The Healthcare Training Academy requires a fully completed application to award scholarship funds. Please follow the directions to ensure acceptance.

Upon submission of your application it will be reviewed by the appropriate committee. Upon approval, a scholarship code will be issued to you. The code will either cover the entire tuition or partial tuition. Funds do not cover course materials (i.e. textbooks).

When submitting your application CLICK THE SUBMIT BUTTON ONCE (DO NOT DOUBLE-CLICK).

When you submit the application it will direct to the home page and send you an email confirmation.

Please complete your application below. Please complete every field where applicable.


Applicant Name

Address


Phone

Primary & Alternate Email

Enter 3 peer references.   ENTER THE NAMES OF FELLOW CLASSMATES WHO WILL PROVIDE A REFERENCE FOR YOU.

The references you enter MUST be fellow students/classmates who will verify how you are to work with during your nursing program.

Please DO NOT included non-nursing students. Your scholarship applications will be invalid if references are not properly entered or if the references you provide are not RN/LPN classmates.

An email will be sent to each of your peer references below to provide a 2-3 question survey to support your scholarship application.

Reference First name Last Name Email Occupation
Reference 1
Reference 2
Reference 3

When entering email addresses use a personal email (do not use school or a work email address ).


Enter the Nursing School you attdend(ed). In some cases we will need to email your dean for
verification. If you do not know your deans email address please look it up on your school's website or directory. The Dean of Student Affairs is an acceptable contact person to enter.

Nursing Program Info

Dean's Information
First Name: Last Name: Dean's Email: Title:


Student Nurse Association Information
This section MUST be completed by ALL applicants.
SNA President First Name:
SNA President Last Name:
SNA President Email:

Click Here if you an SNA member:


If you have already taken certifications please enter the date each certification was issued.
Please email a copy (front and back) to Support@CardiacEd.com

Nursing License Information
Complete as much information as possible. This information will be verified with the National NurseSys database.



BLS (Basic Life Support)
If you have already taken certifications please enter the date each certification was issued.
Please email a copy (front and back) to Support@CardiacEd.com

ACLS (Advanced Cardiovascular Life Support)
If you have already taken certifications please enter the date each certification was issued.
Please email a copy (front and back) to Support@CardiacEd.com


PALS (Pediatric Advanced Life Support)
If you have already taken certifications please enter the date each certification was issued.
Please email a copy (front and back) to Support@CardiacEd.com

IV Therapy Certification
If you have already taken certifications please enter the date each certification was issued.
Please email a copy (front and back) to Support@CardiacEd.com


If none - enter "none"

In one short paragraph please tell us why you should be given a scholarship award
from the fund you have selected.



Click the submit button once (DO NOT DOUBLE-CLICK)
Duplicate entries will be rejected.

 

When you submit the application it will direct to the home page and send you an email confirmation.


Step  of  steps.