eircode)
Home telephone number
Mobile telephone number
Home email address
How did you hear about these scholarships? e.g. word of mouth, 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 titleand 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 applicationa letter of support to include the X days study leave and the travel and expenses financial support 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 or board/association memberships 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 wordcount 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, midwifery and health and social care services:
(up to 300 words only)3.Please outlineyour 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 outline key bespoke activity you may undertake during the scholarship and amount of funding it may utilise:
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 outyour 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 ofany 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 Fully completed the application form
Provided with your applicationthe letter of support required for your scholarship (Outlining support for study leave, travel and expenses)
Signed HSE National Leadership and Innovation Centre Learning Contract
Please email your completed application to:
National Leadership and Innovation Centre for Nursing and Midwifery,
HSE Office for the Nursing and Midwifery Services,
C/o NMPDU, HSE, 31/33 Catherine Street, Limerick,
Ireland V94 AY27
The closing date for receipt of applications is 5pmMonday25th September 2017.
Applications will be acknowledged upon receipt and you will be notified whether you have been shortlisted for interview or not byFriday6thOctober 2017.
INTERVIEWS FOR LEADERSHIPS SCHOLARSHIPS WILL BE HELD BETWEEN 6TH – 17TH NOVEMBER 2017.
Any candidate who is unable to attend for interview on one of these dates cannot be considered. Travel costs must be covered by candidates or their host organisation.
Please note the National Leadership and Innovation Centre for Nursing and Midwifery,
HSE Office for the Nursing and MidwiferyServices 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 by the Florence Nightingale Institute UK.
Page 1 of 7