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  1. 1. ONS FOUNDATION DOCTORAL SCHOLARSHIP APPLICATION INSTRUCTIONS   2010 PURPOSE: To provide scholarships to registered nurses who are interested in and committed to oncology nursing to continue their education by pursuing a doctoral degree. AWARD: Doctoral scholarships awarded at $3,000 and $5,000 annually. SPONSORSHIP: ONS Foundation Roberta Scofield Doctoral Scholarship ONS Foundation Ann Olsen Doctoral Scholarship supported by Pfizer QUALIFICATIONS: 1. The candidate must be currently enrolled in (or applying to) a doctoral nursing degree or related program and enrolled in the 2010- 2011 academic year. 2. The candidate must have a current license to practice as a registered nurse and must have an interest in and commitment to oncology nursing. 3. Candidates entering a doctoral program without a master’s degree must have completed the first two years of the doctoral program curriculum to be eligible. 4. At the end of each year of scholarship participation, the nurse shall submit a summary describing the education activities in which he/she participated. a. NOTE: An individual cannot receive this award more than one time. REQUIREMENTS: 1. All responses must be typed and confined to the space provided on Part A of the application form. Do not attach your curriculum vitae. 2. Part B is to be completed by the School of Nursing. 3. Two professional letters of support are required. One of these letters must address the applicant's ability to perform doctoral level work. ONS Foundation 08/09
  2. 2. APPLICATION PACKET CHECKLIST: Packet must be typed . No faxed materials will be accepted . Remove instructions pages from the application, please do not include with the application Submit original and 5 copies of the application Assemble the original packet in the following order: • Application – Part A • Part B (School of Nursing) - School of nursing form may be handwritten • Transcripts (submit one copy of the transcripts from each nursing degree earned and current doctoral program transcript. Fall transcripts should be forwarded as soon as available). Transcripts may be copies, original/sealed transcripts are not necessary. • Include a maximum of two (2) support letters (extra’s will be discarded). Assemble the copies (5) in the following order: • Application – Part A • Part B (School of Nursing form) – School of nursing form may be handwritten • Support letters (maximum of two (2) support letters) • Do not include transcripts in the copies Submit $5 application fee made payable to ONS Foundation Failure to follo w these guidelines will result in disqualification of the application. DEADLINE DATE: Application packet must be received by the ONS Foundation, regardless of postmark or other circumstances , by February 1, 2010. If you have any questions, please contact the ONS Foundation 1-866-257-4667 choose option #4 from the menu for the Foundation or email foundation@ons.org MAIL TO: ONS Foundation 125 Enterprise Drive Pittsburgh, PA 15275- 1214 ONS Foundation 08/09
  3. 3. ONS Foundation 08/09
  4. 4. PART A Oncology Nursing Society FOUNDATION DOCTORAL SCHOLARSHIP APPLICATION 2010 Please read the attached instructions before completing this application. General Infor ma t io n: Full Name:       Credentials:       Present Address:       (Street/Apt.Number/P.O. Box Number)       (City, State, Zip) Home Phone: (   )       Work Phone: (   )       E-mail address:       Do you practice nursing in a rural urban setting? R.N. License Number:       State:    Expiration Date:             State:    Expiration Date:       OCN® Certification: AOCN® Certification: 1. Doctoral student status: (Choose one) I am currently enrolled in a PhD or DNSc program I am currently enrolled in a DNP program (Choose one) I currently possess a master’s degree in nursing I do not currently possess a master’s degree in nursing and have completed the first two years of the doctoral program curriculum Name of Program:       Percentage of the program completed:       Anticipated date of graduation:       (If graduation is prior to September 1, 2010, you are not eligible for this award) ONS Foundation 08/09
  5. 5. 2. Will you attend full time or part time in the 2010- 2011 school year? If you are not enrolled during this time period explain why.       3. What degree in nursing will you receive?       4. If you are awarded a scholarship, do you agree to participate in long-term evaluations? Yes No Biographical Infor ma tio n 1. Professional Education : Begin with basic nursing education. Instit u t io n Location Degree/Diplo ma Date of Completion                                                                                                                                                                                                                                                                                                                                                                                                                                                                         ONS Foundation 08/09
  6. 6. 2. Professional Nursing Experience: List most recent position last. Dates Position Patient Population (if specifically cancer care, please indicate) Institu t io n Location                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               3. In 250 words or less, describe your role in caring for persons with cancer.       ONS Foundation 08/09
  7. 7. 4. Membership in Professional Organizations: Dates of Membership/Participa ti on Organization Office Held/Com mi t t ee Membership                                                                                                                                                                                                                                                                                                                   5. Volunteer Community Activities Related to Cancer Care: (e.g., American Cancer Society) Dates of Participatio n Organization Description of Participation                                                                                                                                                                                                                                                                                                                   ONS Foundation 08/09
  8. 8. PART A 6. Professional Contributions: List the most significant in the space provided. If none, please write None in the space provided.       Presentations: (Name of Presentation, Date, Target Audience, Location and Number of Hours)       Publications: (Site full reference of any in health related journals/texts, newsletters)       ONS Foundation 08/09
  9. 9. PART A Professional Contributions: (continued) Other publications: (Standards, Guidelines, Teaching Tools and Booklets)       Research: (Date, Title, Specific Involvement, i.e., Principal Investigator, Data Collector)       Honors/Awards: In the space provided, list the most significant honors/awards received in the last five years.        ONS Foundation 08/09
  10. 10. PART A 7. Your role in the Advancement of Oncology Nursing PhD and DNSc Progra m : Describe your research area of interest and your plans for dissertation. Describe how your plans relate to the advancement of oncology nursing and how this program will assist you in achieving your plans.       DNP Progra m: Describe your professional goals, how your goals relate to the advancement of oncology nursing how this program will assist you in achieving stated goals.       ONS Foundation 08/09
  11. 11. PART B ONS FOUNDATION DOCTORAL SCHOLARSHIP APPLICATION To be completed by the School of Nursing. Nurse candidate should provide the follo win g infor ma t io n: Name of Student:       Address:       (Street/Apt.Number/P.O. Box Number)       (City, State, Zip) TO BE COMPLETED AT THE SCHOOL OF NURSING The above student has submitted an application to the ONS Foundation for a doctoral scholarship. 1. Name of School of Nursing:       School telephone number:       2. The student: is currently enrolled as of       has been accepted for admission as of       is an applicant for admission effective       3. This school is NLN or CCNE accredited? NO YES 4. If currently enrolled, how much of the program has the student completed?       Graduate grade point average:       5. If the student is an applicant for your doctoral program, when will acceptance be determined?       6. Who should be contacted to verify admission to doctoral program? Name:       Title:       E-mail:       7. If applicable, name of the faculty member who is responsible for the oncology component of the doctoral program.       8. Name of the Dean of the School of Nursing:       I verify the above information is correct Name (print)       Title       Signature Date       ONS Foundation 08/09