Omicron Delta Past President's Scholarship
Professional Development Application
PURPOSE
The purpose of this scholarship is to recognize Omicron Delta members who
attend or present
at a professional nursing conference. Applications may be submitted at any time
after the event.
Notification of acceptance will be in writing to the applicant within two weeks of the decision. Requests for professional development that meet the criteria will be based on discussion of the committee members who will come to a consensus. Amount requested not to exceed $1000.
TIMELINE FOR APPLICATION
Applications may be submitted any time during our fiscal year (July 1 to June 30). Once all funds have been distributed, the scholarship process is closed until the next July 1.
ELIGIBILITY CRITERIA
1. Omicron Delta member in good standing required.
2. Sigma Theta Tau International and Omicron Delta Conference support are given priority.
3. Other nursing, education or evidence based conferences are considered at the discretion of the Committee
4. Additional scholarly activities that constitute professional development will be considered
APPLICATION INSTRUCTIONS
Please complete all parts of the application form. All information included in the application will remain confidential. All required components must be completed in order to submit application. Only complete online applications will be accepted.
Please upload your documents of support below as PDF documents.
If for some reason you are not able to upload email chapter@omicrondelta.net for assistance.
Please do not apply until event is complete and receipts can be uploaded.
Only applications with completed events will be forwarded to the Scholarship Committee for consideration.
APPLICANT INFORMATION
The applicant must be a member of Omicron Delta in good standing to be eligible.
Name
Credentials
Home Address
Email
RN License Number and State:
Home Phone
Work Phone
Are you a member of Omicron Delta?
Yes
No
Sigma membership number
CONFERENCE INFORMATION
Sigma Theta Tau International and Omicron Delta Conference support are given priority.
Other nursing, education or evidence based conferences are considered at the discretion of the Committee.
Additional scholarly activities that constitute professional development will be considered.
Please upload any documents of support requested below as
PDF documents
.
There are many programs to convert documents to
PDF
online for free.
Name of Conference
Objectives of Conference
Location of Conference
Date of Conference
MM
/
DD
/
YYYY
Personal and/or professional reason for attending
Outcomes expected and how this funding will support this effort
CONFERENCE ACCEPTANCE LETTER
Please upload a copy of the acceptance letter to present/attend conference, as applicable.
Please upload your documents below in PDF format.
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Please provide the conference web site address, and/or brochure so we may verify the conference objectives and program information. Application will not be considered without this information.
Conference Website Address
CONFERENCE BROCHURE
Please upload a copy of the conference brochure, if available.
Please upload your documents below in PDF format.
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ASSESSMENT DOCUMENTS
Please upload your documents of support below as PDF documents.
If for some reason you are not able to upload email chapter@omicrondelta.net for assistance.
STATEMENT OF NEED
Amount of funding requested
USD
Specific need for funding
How funding was used
Scholarship will not be considered unless receipts are uploaded
as
PDF documents
.
Proof of funding use
Please attach the receipts showing how funding was used.
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STATEMENT OF VALUE
Please provide statement of value of event for the OD newsletter.
(How was this helpful to your efforts and the practice of nursing)
CURRICULUM VITAE or RESUME
Please attach your most current CV or resume to the application that includes:
.....Educational background
.....Professional experience
.....Professional development activities
.....Community service
.....Honors and awards
.....Publications, papers, and/or presentations
.....Other items that demonstrate professional accomplishments
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SCHOLARSHIP AGREEMENT
I agree that the all information sent with this application is accurate and has not been altered.
Signature
Clear
Date
APPLICATION SUBMISSION:
Click SUBMIT form button below.
Applicants must demonstrate eligible criteria by completing the scholarship application. If an applicant demonstrates eligibility criteria for more than one scholarship and/or wishes to be considered in more than one category, a separate completed application including a description of funding criteria specific to each scholarship must be submitted.
NOTIFICATION OF SCHOLARSHIP AWARDS
As applications are received, they are reviewed by the Scholarship Committee. Applicants will be notified by the Scholarship Committee of their decision.
Please Note:
Submission of application does not guarantee scholarship will be awarded. Applicants may only submit one Academic Scholarship application per fiscal year (July 1 - June 30). All scholarships are awarded based on the Omicron Delta Chapter Policy and Procedures.
THANK YOU FOR YOUR APPLICATION
We look forward to reviewing your information.
The Scholarship Committee, Omicron Delta Chapter of Sigma
SUBMIT FORM
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