S.E.P.A.B.N.A. SCHOLARSHIP APPLICATION
*Applicants must be an active member of SEPABNA*
Phone Number: ______________ Cell Number: ____________________
Are you: currently a licensed nurse? Y N SEPABNA member? Y N __
Nursing School Enrollment:
School Name: ______________________________________________________ ______
School Address: ____________________________________________ ________
Phone Number: _____________________________________________________
Current Scholastic Level: Undergraduate (Indicate Year) _______________________
Graduate (Type of Program) ________________________
Current GPA ____ _ Expected date of graduation ___ _____ __
Previous Education (Attach a separate sheet if necessary):
Employment History—Include type, location, and dates of employment (Attach a separate sheet if necessary):
Extracurricular/Community Activities (Please List):
Submit a 1 (one) page typewritten double spaced essay, 12 font, Times Roman, which comprehensively and concisely addresses the following “Why I should receive a nursing scholarship? How will I contribute to SEPABNA?”
Proof of active participation in SEPABNA through attendance of meetings, participation in committees, and/or in community/professional events sponsored by SEPABNA for at least 6 months prior to submitting a scholarship application. Attendance in at least 5 activities is expected.
Include an updated resume or CV indicating relevant information such as your community involvement, achievements and educational goals. Professional presentation of this material is critical.
Submit proof of matriculation/acceptance (official transcript) and at least 3 (three) letters of recommendation. One recommendation letter must be from a SEPABNA Board member, one from your nursing school, and one personal reference. Applications MUST be received by March 30th of the current year.
I hereby affirm that all information provided is true. I understand that any false statements will forfeit the award. If I am the recipient of a scholarship, I agree to remain an active* SEPABNA member for a period of at least 2(two) years after receiving the scholarship. An active member denotes presence and/or participation @ 50% or 5 general SEPABNA meetings per year and participation at SEPABNA events are highly recommended.
Print Name: ______________________ _______ Signature: ______________________ __
Date: __________________ ________________
SEPABNA membership meetings are held at 5:30 pm, the first Wednesday of each month at Mercy Hospital of Philadelphia, 501 South 54th Street, Philadelphia, PA 19143 . No meetings are held during the months of July and August. In February, SEPABNA meets the second Wednesday of the month. Please enclose all required information. Incomplete applications may not be considered and consequently may not meet application deadlines. Send all completed information to South Eastern Pennsylvania Area Black Nurses Association, PO Box 42463, Philadelphia, PA 19101-2463.
If you have any questions/ concerns, please contact Roberta Waite, Ed.D, RN @ (215) 762-4975
Revised 01-07-2011 RLW
Rev. 06-01-2012 CBW
Inez Tory Scholarship Award
More Information Coming - Deadline for Applications will be April 30, 2013
Minority Nurse Scholarship Program
We are currently accepting applications for our 14th annual scholarship competition, consisting of two $1,000 awards and one $3,000 award. Scholarships will be paid in summer 2013 for the fall 2013 academic term.