MEMORIAL HOSPITAL SCHOOL OF NURSING
ST. PETER'S HOSPITAL COLLEGE 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 Fleischer Scholarship
o MVMA (pending funding)
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 St. Peter's Hospital College 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 Coordinator: _____________________________ 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 Coordinator: _______________________________ Date: __________________
Committee Review Date:______________ Decision:______
Scholarship Criteria Listing For Spring Semester of 2021
December 18, 2020 Deadline
Craig Duncan Scholarship
Completed Nursing 1 - entering Nursing 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 (Samaritan, St. Peter's Hospital, the Eddy's)
Have a current 20/21 FAFSA on file in the Financial Aid Office and demonstrated financial need.
Completed scholarship application.
Fleischer
Completed Nursing 1 and 2 – entering Nursing IV in the Spring 2021 semester
Be active in AMSNA – please specify in writing (separate sheet or on the application)
OR active in outside community service (requires letter of recommendation).
Be in good academic standing.
Have a current 20/21 FAFSA on file in the Financial Aid Office.
Completed 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.
Completed scholarship application.
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