FCNI Student Scholarship Application Form
Complete the items below and attach required documents
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Applicant Information
Name:
 Membership Number:
 Email:
 Phone:
School of Nursing (name and location)
Academic Program Level
Clear selection
Year of Study
Current Employment Status
Clear selection

Work History   

Employer/Organization                              

Role/Title

Dates of Employment

Key contributions or leadership activities

Professional Affiliation(s)  
Organizational affiliation and/or membership (including volunteer work)
Faith Affiliation

Please identify your:

Faith tradition

Denomination (if applicable)

Financial Need & Rationale for Scholarship
Please describe your need for a scholarship and complete the sections below.  
Income Sources
List all current income sources (employment, retirement, disability, scholarships, grants, loans, tuition discounts, financial awards, etc.).  
Family Composition
Describe your household and family responsibilities.  

Please include:

Family members you are supporting

Relationship to you

Living situation (living with you, living elsewhere, traveling to provide care, etc.)

Hardships (if applicable)

Please indicate and describe any hardships you are experiencing:

Caregiver responsibilities

Personal illness or disability

Family obligations

Other relevant circumstances

Additional Information
Please include any other information that would help the committee understand your financial need.  
Personal Statement (Essay)

Copy and Paste 400 Word Count Maximum (from MS Word:12 point Arial, Calibri, or comparable font) 

Please respond to the following in essay format:

What goals do you have for your practice?

Students: Describe your career goals.

What would this scholarship mean to you and your practice/career?

Letters of Recommendation: Submit 2 letters of recommendation via email

Please list here the individuals submitting a letter of recommendation. 

Include:

Name, position, email, phone number

Relationship to you

Organization / Role


Letters of Recommendation Email instructions:

Submit 2 letters of recommendation and a statement that you have completed the online application to contact@fcninternational.org 

Please list individuals submitting a letter of recommendation in the body of the email. Include one letter of recommendation from a supervisor, colleague, mentor, pastor, etc., and one letter of recommendation from a current or previous faculty.

I certify that the information provided is true and complete to the best of my knowledge.
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