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Minot State University
Department of Nursing
Scholarship and Awards Application Form
Application Deadline:
February 1
stP
lease refer to Department of Nursing Handbook and MSU Undergraduate Catalog for detailed information and criteria about each of the scholarships for which you are applying.Submit this completed application to the Nursing Office, Memorial Hall 302.
1. Complete the Financial Aid scholarship application online by February 1st http://www.minotstateu.edu/finaid/scholarships.shtml
2. To qualify for as many scholarships as possible, complete the following:
Student Name
_________________________________
Semester in Nursing (in Spring) 1 2 3 4 5 or
Licensed as LPN_______ RN_______
Are you a resident of North Dakota? Yes________ No___________
What State and County are you from? __________________________________ Are you older than 24? Yes__________ No__________
Do you have financial need? Explain______________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________
Current GPA__________________________________________________________ Are you a member of NSA? Yes____________ No____________
Have you completed any community service? Explain_____________________ ________________________________________________________________ _________________________________________________________________ What area of nursing are you interested in or planning on going into?
Medical _________ Surgical _________ Pediatrics ________ Obstetrics ________ Psychiatric _______ ICU _________ ER __________ CRNA ________ Rehab________ Hospice _______ other/explain______________________________________________________ Where are you planning on working after you complete your nursing degree? Minot ___________ other (include place)_____________________
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Please mark box by scholarship for which you are applying. Answer questions and attach essay if applicable.
__________ BETSY NOKLEBY SCHOLARSHIP
1. Current S2 or S3, RN-BSN (circle one)
2. Full-time student _______ Part-time student _________
∗ Need not be a North Dakota resident
∗ Based on financial need and work output
∗ Second semester junior and senior students and faculty may submit names of nominees to be considered
by Student-Faculty Affairs Committee.
__________CHAIR’S AWARD: The Chair’s Scholarship from the Fabricius-Steinle Endowment
1. Do you display innovation, creativity, or leadership? 2. Can you communicate an idea or raise a question? 3. Have you implemented a project?
∗ Attach essay explaining 1, 2, and 3
∗ Students are recommended by the faculty. Selection is made by the Chair of the Department.
__________ ELIZABETH PROSS SCHOLARSHIP ENDOWMENT - Awarded to Female nursing student
1. Can you show evidence of community service during previous semester (a minimum of 10 hours)?
2. Can you show a dedication to the caring theory of nursing (explanation of how you have or how you plan to implement the theory in your career in the future to improve the quality of nursing)?
∗ Attach essay explaining 1 & 2
__________ EMMA MISNER SCHOLARSHIP ENDOWMENT
1. Are you a ND resident/graduate? Yes _____________ No ____________
2. Are you in your second nursing semester (junior year, 2nd half) Yes _________ No _________
∗ Attach one page essay on “What is the most important quality of a nurse and why?”
__________ EVELYN R. NIELSEN SCHOLARSHIP
1. Cumulative GPA __________ (must be 3.0 or higher)
2. Are you an officer or member of the Nursing Student Association- MSU? Yes _____ No ______ 3. Have you made an active contribution to and/or held a leadership position in the NSA, Department of
Nursing, nursing profession, or community service? Yes __________ No ________ If Yes, explain: ___________________________________________________________ ___________________________________________________________
__________ FRANCIS SVEE SCHOLARSHIP
1. Are you a ND resident? Yes ______ No______
2. Full-time student _______ Part-time student _________ 3. Current S2 or S3, RN-BSN (circle one)
∗ Students and faculty may submit names of eligible nominees in writing to SFA Committee that meet
psychosocial criteria:
o Caring
o Unconditional acceptance
o
__________ GRACE FISHER
1. Are you a full-time student? Yes __________ No _________
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__________ GUNNAR SOLBERG SCOLARSHIP
1. Are you eligible for junior or senior year? Yes _________ No ___________ 2. Are you a citizen or eligible non-citizen? Yes __________ No ___________ 3. Are you maintaining satisfactory progress? Yes __________ No ___________ 4. Are you a full-time student? Yes _________ No __________
__________ HALVOR AND ORMA NESHEIM SCHOLARSHIP
1. Are you a resident of Mountrail or Ward County? Yes ______ No _______ 2. Do you have a GPA of 3.0 or higher? Yes _________ No ____________
3. Are you planning to stay in ND following graduation? Yes _______ No ________
__________ HELEN CHATFIELD SHURR ENDOWMENT SCHOLARSHIP
1. Cumulative GPA ________________
2. Do you plan to be enrolled in 4 to 6 credits of nursing courses toward BSN degree? Yes ____ No _____ 3. Are you eligible to enroll in 400 level nursing courses at Minot State University?
