2025 Scholarship Sponsor Commitment Form

2025 Scholarship Sponsorship Commitment Form
Sponsor Organization*
(As you wish it to appear in publicity materials)
Contact Name*

First NameLast Name
Title *
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2025 Scholarship Program - Yes, we will participate!
(Minimum scholarship amount is $2,500 with an additional 15% administration fee)
Scholarship Name (As you wish it to appear in publicity materials)*
Number of scholarships to be awarded *
Scholarship Amount*
Administration Fee*
Total Scholarship Sponsorship *
Scholarship sponsors have the opportunity to establish specified selection criteria. These criteria's are used to select the award recipient.
Please select the type of degree:*

Associate Degree in Nursing (ADN)Bachelor Degree in Nursing (BSN)Accelerated BSN (12-18 Month Program)Diploma in Nursing (hospital-based nursing program)Direct-Entry Master’s DegreeLPN/LVN – RN DegreeRN - BSN DegreeRN - MSN DegreeAll of the Above
Minimum GPA requirement (if any): (Note: a 2.7 GPA is required by most schools of nursing to remain in the program)
Under-Represented Population Criteria:*

Ethnic Minority StudentsMen In NursingOpen to all nursing studentsOther
Nursing Specialties - Please select:*

No PreferenceAmbulatory CareAnesthesiologyCommunity NursingCritical CareDermatologyEmergencyFlight NursingForensicGerontologicalHolisticHospice/ PalliativeInformaticsLabor and DeliveryMedical-SurgicalNeonatal ICUNephrologyNeuroscienceNurse EducatorNurse MidwifeObstetricsOncologyOrthopedicPediatricPerioperativePsychiatricRespiratorySchool NursingTraumaWomen's HealthOther
Signature*

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Website URL
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We're Planning ahead - Won't you?

Please indicate below your continued support in the 2026 Scholarship Program!
Yes, we will continue our support in the 2026 Scholarship Program.
Thank you for supporting our future RN's!
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2025 Scholarship Sponsorship Commitment Form

2025 Scholarship Program - Yes, we will participate!

(Minimum scholarship amount is $2,500 with an additional 15% administration fee)

Scholarship sponsors have the opportunity to establish specified selection criteria. These criteria's are used to select the award recipient.

We're Planning ahead - Won't you?

Thank you for supporting our future RN's!