TXENA 2021 Graduate Scholarship Application

Application submission deadline is June 1, 2021.

Please make sure you meet all of the eligibility and application requirements before completing this application.

This application must be completed in a single session as your progress will not be saved on this web page to be completed at a later time. Before submitting this application, review it to ensure that you have completed all necessary fields and uploaded all required documents.

Type of Scholarship (required)

If MS in health related field is selected, enter that here:

Applicant Information

Applicant Name (required)

Applicant Street Address (required)

Applicant City (required)

Applicant State (required)

Applicant ZIP Code (required)

Applicant Email (required)

Applicant Mobile Phone (required)

Applicant Work Phone

Licenses, Memberships and Credentials

Current Professional Credentials (required)

Nursing License Number / State (required)

Upload copy of nursing license (required)(2MB file size limit)

ENA Membership Number (required)

Month and Year you Became ENA Member (required)

BCEN Certifications (Check all that apply)
CENCPENCTRNCFRNTCRNNone
Upload a single file that contains copies of all of your certifications (2MB file size limit)

Educational Institution Information

Educational Institution Currently Enrolled (required)

Degree Pursing (required)

Degree Pursing Start Date (required)

Expected Completion Date (required)

Degree Status (required)
Full timePart time
Number of Credit Hours Enrolled/Accepted (required)

Scanned transcripts from other institutions are accepted electronically as part of the application. Official transcripts required upon completion of course(s) and must include the university seal.
Upload a copy of your current institution's transcripts / proof of enrollment. (required)(2MB file size limit)

If you are in the first semester of a program and do not have current grades, submit transcripts from previous degree(s).
Upload a copy of your previous institutions transcripts (2MB file size limit)

Upload a copy of your next previous institutions transcripts (2MB file size limit)

If you are a Doctorial PhD or EdH Applicant, did you Complete your Course Work?

Did you Advance to Candidacy?

If Yes, when?

Upload a copy of your institutions accreditation (2MB file size limit)

If you are a DNP Applicant, select your Institutional Accreditation

Upload a copy of your institutions accreditation (2MB file size limit)

Education and Experience
Attaching a curriculum vitae or resume is not acceptable. All dates must be included.

Name of Most Recent Education Institution (required)

City of Most Recent Education Institution (required)

State of Most Recent Education Institution (required)

Degree from Most Recent Education Institution (required)

Major from Most Recent Education Institution (required)

Graduation Date for Most Recent Education Institution (required)

Name of Next Most Recent Education Institution (required)

City of Next Most Recent Education Institution (required)

State of Next Most Recent Education Institution (required)

Degree from Next Most Recent Education Institution (required)

Major from Next Most Recent Education Institution (required)

Graduation Date for Next Most Recent Education Institution (required)

Professional/Employment Experience (Past 5 Years)

Current Employer (required)

Current Employer Dates (required)

Title with Current Employer (required)

Current Employer City (required)

Current Employer State (required)

Previous Employer

Previous Employer Dates

Title with Previous Employer

Previous Employer City

Previous Employer State

Honors and Achievements

Year

Agency

Honor/Achievement

Professional Activities
ENA and other professional organizations, community activities, presentations for the past 10 years only

Year

Agency

Honor/Achievement

Statement of Professional / Education Goals

Explain your professional emergency nursing and educational goals and how this scholarship will help you obtain them. (Note: Limit of 500 words and points will be deducted for exceeding this limit.)

For Doctoral Applicants
Explain how this doctoral scholarship will further the practice of emergency nursing. (Note: Limit of 500 words and points will be deducted for exceeding this limit.)

References
Two reference letters are required for all applicants. It is highly recommended that one of the two letters come from either your ENA National State Council or Local Chapter officers to validate ENA participation. Points will be deducted if one of the letters is not from an ENA National, State or Local Chapter Officer.
Upload a copy of your first letter of reference (required) (2MB file size limit)

Upload a copy of your second letter of reference (required) (2MB file size limit)

Applicant Attestation
By checking the box below, I attest that I have reviewed this application for a TXENA Scholarship and to the best of my knowledge, the information enclosed is accurate. I also attest that my name below indicates my electronic signature. I understand the decision as to whether this application qualifies me for approved funding rests solely and exclusively with the TXENA Scholarship Committee and the decision is final.

I agree
Applicant Name (required)

Date (required)

Upload a copy of your W9. (required) (2MB file size limit)Download Form W9

2021 Graduate Scholarship Application

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