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LANDER UNIVERSITY DEPARTMENT OF NURSING GRADUATE SCHOOL NURSING (Lander University)

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  • 6 check-boxes
  • 32 other fields

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File type: PDF

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Due in Department Office by March 31.
LANDER UNIVERSITY
DEPARTMENT OF NURSING
GRADUATE SCHOOL
NURSING SCHOLARSHIP APPLICATION
Attach a CURRENT TRANSCRIPT from BEARCAT WEB
(Applications will not be accepted unless transcript is attached.)
NAME: _____________________________________________ SS# __________________________
L # __________________________
AGE: ______ GENDER: ______ MARITAL STATUS: ______
CAMPUS ADDRESS: (if applicable) _____________________________________________________
PARENT’S NAME (if applicable) ________________________________________________________
PERMANENT ADDRESS: _____________________________________________________________
CITY: _________________________________ STATE:_______ ZIP ____________
TELEPHONE ________________________________ COUNTY _____________________
EDUCATION: (Indicate dates attended or degree obtained)
(1)_________________________________________________________________________________
(2)_________________________________________________________________________________
DATE ENTERED LANDER: _________________________________________________________
DATE ADMITTED TO NURSING MAJOR:_____________________________________________
CURRENT LANDER (Institutional) GPA: ______ CREDIT HOURS EARNED AT LANDER ____
NAME OF GRADUATE SCHOOL (applied/accepted) to: ____________________________________
FINANCIAL AID
Have you completed a financial aid application form in the Financial Aid Office?
_____ yes _____ no
Are you receiving financial aid? _______ Yes _____No
If yes, list the name and amounts received ____________________________________________
______________________________________________________________________________
Are you receiving any scholarships? _______ Yes _____No
If yes, list name and amounts received_______________________________________________
_____________________________________________________________________________
Due in Department Office by March 31.
AREA OF INTEREST IN NURSING (ex. Mental Health, Community Health, Neuro, Psych, Cancer, Orthopedic, Geriatric)
_____________________________________________________________________________________
LIST LANDER UNIVERSITY ACTIVITIES:
LANDER UNIVERSITY STUDENT NURSES ASSOCIATION (LUSNA) ACTIVITIES
(Include related activities, membership, offices held, and committee activities.
Also include State and National activities).
CIVIC AND COMMUNITY ACTIVITIES
HONORS AND AWARDS RECEIVED
Are there any unusual or significant circumstances of which the scholarship committee should be aware?
Please explain, describing financial and any other circumstances attaching additional page if necessary.)
I certify that the information submitted on this application is accurate to the best of my knowledge.
DATE: ____________ SIGNATURE: ________________________________________________
Approved by NFO 9/21/94
Revised 1/30/01, 2/3/04
2010
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LANDER UNIVERSITY DEPARTMENT OF NURSING GRADUATE SCHOOL NURSING (Lander University)

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Completed 16 August 2020

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