School of Nursing Tuition Scholarships

School of Nursing-Funded Tuition Support

To receive tuition support in the form of Scholarships or Grants funded through the School of Nursing, please fill out this form at the beginning of each semester after you register for courses.

**Submission of this scholarship application does not replace any paperwork which may be required for you to receive tuition benefits through your employer.**

Student Information

First Name

Last Name

Student Email Address

Daytime Phone Number

URID #
UR employees: this is distinct from Empl ID. It is an 8-digit number located on the last line of the "Your Information" badge in HRMS.

Permanent Mailing Address

Street

City

State

Postal code

Program Details

Employment Information

Are you currently employed?

Yes

No

Do you work at the University of Rochester or Strong Memorial Hospital?

Yes

No

Do you work at an affiliate of URMC?
(Highland Hospital, Jones Memorial Hospital, Visiting Nurse Service, F.F. Thompson Health System, Noyes Memorial Hospital, St. James Hospital, Highlands Living Center, Highlands of Pittsford, Highlands of Brighton)

Yes

No

Unsure

Employer:

Position Title:

Employment Status:

Full time

Part time

Per Diem/TAR

Are you eligible for tuition benefits today and expecting to receive benefits for this semester?

Yes

No

Unsure

Do you expect to become eligible for tuition benefits with your current employer?

Yes

No

Unsure

When would you expect to start receiving tuition benefits:

Please select the tuition benefit rate that you expect to receive:

To confirm your benefit rate, please visit our website.

Please describe the tuition benefits you expect to receive (optional):

Semester and Course Registration Information

This scholarship application should be submitted for the current term(s) you wish to receive scholarship support. You will be asked to submit this form for each semester you intend to receive scholarship or grant support from the University of Rochester School of Nursing.

Semester

Fall

Spring

Summer

Year

Please select the APNN prerequisites you plan to complete at UR SON:

First Course Number and Title

Number of Credits

Second Course Number and Title

Number of Credits

Third Course Number and Title

Number of Credits

Fourth Course Number and Title

Number of Credits

Fifth Course Number and Title

Number of Credits

Sixth Course Number and Title

Number of Credits

Seventh Course Number and Title

Number of Credits

Eighth Course Number and Title

Number of Credits

Ninth Course Number and Title

Number of Credits

SON-Funding Sources

You have indicated above that you intend to receive financial aid for one of our labs. Please be sure to select the correct funding source. When in doubt, select "Other" as your funding source below, and list "Program Prerequisite" as the description.

Please indicate your motivation for enrolling in APNN Prerequisites

Program Eligibility at UR SON

Program Eligibility at another School of Nursing

Dual Degree in Nursing enrollment (APNN program, only)

State Licensure Requirement

Personal Interest

We will verify your enrollment an an approved DDN program and respond with any additional documentation required to approve your request.

Please list the scholarship or grant you are interested in receiving:

Are you interested in talking with a financial aid counselor to explore other options available to you to finance your education such as student loans, private loans, and externally-funded scholarships or grants?

Yes

No

Student Signature

Scholarships have been funded by the generosity of School of Nursing donors. Upon approval, scholarships will be awarded each semester based on course registration and available funding. You will receive written notification of the status of your application within five to ten business days from receipt of all completed requested documents. I acknowledge that the URSON scholarship will be used in addition to employer tuition benefits and the combination of the two will not exceed the full cost of tuition. I am aware that this scholarship may impact financial aid packages, including loan amounts. I also understand that I may be contacted by the Alumni Relations Office to meet with the donor of my scholarship and/or to provide biographical information to the donor. I understand that any changes in course registration must be reported to the Sr. Financial Analyst. I certify that the information contained in this application is true and correct to the best of my knowledge. I authorize the Registrar/Bursar to release grade information to my employer as a condition of receiving tuition reimbursement. I understand it is the employer’s decision to continue funding pending receipt of this information.

Signature:

Today's date: