Culture Diversity Award
Instructions for Completing Application
The purpose of this scholarship is to assist active members of Sigma Theta Tau Iota, Iota Chapter-atlarge be able to participate in a cultural or diverse experience in 2013. The experience should allow
members to learn about a culture or group different than their own and learn how health is impacted
by culture. Up to $1000 will be awarded (and split among the awardees). The number of awards
given will depend on the number of applications. A person must be an active member of Sigma
Theta Tau Iota Iota chapter to be eligible to receive the scholarship. A service component is
encouraged, but not required. Scholarship amounts and number of awardees will depend upon
number of applicants and quality of applications. (We will award up to $1000, divided between
awardees).
1. Please complete each section of the application. Incomplete applications will not be
reviewed.
2. Reviewers are faculty from both Brigham Young University and Westminster College, so
please describe the experience in enough detail so that an ‘outsider’ would understand
what YOU will be doing and how it will impact YOUR nursing career. (i.e do not assume
the person is familiar with the program in which you want to participate)
3. Applications should NOT exceed 2 pages. Applications exceeding this limit may not be
considered.
4. Please send completed application via email to Leslie Miles (leslie_miles@byu.edu).
She will confirm when she has received it. If you do not receive a confirmation within 12
hours please re-email the application or contact Leslie. It is the applicant’s responsibility
to ensure the application has been received by the due date indicated.
5. If you have any questions, please contact Leslie Miles at 801-422-6086 or email:
leslie_miles@byu.edu
6. Applications are due Feb 11, 2013 by Midnight. No exceptions.
7. Funds must be used for a culture or diverse experience outlined in this application (or
as approved by the board) or funds must be returned to lota Iota Chapter-at-large
Sigma Theta Tau.
8. Those receiving funds will be expected to provide a short summary of their experience
to the Board of Iota Iota Chapter at Large as well as a presentation of their experiences
at a chapter meeting or the Brigham Young University Iota Iota Chapter at Large annual
Research Conference.
APPLICATION FOR SCHOLARSHIP FUNDS
CULTURE & DIVERSITY PROGRAM
SIGMA THETA TAU IOTA IOTA CHAPTER
Name: ________________________
Contact Information: ______________________
Student at (Check one: BYU _________Westminster________________
If non-student, where are you employed? ____________________
Culture and Diversity Program Location:
_________________________________
Languages you speak (or other unique factors that will impact the
experience for you or others): ______________________________
Please describe what you will be doing in this cultural or diverse experience.
Include if it has a service and/or academic component to the program and
how this funding will be used for the experience. (Keep in mind STTI’s
mission-“to provide leadership and scholarship in practice, education and
research.”)
Please describe in a paragraph why you would like to participate in this
program (the goals you hope to achieve).
Please describe in a short paragraph your financial circumstances that
would necessitate your receiving a scholarship. If you would be unable to
participate in the program if you did not receive a scholarship, please
indicate so. Indicate other scholarships you have received for your
schooling and/or cultural experience.
Grading Sheet
Each question will be graded on a scale of 1 to 5 (with 5 being fitting best with the mission and vision
of Sigma Theta Tau). At least 2 different evaluators will review each application; scores will then be
averaged. Those receiving the highest scores will be awarded the scholarships.
Please describe what you will be doing in this cultural or diverse experience. Include if it has a
service and/or academic component to the program.
___5 Excellent fit with mission/vision/value of STT (promotes new learning, professional development, connects with nurses or
others from a different country/culture or who have worked in other countries/cultures, opens eyes to the world and global
issues, etc). Clear articulation of how funds will be used and are needed for program
___4 Above average fit with mission/vision/value of STT
___3 Average fit with mission/vision/value of STT
___2 Below average fit with mission/vision/value of STT
___1 Minimal if any culture/diversity learning, minimal leadership or professional opportunities
___ Bonus up to +2 for service component
Why you would like to participate in this program (the goals you hope to achieve).
___5 Clearly articulated goals that advance nursing career and promote future nursing leadership and scholarship
___4 Goals well articulated but not clear and/or nursing development goals good but not excellent
___3 Average goals and/or average articulation of goals
___2 Fair goals or fair articulation of goals
___1 Poor articulation of goals or poor goals
Financial circumstances
___5 Financial need clearly articulated, not completely relying on this money for experience (taken personal initiative to
ensure cultural experience)
___4 Financial need above average, some personal effort made to ensure experience (beyond this funding)
___3 Some financial assistance needed, some personal efforts beyond this application
___2 Minimal need or minimal personal efforts beyond this application
___1 Poorly articulate need, no outside effort
_____ TOTAL SCORE