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Reach for the Stars Nursing Scholarship Program
To be considered, your application must be received before 5 p.m. on Sunday, October 1, 2023.
Employee Name:
(Required)
First Name:
Last Name:
Employee ID:
(Required)
Personal Phone #:
(Required)
Personal Email:
(Required)
Work Email:
(Required)
Work Phone #:
(Required)
Employee Hire Date:
(Required)
MM slash DD slash YYYY
Employment Status:
(Required)
Full-time
Part-time
PRN
Current Performance Rating:
(Required)
Have you completed all pre-requisites for nursing school? If not, are you in the last semester of your pre-requisites?
(Required)
Yes, I have completed all pre-requisites.
No, I have not completed all pre-requisites; I am not in the last semester of pre-requisites.
No, I have not completed all pre-requisites; I am in the last semester of pre-requisites.
Current GPA:
(Required)
Name of the Nursing School at which you are enrolled in or have been accepted to:
(Required)
Expected Graduation Date:
(Required)
MM slash DD slash YYYY
Do you qualify for in-state tuition rates?
(Required)
Yes
No
Current Unit/Department:
(Required)
Current Manager:
(Required)
Grady Manager/Supervisor Name:
(Required)
Grady Manager/Supervisor Email:
(Required)
Professional Reference Name:
(Required)
Professional Reference Email:
(Required)
Personal/Professional Reference Name:
(Required)
Personal/Professional Reference Email:
(Required)
Personal Statement:
(Required)
Directions: Please provide a personal statement on why you should be chosen for this scholarship program. Your statement is limited to 500 words.
Official College Transcripts/Nursing School Admittance Letter (if applicable):
Drop files here or
Select files
Max. file size: 50 MB, Max. files: 2.
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