Nursing Degree Completion Scholarship

Genesis Health Services Foundation

Nursing Degree Completion Scholarship Application

Genesis Health System Employees Only


Click here to read the Eligibility Requirements and Terms of Scholarship.

 

 

Name:* 
Employee Number: * 
Birth Date:* (i.e. 08/20/1986)
Address: *

City/State/Zip:* 

 , ,
Day Phone:*
Evening Phone:*
Entity:*
Department/Unit:*
Job Title:*
Manager or Supervisor's Name:*
FTE Status: *
Years of Service:*
Email Address: *
Education Level: * ADN   Diploma   Non-nursing Degree   BSN
I am accepted into the following program: *    
       BSN Completion Program   Master's Degree Program
What college/university are you attending to attain your BSN or MSN?*
     College Address: *
     City/State/Zip: *
Genesis Committee Memberships: (List most recent)
     Name of Committee:
     Dates of Service:
     Committee Chair? Yes     No
     Name of Committee:
     Dates of Service:
     Committee Chair? Yes     No
     Name of Committee:
     Dates of Service:
     Committee Chair? Yes     No
     Name of Committee:
     Dates of Service:
     Committee Chair? Yes     No
Professional Organizations: (List most recent)
     Name of Organization:
     Member since (date):
     Officer? Yes     No
     Name of Organization:
     Member since (date):
     Officer? Yes     No
     Name of Organization:
     Member since (date):
     Officer? Yes     No
Genesis Department Preceptor?  Yes    No
Special Genesis Projects: (List most recent)
     Project Name
     Date
     Presenter or Poster? Presenter     Poster
     Project Name
     Date
     Presenter or Poster? Presenter     Poster
     Project Name
     Date
     Presenter or Poster? Presenter     Poster
Community Involvement (List most recent)
     Event Name
     Date
     Leadership Role? Yes     No
     Event Name
     Date
     Leadership Role? Yes     No
     Event Name
     Date
     Leadership Role? Yes     No
Certification
     Name of Certification
     Date Attained
     Name of Certification
     Date Attained
     Name of Certification
     Date Attained
     Actively Pursuing Certification
Essay
Please write a 500 - 600 word essay on how attaining a BSN or MSN degree will promote Magnet Force #6, Quality of Care, as it relates to patient safety, ethical practice and research, and evidence-based practice and e-mail it to: scholarships@genesishealth.com
Virginia L. Pilcher, RN Scholarship - GMC- Davenport Nurses ONLY
Overview & Criteria
Yes, I would like to apply for the Virginia L. Pilcher, RN Scholarship
If you would like to apply for the Virginia L. Pilcher, RN Scholarship, please fill in the information below, and e-mail a 500-600 word essay on how attaining a BSN or MSN will promote Magnet Force #7 Quality Improvement as it relates to patient care within our organization in terms of new knowledge, innovations and improvements. You will also need a letter of recommendation from your immediate supervisor. Please send them both to scholarships@genesishealth.com.

Class Information
Class Title:
Class Dates:
Number of Credit Hours:
Cost:
Class Title:
Class Dates:
Number of Credit Hours:
Cost:

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1227 E. Rusholme Street Davenport, IA 52803 563-421-1000