KAISER PERMANENTE KENT M. NELSON
CLINICAL PHARMACY SCHOLARSHIP
Dear Pharmacy Student,
We are pleased to announce the continuation of the Kent M. Nelson Clinical Pharmacy
Scholarship generously funded by Kaiser Permanente. These are substantial ($4,000 each)
scholarships to P3 (current P2) students for the 2014-2015 academic year. Guidelines and the
application form are attached. Applications are due in the Office of Student Services by 4 p.m.
on Monday, March 24, 2014. Late applications will not be accepted.
In addition to the scholarship, the following opportunities exist for the students who are selected:
• ongoing mentoring relationship with pharmacy leaders in Kaiser Permanente and flexible
opportunities to shadow Kaiser Permanente clinical pharmacy staff
• opportunity for participation in ongoing clinical pharmacy research projects
The following factors will be taken into consideration in selecting the scholarship recipient(s):
Criteria:
• current P2 student
• academic achievement
• demonstrated interest in clinical pharmacy practice
• strong communication skills
• plans to complete a post-PharmD residency and pursue a career in clinical pharmacy
• evidence of involvement in community service and/or student/professional
organizations (e.g. ASP, Rho Chi, etc)
• evidence of financial need is not required
Additional items:
• Essay (1 page) describing the three most important attributes you feel are necessary
to be a successful clinical pharmacist in the changing health care environment.
• Two letters of recommendation from Clinical Pharmacy/Pharmacy Practice faculty (or
Adjoint Clinical Pharmacy Faculty).
Finalists may be requested to attend an interview.
The scholarship recipient(s) will be announced at the May 2, 2014 School of Pharmacy Awards
Convocation.
Sincerely,
Daniel LaBarbera, Asst. Professor
Chair Awards & Scholarships Committee
KAISER PERMANENTE KENT M. NELSON
CLINICAL PHARMACY SCHOLARSHIP FUND
APPLICATION FOR SCHOLARSHIP
Complete and submit this application form in accordance with the guidelines for the
academic year 2013-14.
Complete all sections (A. - D.).
Essay (1 page section C) describing the three most important attributes you feel are
necessary to be a successful clinical pharmacist in the changing health care
environment.
Two letters of recommendation (section E) from individuals who know you well enough
to be able to comment on your suitability for the scholarship (e.g. Clinical
Pharmacy/Pharmacy Practice faculty (or Adjoint Clinical Pharmacy Facility.)) This
should be provided to you by the faculty member in a sealed envelope.
Submit your completed application (sections A. - E.) to the Office of Student Services
by 4 p.m. on Monday, March 24, 2014. The School of Pharmacy’s Scholarship
Committee will select finalists (number to be determined by dollar amount available for
award and may vary from year to year) from applications of students who are deemed
to meet the requirements of the scholarship. A committee of clinical pharmacy
practitioners and leaders from Kaiser Permanente will review the finalists’ applications
and provide feedback to the school’s scholarship committee, which will make the final
decisions.
A transcript (official or unofficial) of your professional pharmacy courses from the
Skaggs School of Pharmacy and Pharmaceutical Sciences University of Colorado
All requested information must be completed and provided for the application to be
considered.
I understand that if I am awarded the scholarship, I will be open to discussing the
possibility of a paid internship at Kaiser Permanente of Colorado and I will commit to
ongoing mentoring relationships with pharmacy leaders at Kaiser Permanente.
A. Biographical sketch
Name:
Student ID#:
Local address:
Phone number & School E-mail Address:
Are you currently employed while attending the School of Pharmacy?
If so, where?
Employer phone #:
Number of hours per week:
Year in pharmacy school for fall 2012:
P3
yes
no
APPLICATION FOR SCHOLARSHIP (continued)
B. Student activities. Describe membership in student or professional associations,
participation, leadership, office held, etc. Please include dates of participation.
i.
Pharmacy/School of Pharmacy/Healthcare related activities (include student
organizations):
ii.
Community service activities (not limited to School of Pharmacy):
iii.
Employment history (most current listed first):
iv.
Any other pertinent information?
v.
Any explanation for above information?
vi.
Plans to complete a post-PharmD residency? Explain.
vii. Plan to pursue a career in clinical pharmacy? Explain.
C. Essay. Essay (1 page) describing the three most important attributes you feel are necessary
to be a successful clinical pharmacist in the changing health care environment.
I hereby certify that to the best of my knowledge, the information furnished on this
application is true and complete without omission or misrepresentation of fact. I understand that
if found to be otherwise, it is sufficient cause for dismissal and withdrawal of any scholarship I
may be awarded.
name of applicant
___________
signature
date
KAISER PERMANENTE KENT M. NELSON
CLINICAL PHARMACY SCHOLARSHIP FUND
E. Letters of recommendation (two are required).
This is to be completed by a University of Colorado School of Pharmacy faculty or clinical
faculty member.
Comment on the applicant’s interest and skills in clinical pharmacy, his/her desire and ability
for a post-PharmD residency and his/her desire and potential success for a career in clinical
pharmacy. In addition, comment on the applicant’s dependability, judgment, academic
achievement, character, extracurricular or community activities, as well as any other
qualities and traits that you feel are pertinent in recommending this candidate. When
completed, please enclose this letter in a sealed envelope, write the applicant's name
on the front of the envelope and sign your name across the envelope seal (to ensure
confidentiality).
CONFIDENTIAL STATEMENT
Signature
Name
Title
Date