How to Complete Your Application

1. Vocational Nurse Scholarship (VN)Licensed Vocational Nurse to Associate Degree Nursing Scholarship (LVN-ADN)Programs How to Complete Your Application

2. Application Process • Scholarship Eligibility • Service Obligation • Selection Criteria • Application Overview • Application Instruction • Completing the Application • Where to Send the Application • Contact Information

3. Scholarship Eligibility • Be enrolled or accepted into a vocational nurse or registered nurse program. • Be a full-time or part-time student in a California accredited school approved by the Board of Vocational Nurse or Registered Nurse. • Maintain a minimum cumulative GPA of 2.0 each year funds are received. • Must have a valid legal presence and ability to work and direct patient care must be provided in the state of California.

4. Selection Criteria • Award are made on a competitive basis. Selection for the VN and LVN to ADN programs are based solely on information contained in the application and supporting documentation. Selection for awards is based on the following criteria: • Work Experience • Financial Need • Career Goals • Community Service • Community Background • Academic Performance • Priority will be given to applicants whose community background and commitment indicates the likelihood of long-term employment in a medically underserved area (MUA) even after the service obligation ends.

5. Service Obligation • “Service Obligation” means the contractual obligation agreed to by the recipient of a scholarship where the recipient agrees to practice their profession for a specified period of time in or through a designated facility. • Recipients will be required to complete a 2-year service obligation to practice in a MUA of California as a LVN/RN providing direct patient care full-time or a minimum of 32 hours per week or its equivalent. • The start date for the service obligation will begin after you are awarded and will be identified in the contract. • Prior employment (prior to award) in a qualified facility can not be used to meet the service obligation. • To find out if your employer is in a MUA, visit the website at http://datawarehouse.hrsa.gov/GeoAdvisor/ShortageDesignationAdvisor.aspx

6. Application Overview • Application • Official Transcript(s) • Personal Statement • Two Professional Letters of Recommendation • Graduate Date Verification Form • Work History HRSA printout regarding your practice location • Current year Student Aid Report (SAR) or Signed prior year’s Federal Tax Return and all W-2’s • Copy of Cost of Attendance/Tuition

7. Application Instructions Read all instruction pages carefully before you fill out your application. This will help to answer most of your questions and explain the following: Award Amount Service Obligation (Medically Underserved Areas) Selection Criteria Eligibility Required Documentation Application Submission Notification of Awards

8. Application Page 1 • Top of Page • Check which program you are applying for (VN scholarship, or LVN to ADN Scholarship) • Enter the award amount you are requesting (you can not request more than what you owe in educational debt) • Part A - Personal Information: • Fill out all of your personal information and do not leave any line blank. Note: You must have valid legal presence and ability to work and direct patient care must be patient in the state of California

9. Application Page 2 Part B - Work Experience Indicate whether you’re currently employed as an LVN or not. If yes, provide the license number and expiration date. Part C - Community and Language Background 1. List any languages in which you are fluent and this must be verified by your program director on the Graduation Completion Form. 2. Indicate whether you have lived in an economically disadvantaged background for at least two (2) years. If yes, check the appropriate range of yearsand describe in your personal statement. Note: Disadvantaged Background –income below the federal poverty level, low income, subsidized income, qualified for public programs, lived in rural, inner city or medically underserved areas.

10. Application Page 2 Part D - Personal Statement Answer all questions numbered 1-7. Your statement questions must be typed. Restate and number each question along with a comprehensive response to each question. Your personal statement should be no more than 2 pages. For a template of personal statement questions, please visit our website at www.healthprofessions.ca.gov.

11. Personal Statement • When writing your personal statement, consider these recommendations: • Work Experience – nursing and non-nursing work experience in a medically underserved area (MUA) • Financial Need – actual or potential difficulty in completing your education/employment in the absence of an award. • Career Goals –as they relate to your chosen health profession. • Unpaid Experience-community outreach, volunteer service, and organizational memberships you have been involved with. • Community Background – your life experiences, family structure, socio-economic background and community where you grew up. • Academic Performance – prior and current academic performance. Note: Elaborate and provide as much information as you can. Personal statements that lack detail may be considered incomplete and therefore, ineligible.

