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2026 AgriSafe Nurse Scholar Program Scholarship Application

Scholarship Seats Currently Available

Thank you for your interest in the AgriSafe Nurse Scholar Program. 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.

Thank you to our generous program sponsors for supporting the AgriSafe Nurse Scholar Program.
1.Contact Information:(Required.)
2.Mailing Address:(Required.)
3.Work Information:(Required.)
4.Which best describes your employer? select all that apply.
5.Please list the state(s) and counties where patients are impacted by your work (this can be defined as your service area). You may list more than one state/counties(Required.)
6.Type of Nursing Practice:(Required.)
7.Level of Education:(Required.)
8.Briefly describe your experience in rural healthcare:(Required.)
9.What is your reason for wanting to participate in the Nurse Scholar program?(Required.)
10.Describe your plan for implementing change in your work environment, patient care, or community as a result of your participation in the Nurse Scholar program.(Required.)
11.If you are awarded a scholarship, would you like to be featured as a recipient in AgriSafe’s social media and email announcements? (Your response will not impact scholarship selection.)(Required.)
12.Please upload the photo you'd like us to feature in the scholarship awardee recognition announcement.
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