Nursing Students Submission Form

2021 Open / Close Dates for all AAACN Scholarships & Awards:
- Application / nomination submissions are for the time period January 15, 2021 – November 15, 2021.
- Submissions must be received in the National Office by November 15, 2021, 11:59 PM Eastern.
- All submissions received after that date will be considered for the next year.

Conference Scholarship for Nursing Students Submission Form

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Fields marked with an asterisk (*) are required.

CONTACT INFORMATION

First and last name *

Credentials (If applicable)

Primary email *

Mailing address *

Mailing address 2

City, State. Zip *

Primary phone *

YOUR JOB & EMPLOYER

Job title *

Employer *

ABOUT YOU

Are you certified?

Ambulatory

Care Coordination

Telehealth

Other

Please select all that apply.

Other - please describe

What is your highest level of education? *

Other education, please describe *

What is your degree in? *

Other degree, please describe *

Are you a member of any other professional organizations? *

Please list organizations *

AAACN & YOU

Are you a member of AAACN *

If you answered "Yes" above, please complete fields A-D below that are applicable to you

A. What volunteer committees, task forces, etc., have you participated in for AAACN?

B.How do you promote AAACN?

C. Number of AAACN Conferences attended in the past?

D. Year and number of presentations given at AAACN Conference(s), including poster presentations?

SCHOLARSHIP SPECIFIC INFORMATION

The rest of this form contains information that is specifically for the Conference Scholarship for Nursing Students.

ACADEMIC INSTITUTION INFORMATION

Name and Address of Academic Institution *

Please submit proof of your student status. *

More information

Files must be less than 8 MB.
Allowed file types: pdf doc docx.

What degree are you seeking? *

ADN

BNS

Select all that apply.

LETTER OF RECOMMENDATION AND VIEWPOINT

Name of current AAACN member recommending you for this scholarship *

Submit a letter for recommendation from current AAACN member. *

More information

Files must be less than 2 MB.
Allowed file types: pdf doc docx.

Write for the ViewPoint Publication *

I am willing to write an article for the ViewPoint publication within one year of receipt of the award describing my journey from nursing school graduation to competence in the profession of nursing. Additionally, will include a description of the professional benefits I have derived from this award.

NARRATIVE (50-100 WORDS)

As you begin your career in nursing, please select and respond to one of the four statements below to be included as part of your application.

Select your statement *

Your Response (50-100 Words) *

SIGNATURE AND DATE

The information provided in this application is accurate and complete. I understand that acceptance of an AAACN award, scholarship, or research grant obligates me to use the funds awarded for the intent described in this application. I further understand that misuse of a AAACN award, scholarship, or research grant may result in permanent revocation of my AAACN membership and a requirement that I refund any misused funds to AAACN. All information contained in this application will be considered confidential and will be reviewed only by members of the Nominating Committee of AAACN and staff. All applications are blinded by staff before they are sent to the Nominating Committee for consideration.

Your electronic signature *

Date *

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Nursing Students Submission Form

Conference Scholarship for Nursing Students Submission Form

The rest of this form contains information that is specifically for the Conference Scholarship for Nursing Students.