<p> Application for Cherokee Uniforms 2015 A Nurse I Am Scholarship</p><p>Applicants must be students who are enrolled or accepted for enrollment in an accredited LVN/LPN, RN degree (ADN or BSN), diploma, or RN-to-BSN program, and must begin classes no later than Jan. 31, 2015. Enrollment may be full-time or part-time. Applicants’ educational programs must be located within the 50 U.S. states. Deadline: Postmarked by March 1, 2015. Cherokee Uniforms will award up to 10 scholarships of $2,000 each for students who are judged as winners. To be eligible for consideration, please complete this application and the essay requirement below.</p><p>GENERAL INFORMATION</p><p>1. Name: ______(Last) (First) (Middle)</p><p>2. Academic Status Eligibility:  I am enrolled in or have been accepted for enrollment by an accredited nursing education program for the Winter/Spring term 2015, and will begin/ began classes by Jan 31, 2015. </p><p>Degree: ______Graduation Date: ______</p><p>3. Current Contact Information:</p><p>Address: ______City: ______State: ______Zip: ______Phone: ______Alternate Phone: (cell) ______E-mail: ______</p><p>4. Permanent Contact Information:</p><p>Address: ______City: ______State: ______Zip: ______Phone: ______Alternate Phone: (cell) ______E-mail: ______</p><p>EDUCATION & FILM INFORMATION</p><p>5. Number of Nursing School hours you have completed: ______Semester hours ______Quarter hours</p><p>6. Information on Nursing School now attending:</p><p>Name of Institution: ______</p><p> Location of School: ______</p><p>Nursing classes now attending: ______</p><p>Date first enrolled in this School: ______</p><p>7. Where did you view the film “A Nurse I Am”? </p><p> In the classroom Course Name: ______Instructor’s Name: ______</p><p> At work. </p><p>Title of person who introduced the film: ______Approximate number who viewed film: ______Where do you work? ______</p><p> Other. Please describe: ______</p><p>8. What version(s) of “A Nurse I Am” did you view?</p><p> 32-minute Educational Version  62-minute Documentary  Both Films</p><p>9. Essay Assignment & Requirements (Please address BOTH questions below): Patients and their family members base their perceptions of the care received on their personal experience with the medical personnel they interact with. After viewing the film “A Nurse I Am” describe how the nurses in the film build a positive rapport with patients and their family members. How will you ensure that you provide those you care for with a positive healthcare experience? </p><p>Essay Requirements:  The essay must be typed and double-spaced in 10 point Times New Roman font.  In the top left corner of each page, include the following on separate lines: first and last name, contact telephone number, e-mail address, and date.  Word limit: 750 words</p><p>This scholarship application and your essay must be postmarked no later than March 1, 2015 . Please mail these to: </p><p>Cherokee Uniforms A Nurse I Am Scholarship Program 9800 De Soto Avenue, Chatsworth, CA 91311</p><p>Also, please send an electronic copy of your essay to Veronica Fuentes @ [email protected]. </p><p>**We would like to take this opportunity to learn from you. Please answer these 3 questions. </p><p>1. When you are thinking about the scrubs you are going to wear after nursing school, describe your “perfect scrubs.”</p><p> ______</p><p>2. How concerned, if at all, are you with the transmission of germs via the clothing you wear?</p><p>1 2 3 4 5 Not at all Somewhat Neutral Somewhat Extremely concerned unconcerned concerned concerned</p><p>3. Why do you say that? </p><p>______</p><p></p>