Yes _________ No __________ (Current S3 or S4 or RN-BSN)
4. Have you completed at least 30 semester hours in nursing courses? Yes ______ No _______ 5. Are you a ND resident? Yes ________ No ________
∗ Preference is given to an RN or LPN pursuing a BSN degree
∗ Attach one page on “Describe your professional growth since your decision to obtain a BSN.”
__________ IRENE ELLA AND OTTO JOHNSON ENDOWMENT SCHOLARSHIP
1. Are you 24 years old or older? Yes __________ No __________ 2. Cumulative GPA ___________
3. Have you completed the first group of nursing courses that include a clinical "hands-on" nursing care component? Yes ______________ No ___________
∗ Recommendations will be made by Nursing Foundations faculty at the completion of each Foundations
course; the names are then submitted to Student-Faculty Affairs Committee.
∗ Nursing Foundations faculty will submit potential recipient names at the end of each spring and fall
Nursing Foundations course to ensure fair representation of all sophomore level students.
∗ Awards will be allotted to a student from each spring and fall semester group of Nursing Foundations
students (two monetary awards per year).
__________ JANICE SMITH NURSING SCHOLARSHIP ENDOWMENT
1. Are you a full time nursing student? Yes ______________ No ___________ __________ JIM AND KAREN JENSEN NURSING SCHOLARSHIP ENDOWMENT
1. Are you a full time nursing student? Yes ______________ No ____________
__________ JOAN LOVE CHRISTIANSON SCHOLARSHIP
1. Cumulative GPA ____________
∗ Must meet minimum requirements set by MSU Department of Nursing
2. Are you a full time student? Yes ______________ No _______________
__________ KEITH AND ELEMA CUNNINGHAM ENDOWMENT
1. Is there a financial need? Yes _____ No ______
∗ Awarded through Financial Aid Office
__________ LOIS BELLET WILLIAMS NURSING SCHOLARSHIP ENDOWMENT
1. Are you from Williams, McKenzie, Burke or Divide counties? Yes _______ No _______
∗ If no applicants are from the above mentioned counties the chair of the department will first consider
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__________ LORETTA F. HOLUB SCHOLARSHIP
∗ Award based on financial need.
__________ MALONEY SCHOLARSHIP:
∗ Awarded to ND residents on basis of financial need, academic excellence, character and citizenship.
__________ MARGARET BRUCE NURSING SCHOLARSHIP
1. Are you from one of the following counties: Divide, Williams, McKenzie, Burke, Mountrail, Renville, Ward, Bottineau, McHenry, Sheridan, Wells, Rolette, Pierce, and McLean? Yes _______ No _______
If yes, which county? ______________
∗ Student must demonstrate a financial need.
∗ Must demonstrate good character, citizenship and academic promise.
__________ MARK RONDE MEMORIAL SCHOLARSHIP
1. Are you an RN to BSN student? Yes _____ No _____ 2. Is your GPA at least 3.0? Yes ____ No _____
3. Is there financial need? Yes ____ No _____
∗ Students and faculty may submit names of nominees to be considered.
__________ MINOT MOOSE LODGE SCHOLARSHIP
∗ Based on financial need, academic performance, character, and citizenship.
__________ MSU DEPARTMENT OF NURSING ALUMNI SCHOLARSHIP
1. Have you received a formal letter of acceptance for admission by the Department of Nursing and begun the nursing major? Yes ___________ No __________
2. Attach 1 or 2 page essay about “Why you chose nursing as a career?”
∗ SFA will evaluate essays by selecting committee to review essays and make selections using established criteria.
o Clear articulation of personal factors that came to bear on your choice of nursing as a career
o Collegiate level communication abilities should be demonstrated in essay
o Rank essay based on these criteria and make recommendation
__________ NELS T AND OLINE BLIKRE SCHOLARSHIP
1. Are you from Mountrail County? Yes _____ No _____ 2. Do you demonstrate financial need? Yes ____ No ____
__________ PBC SCHOLARSHIP
∗ Students from the College of Business, College of Education and Human Services or the Department of
Nursing.
