Scholarship Fund Form

NOTE: If you believe a field is not applicable please insert N/A

Current name *

Name used during training (if different) *

Insert N/A if not applicable

League Membership Number *

(only fully paid-up members can apply for funding from the Scholarship Committee)

Address *

Address Line 1

Address Line 2

City

County

Postal Code

Country

Email *

Landline &/or mobile telephone number *

Date of qualification as a nurse *

Your Application

ARE YOU APPLYING FOR A WORK RELATED/PROFESSIONAL OR NON WORK RELATED COURSE OF STUDY? *

Work Related/Professional
Non Work Related

Word Related Info

Your current job title & brief description of your role *

Employer Name *

Employer Address *

Address Line 1

Address Line 2

City

County

Postal Code

Country

Brief description of your career over the last 5 years *

Title of Course/Conference for which financial assistance is required *

Website link to course/conference *

Date of Course/Conference for which financial assistance is required

Please give details of the awarding body *

Details of the qualification to be obtained *

Who is the accrediting organisation? *

What benefit do you think the course/conference will have on your current role? *

How do you think it will benefit patient/client care and outcomes? *

If you are looking for a change of direction, explain how you think it will help? *

Non-Work Related Info

Title and brief details of the course *

Website link to course *

Awarding body (if applicable) *

Qualification to be obtained (if applicable) *

Why do you want to do this course? *

Duration of conference/course (including which year of study if applicable): *

Please note, each year’s study requires a separate application and repeated funding cannot be guaranteed.

Fees/Registration: £ *

Other Costs: £ *

Please specify items (e.g. books, travel, accommodation etc.) and amounts. Insert N/A if not applicable

For which of the above are you seeking funding & how much do you require in total? *

Have you applied for funding elsewhere? *

If so, please state the outcome of your application.

Have you undertaken or are you undertaking any other study over the past year? *

If so, what, and how was it financed?

Has the League funded any study for you before? *

If so, when and how much?

If you believe a field is not applicable please insert N/A. Please note we expect all successful applicants to provide the committee with a 250 – 400 word reflective report on completion of your studies outlining the impact made on you by the course/conference that has been supported, both professionally and personally. The report may be published in the League News and/or on the League website.

GDPR Agreement *

By submitting this scholarship application form, you consent to the The League of St Bartholomew’s Nurses having access to and using your personal data for the purposes of processing your application in accordance with The League of St Bartholomew’s Nurses Privacy Policy. *

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Scholarship Funding Application Form

Your Application

Word Related Info

Non-Work Related Info

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