<p> Boston Chapter of American Association of Neuroscience Nursing 2018 Annual Conference Educational Grant Application</p><p>Name: Address: </p><p>Email: Telephone:</p><p>Employer: A.A.N.N. Membership #</p><p>Are you actively working as a neuroscience nurse? Y N Position: </p><p>Are you a member of the Boston AANN Chapter? Y N</p><p>Have you attended a Boston Chapter meeting or activity? Y N Dates:</p><p>Have you attended a Boston Chapter conference? Y N Year/s: </p><p>Have you presented at a Boston Chapter conference? Y N Year/s: </p><p>Have you attended the AANN National conference? Y N Year/s: </p><p>Have you presented at the AANN National conference? Y N Year/s: Title/s:</p><p>Will you be presenting at the 2018 National conference? Y N Title/s:</p><p>Are you a past or present Board/committee member Y N Year/s: of AANN? Position: </p><p>Do you have active certification in Neuroscience Nursing? Y N </p><p>Do you have active certification in Stroke Neuroscience Y N Nursing?</p><p>Have you given a Neuroscience nursing presentation in the past year? Y N Title/s:</p><p>In the past year have you:</p><p>Conducted nursing research? Y N Title/s: </p><p>Authored/co-authored a nursing publication Y N Title/s: </p><p>I agree to present a review of the 2018 AANN conference at a Boston Chapter meeting.</p><p>Signature: Date: </p><p> Please attach a short paragraph explaining why you should receive this scholarship.</p><p> You must be present at the Brain Matters Conference November 8, 2017.  Application must be emailed by October 30, 2017 to [email protected]</p><p> Contact Mary Guanci with questions at email above or call 1-857-238-5649</p>