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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