MEMORIAL HOSPITAL SCHOOL OF NURSING



SAMARITAN HOSPITAL SCHOOL OF NURSING

SCHOLARSHIP APPLICATION

Spring 2021

Student Information

Last Name: ____________________________ First Name: _________________

Phone Number: _________________________ Current GPA_________________

Street Address: ________________________________________________________

City: __________________ State: _________ Zip Code: __________________

E-Mail Address: ___________________________________

Semester Applying for: ____________ Expected Graduation Date: _____

Nursing Course Currently in: _________________________________

I am applying for the following scholarship (Check all the apply):

o Craig Duncan Scholarship

o Lillian Russ Scholarship

o Belknap Leadership – attach a list of leadership opportunities

o MVMA – pending funding

o Leah Schwebel Gaines Nursing Scholarship- Essay required

o Mouso Shoobe Nursing Scholarship

Employment Data

Employed at_____________________________________________________________

Position__________________________________________ [ ] Full Time [ ] Part Time

PLEASE NOTE:

The committee will not review any applications that do not meet ALL the criteria.

If an essay is required, please submit it with this application.

I acknowledge that the above information is true and complete.

If I am granted a scholarship, I agree to use the monies solely for educational purposes.

I am presently in satisfactory academic standing.

I understand that this application and all credentials submitted by me will remain in confidence and the property of Samaritan Hospital School of Nursing.

I understand that this scholarship may be taxable under state and federal laws.

I understand that if I do not return in the semester for which the scholarship is awarded or go on academic probation, I will forfeit my award.

Required Signatures

Student Signature:_____________________________ Date: __________________

Office Use ONLY:

Academic: I certify that the above named applicant is currently in good academic standing and has completed all of the required coursework for this scholarship.

Student Services: _____________________________ Date: _________________

Financial Aid: I certify that the above named applicant has complied with all documentation requirements needed to determine financial need: Need_________ Aid___________ Unmet Need_____________

Prior Scholarships_________________________ How much awarded: _______________________

Financial Aid Director: _______________________________ Date: __________________

Committee Review Date:______________ Decision:______

Scholarship Criteria Listing For Spring Semester of 2021

December 18th, 2020 Deadline

Belknap Leadership Scholarship

Be entering Nursing V in the Spring 2021 semester

Be in good academic standing

Have a current 20/21 FAFSA on file in the Financial Aid Office and demonstrated financial need.

Submit a list of your leadership opportunities.

Complete scholarship application.

Craig Duncan Scholarship

Completed Nursing 1 or PN 1 - entering Nursing II or PN II in the Spring 2021 semester

Be in good academic standing

Be an employee of St Peter's Health Partners with a preference given to an employee of a Northeast Health Legacy partner (including Samaritan, Memorial, the Eddys, Sunnyview)

Have a current 20/21 FAFSA on file in the Financial Aid Office & demonstrated financial need.

Complete scholarship application.

Lillian Russ Scholarship

Have completed Nursing I – any semester

Be in good academic standing

Have a current 20/21 FAFSA on file in the Financial Aid Office and demonstrated financial need.

Complete scholarship application.

Leah Schwebel Gaines RN, '42 Nursing Scholarship

Be entering Nursing 3, BH, 4 or 5

Be in good academic standing, exhibit academic excellence. GPA of 3.0 or higher

Have a current 20/21 FAFSA on file in the Financial Aid Office and demonstrated financial need.

Be interested in working with the geriatric population.

Essay required – explain interest in becoming a nurse and in providing nursing care to geriatric patients.

Complete scholarship application.

Maureen A. Mouso RN, '67 and Dr. Marcus L. Shoobe Nursing Scholarship

Be entering Nursing 2, 3, BH, 4 or 5

Be in good academic standing and exhibit academic excellence

Have a current 20-21 FAFSA on file in the Financial Aid Office and demonstrated financial need.

Not be eligible for Federal or State grants.

Complete scholarship application.

MVMA Scholarship (pending funding)

For students who intend to seek employment in the 9 county Mohawk Valley region after graduation

Be entering Nursing 5 in the Spring 2021 semester

Have a current 20/21 FAFSA on file in the Financial Aid Office and demonstrated financial need.

Be in good academic standing.

Complete scholarship application.

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