NLN Scholarly Writing Application Form 2016
(Clicking the 'Save and Continue' button at the bottom of this page will save your answers so you
can come back and finish your application at another time). Please click the 'submit' button when
you are ready to have your application reviewed. You will receive a confirmation email once it has
been received.
Applicant Information
All fields required.
First Name
Last Name
Credentials
Home Address
City
State/Province
Zip Code
Home Phone
Home Email
Are you an NLN Member? (Individual or Education Agency)
Yes
No
If yes, please provide Membership Number
Did a previous participant refer you to the NLN Scholarly Writing program? If
so, who?
Employment Information
All fields required.
School Name
Title
Street Address
City
State
Zip Code
Work Phone
Work Email
Total number of years in faculty position?
Employment status during these years:
(check all that apply)
Part-time
Full-time
School or Program Information
Practical/Vocationa
l
1. Which types
Associat
e
Diplom
a
Baccalaureat
e
Master'
s
Doctora
l
of programs are
offered for the
School of
Nursing?
2. In which
programs do
you generally
have teaching,
advisement, and
leadership
responsibilities
?
3. Indicate the
ONE program
where you have
the MAJORITY
of your
teaching,
advisement, and
leadership
responsibility.
In a few sentences, discuss why you want to participate in the NLN Scholarly
Writing program and what your greatest challenge has been in regard to
scholarly writing.
In no more than 250 words, please provide a concise overview of your proposed
manuscript. Be clear, precise, and include sufficient detail so that the proposed
manuscript can be assessed.
Although optional, but strongly encouraged, you may include a second
proposed manuscript.
In no more than 250 words, please provide a concise overview of your proposed manuscript. As
before, be clear, precise, and include sufficient detail so that the proposed manuscript can be
assessed.
Please upload a brief curriculum vita that includes information relevant to your
project.
Please upload a letter of support from your Dean or Program Director.