Foundation

Iowa Nurse Practitioner Society

Scholarship Application

Name         __________________________________________

Address     __________________________________________

Telephone  __________________________________________

Enclose Vitae with a minimum of the following information:

1.      Educational Background and degree(s)  

(Include a copy of your current RN license)

                Certifications (Include a copy)

                Publications

2.      Work Experience

                Current position

                Previous Health Care positions

3.      Professional organization (s) (Include offices held)

4.      Awards and/or Scholarships

5.      Submit a paragraph of 50 to 150 words how you perceive your future role as an advanced nurse practitioner. Include your intent toward professional commitment to INPS and your colleagues.

6.      Letter from faculty member advocating the student’s successful work in the program.

7.      Three references (Name, address, organization and the position held, and relationship to applicant)

PLEASE, postmark of application to be
no later than October 1, 2007

If you have questions please contact Charlotte Kelley, ARNP   515-277-7743 (home) or 515-277-3400 (work).  Email is foundation@iowanpsociety.org.

Mail application to:   

Charlotte Kelley,
ARNP Iowa Nurse Practitioner Society
Scholarship and Grant Fund
3943 Welker Avenue
Des Moines, IA  50312-3057