AgriSafe Nurse Scholar Program - Farm Credit Missouri Scholarship Application 2022

Thank you for your interest in the AgriSafe Nurse Scholar program. Nurses working in Missouri that work in rural health clinics, government agencies, academia or non-profit organizations are eligible for this scholarship. Farm Credit covers the full amount for the course. You will need to pay a $100 deposit, which will be refunded upon completion of the course. Applications will be reviewed on a rolling basis and applicants will receive a response within 5 business days from when the application was received.

Applicants granted a scholarship will receive a coupon code to use on registration, so please do not register for the course until you have received your coupon code.

In order to receive CNEs for this course, you must complete all course content before the March 15, 2023 deadline.

These scholarships are made possible by FCS Financial and Farm Credit Services of Southeast Missouri.

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Email

Question Title

* 4. Mailing Address

Address

City

State

Zip Code

Question Title

* 5. Level of Education:

Question Title

* 6. Type of Nursing Practice:

Question Title

* 7. County of Residence

Question Title

* 8. Phone number

Work Phone

Mobile Phone

Question Title

* 9. State of Nursing Licensure

Question Title

* 10. Job Title

Question Title

* 11. Current Employer

Question Title

* 12. Are you an immediate family member of an employee at Farm Credit?

Yes

Question Title

* 13. Briefly describe your current work in rural healthcare:

Question Title

* 14. What is your reason for participating in the Nurse Scholar program?

Question Title

* 15. Describe your plan for implementing change in your work environment, patient care, or community as a result of your participation the Nurse Scholar program.

Question Title

* 16. If you do not receive the Farm Credit scholarship are you interested in this application being used for consideration of the standard NS Scholarship? This scholarship is a partial scholarship of $250 (half of the cost)

Yes

Question Title

* 17. If you receive the scholarship do you agree to share your contact information, photo and statement to the sponsoring association for promotion?

Yes