Gertrude G. Campanella Scholarship Application

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* 1. Applicant Contact Information

Name

Home Address

City/Town

State/Province

ZIP/Postal Code

Preferred Email Address

Preferred Phone Number

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* 2. At which Saint Elizabeth Location are you employed?

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* 3. Employment Information

Date of Hire

Date

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* 4. Current Position

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* 5. Provide current educational background including any degrees or licensed certifications earned. Include the name of the school, year achieved and credential earned, if applicable.

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* 6. Describe the course of study in which you are currently a student or aspire to be enrolled.

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* 7. Provide details of the course the scholarship award will support.

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* 8. Which school or program is this course offered by:

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* 9. Estimated Tuition and Fees for this Course

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* 10. Course Type

Certification Course

College Course

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* 11. Which semester or timeframe will you take this course?

Spring 2023

Summer 2023

Fall 2023

Spring 2024

NA

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* 12. In order to be considered for this $1,000 scholarship, a personal statement is required.

In 250 words or less, provide a personal statement answering the following:

How will this program of study advance your career?

What has inspired you to seek opportunities for professional advancement?

How will this program impact your experience as a member of the Saint Elizabeth family?

How will receiving the Gertrude G. Campanella Scholarship make a difference to you?