NER-WOCN Scholarship Application

NER WOCN Scholarship Application

(WOCNEP Students)
Please submit the completed application and necessary documents.
One submission per person, per year.

If you have any questions, please direct them to the Membership Committee Contact Person Vashti Livingston (vashtiner@aol.com) .

The Application Submission Deadline is AUGUST 1, 2018.
Incomplete applications will not be accepted.

Scholarship Awards are announced at the NER WOCN® Region Fall Conference. Awardees not present will receive their scholarship via mail after the conference.
Name *

First Name Last Name
Credentials *
Home Address: *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number/Mobile
Phone Number/Work
E-mail *
Are you a member of the WOCN national organization? *

Yes No
IF you are a member of the WOCN, please provide your membership #:
How long have you been a member of the WOCN Society?
Your WOCNEP Program? *

Cleveland Clinic Rutgers San Jose State UW WMEP Web WOC Emory
What is your status? *

Accepted to this WOCNEP/not yet matriculating Currently attending this WOCNEP Graduated
Dates of expected/current/completed attendance:
Start Date *

Month Day Year
Date
End Date

Month Day Year
Date
Content Focus (click all that apply) *

Wound Ostomy Continence Foot Care
Please attach the following documents to your application:

A. 2 Letters of Recommendation

B. Letter of WOCNEP Acceptance or current enrollment, OR proof of Graduation from a WOCN-accredited WOCNEP program within the last 6-12 months

C. Your Personal Statement of 100 -150 words describing your interest in the WOCN discipline.
A. 2 Letters of Recommendation *

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B. Letter of WOCNEP Acceptance/Graduation *

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C. Personal Statement *

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I hereby certify that the information on the application and additional documents are true and accurate. *
Type, "I agree" in the box above
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NER WOCN Scholarship Application