12. Application Page 3 Part E – Questionnaire Indicate whether you are a previous awardee of the Foundation. Indicate whether you owe a service obligation to another entity. If you owe an existing service obligation to another entity, you are ineligible to apply until you have completed your existing obligation. Indicate where you heard about our programs. Check all that apply. Part F - LVN to ADN Applicant (only LVN to ADN applicants) Check the box “yes” if you would like your application to be reviewed by the ADN selection committee. If you are not awarded by the ADN program, your application will be automatically considered eligible for the LVN to ADN program. Note: If you select “no”, you will be ineligible for the LVN to ADN program until the next cycle.

13. ADN Application • Scholarships are available to students who are enrolled or accepted in an ADN program. • Students may receive up to $10,000 for the ADN program per academic year. • In exchange for the award, recipients are required to complete a two-year service obligation to practice in a MUA of California as a Registered Nurse providing a minimum of 32 hours a week or its equivalent of direct patient care.

14. Application Page 3 & 4 • Part G-Reference • List names, relationship, address and telephone number of three (3) persons not living with you. • Part H-Information Release • By signing the application you authorized the Foundation to verify your education and employment status. • Part I-Application Certification • By signing the application you certify that all the information in this application is true and accurate.

15. Application Pages 5 & 6 • Work History • List all of your work experience. Please list your most recent employer first. Attached a HRSA printout regarding your practice location by visit the website at http://datawarehouse.hrsa.gov/GeoAdvisor/ShortageDesignationAdvisor.aspx • Program Completion Verification Form • This form must be completed by the Program Director of the school or His/Her Designee. Note: This form must be returned to the Foundation with an original signature

16. Application Checklist • The checklist must be attached to the front of the application • Use this checklist to ensure that all required documentation is included prior to mailing your application packet Scholarship Checklist: 1. Completed Application (must be signed) 2. Official Transcript(s) 3. Personal Statement (restate and number each question) 4. Two (2) Professional Letters of Recommendation (signed & dated with 6 months) 5. Program Completion Verification Form (must be signed) 6. Work History HRSA printout regarding your practice location 7. Current year Student Aid Report or signed prior year’s Federal Tax Return & all W-2s 8. Copy of the cost of attendance/tuition for VN/RN program 9. Proof of current and active California LVN license and be in good standing with the the BVNPT (only LVN to ADN applicants)

17. Incomplete/Ineligible Applications • Frequent reasons why applications are incomplete/ineligible: • Application postmark is passed the deadline • Missing signatures on one or more documents: • Application • Graduation date verification form • Letters of recommendation • Employment verification form • Federal Tax Return • Missing one or more supporting documents: • Graduation date verification form • Official transcripts • Letters of recommendation • Financial Aid documentation (SAR) • Federal Tax Return and/or W-2s • Personal Statements • Employment verification form

18. Application Submission and Notification of Awards • Applications must be postmarked by the deadline. The Foundation will not notify applicants if their application is received incomplete. Applicants are urged to contact the Foundation at (800) 773-1669 prior to the final filing date to verify if their application was received complete. • The Foundation will notify applicants of their application results within 120 days of the postmark deadline.

19. Technical Assistance • The Foundation will convene a technical assistance call to discuss the application process for this program. The technical assistance call will be on August 19 from 12:00 p.m. – 1:00 p.m. Please contact the Foundation to obtain the phone number and pass code if you would like to participate in this call. • Please also visit the Frequently Asked Questions (FAQ’s) section of our website in order to find out more information about this program as well as the other programs offered by the Foundation.

20. Cycle Deadline Fall Postmark: September 11 Submit current year applications to: Health Professions Education Foundation ATTN:VN Scholarship & LVN to ADN Scholarship 400 R Street, Suite 460 Sacramento, CA 95811

21. Contact Information If you have questions regarding how to complete any required documents or you have questions in general, please feel free to contact the Foundation staff: Program Officer: Stephanie Tran Phone: (916) 326 - 3646 (Direct) (916) 326 - 3640 (Main) (800) 773 -1669 Email: hpef-email@oshpd.ca.gov www.healthprofessions.ca.gov