__________ PATRICK KELLY MUUS NURSING SCHOLARSHIP
1. Are you a full time student? Yes ___________ No _____________ 2. Are you a ND resident? Yes ______________ No ______________ 3. Are you planning a career as a CRNA? Yes _________ No ________
∗ Students and faculty may submit names of nominees to be considered to the Student Faculty Affairs
Committee, who will then make a recommendation to the Faculty Committee. __________ PATTY LOU PIETSCH TRZPUC MEMORIAL SCHOLARSHIP:
1. Are you a regularly enrolled, full-time, MSU Nursing student? Yes _____ No ______ 2. Cumulative GPA ________
∗ The Junior (Semester 2 or Semester 3) with the highest GPA at the time of selection will be awarded.
∗ Student-Faculty Affairs Committee will determine eligibility and bring names forward to Faculty
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__________ DR. RICHARD DORMONT NURSING SCHOLARSHIP ENDOWMENT
1. Do you have an interest in pediatrics? Yes ____________ No ____________ 2. Are you from NW ND? Yes _________ No ________
3. Attach essay covering the topic of history of involvement and achievement that benefits the community.
∗ Selection also based on: Financial need and Excellent scholastic record
__________ ROGER DROBASH NURSING EDUCATION SCHOLARSHIP
1. Are you a relative of a current or former member of either Trench Rat Dugout No. 436 or Disabled American Veterans Chapter No. 4? Yes _____ No ______
__________ RUBBELKE SCHOLARSHIP:
1. Are you a relative of Leona Rubbelke? Yes _____ No _____
∗ Preference will be given to any of Leona’s nieces, nephews, grandnieces, grandnephews, etc. who may apply for scholarship
__________ ST JOSEPH’S COMMUNITY FOUNDATION SCHOLARSHIP
∗ Apply through Department of Nursing
1. Are you from one of the following counties? Please circle
∗ Bottineau ∗ Burke ∗ McHenry ∗ McLean ∗ Mountrail ∗ Pierce ∗ Renville ∗ Rolette ∗ Sheridan ∗ Ward ∗ Wells
∗ Selection will be based on academic performance, financial need (not based on federal guidelines), financial circumstance, family status, and other factors determined by the department to affect the ability of a student to attain a nursing degree.
__________TRACY PETERSEN SNYDER ENDOWED SCHOLARSHIP
1. Are you a Junior or Senior in the nursing program? Yes ____ No ____
∗ Students and faculty may submit names for consideration to the SFA.
o Demonstrates excellence in scholarship.
o The scholarship is not to be given solely on the basis of need.
o Display attributes of being a dedicated, qualified student of professional nursing.
o Consideration may be given to attributes reflecting Tracy’s professional skill and interest
in the nursing care of children.
__________ William N. “Skip” Shirley Memorial Nursing Scholarship Endowment
1. Are you a ND High School graduate? Yes _________ No ___________ 2. Nursing major? Yes ____________ No __________
__________ YVONNE FALSTAD HOOVER
∗ Allocation is based solely on financial need.
6 **Other awards and scholarships available.
AMVET SAD SACKS OF ND: Application is scanned and emailed to all students in the Nursing Program.
NURSING STUDENT LOAN (NSL): Apply at Financial Aid Office.
ND NURSING SCHOLARSHIP LOAN PROGRAM: Apply to the ND Board of Nursing.
ND NURSES ASSOCIATION: Apply to NDNA.
TRINITY HEALTH EDUCATIONAL SCHOLARSHIP: Complete the appropriate application form provided by
Trinity Health Foundation. Contact the Foundation at 701-857-5432.
TRINITY ALUMNI SCHOLARSHIP: Offered through Trinity Alumni Association. Application due by
December 1st. Contact nursing faculty (Linda Schaefer or Linda Haider) or SFA.
