2016 Application Form

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ARMY NURSE CORPS ASSOCIATION
SCHOLARSHIP PROGRAM
PO Box 458
LISBON, MD 21765-0458
2016 SCHOLARSHIP PROGRAM GUIDELINES
HISTORY OF THE ARMY NURSE CORPS ASSOCIATION
In 1976, a group of retired Army Nurse Corps officers expressed their desire to continue the
camaraderie and close ties of the Army Nurse Corps in retired life and to establish a means of
communication by, for and about Army nurses. The Retired Army Nurse Corps Association was
established as a private, non-profit organization. In 2000, the name was changed to the Army Nurse
Corps Association (ANCA) to better reflect the membership composition of retired and active duty
members from both the active and reserve components. The mission of the ANCA is to preserve the
legacy of Army nursing and to foster programs and activities that are beneficial to the Army Nurse
Corps and to our civilian communities.
Membership is comprised of Army Nurse Corps officers from the Active Army, Army National Guard
or Army Reserve. They may be currently serving, retired or honorably discharged from one of these
components.
In accordance with our stated mission, the association promotes literary, educational, research,
charitable and artistic endeavors. One of these is the Army Nurse Corps Association Scholarship
Program. All funds to support the scholarship program are contributed or bequeathed to the ANCA
Education Fund by others.
ARMY NURSE CORPS ASSOCIATION SCHOLARSHIP PROGRAM
The purpose of this program is to provide $3,000.00 scholarships to nursing students who are enrolled
in colleges and universities, hereafter referred to as “schools,” with accredited baccalaureate and
graduate nursing/nurse anesthesia programs. These may include generic Bachelor of Science in
Nursing (BSN), RN to BSN, accelerated nursing degree programs, Master’s degree in Nursing (MSN) or
anesthesia and doctoral programs in nursing. Nurses may also pursue a graduate degree in related
healthcare field (such as Public Health), however the applicant must clearly outline how this degree
furthers his/her nursing career.
1 . Basic application eligibility criteria include:
a. Students currently enrolled in baccalaureate nursing or advanced degree in nursing, nurse
anesthesia, or related healthcare field who are or have previously served at any rank in any
component of the Active Army, Army National Guard or Army Reserve.
b. Students currently enrolled in baccalaureate nursing or advanced degree in nursing, nurse
anesthesia, or related healthcare field whose parent(s), spouse, or children is/are serving or
have served in the Active Army, Army National Guard or Army Reserve.
c. If the applicant is pursuing a nursing degree, the nursing program is accredited by a
national nursing accreditation agency that is recognized by the U.S. Department of
Education.
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2. Those ineligible to apply for an ANCA Scholarship include:
a. Students receiving financial support for educational endeavors through military programs
sponsored by the U.S. Army, Army National Guard, Army Reserve or other military
programs.
b.
Students receiving full benefits from any of the GI Bill programs (Montgomery, Post 9/11,
sponsored by the US Army, Army National Guard, Army Reserve or other military services,
MGIB-SR, REAP and /or VEAP). Those receiving less than full GI Bill program monies for
education may be eligible. Such an applicant must clearly outline the scope of benefits
(period of eligibility, projected financial payment amounts, usage restrictions, etc.) in the
“Current and Projected Financial Sources” section of the application.
c. ROTC scholarship recipients. (NOTE: ROTC program students who are not receiving an
ROTC Scholarship are eligible to apply.)
3. Other important information regarding eligibility.
a . Appeal of application eligibility. An individual who believes he/she should be eligible to
apply for a scholarship may submit an application, with supporting documentation, to be
reviewed by the Education Committee for eligibility determination prior to being
considered during the scholarship selection process. The request for consideration should
be initiated well before the application deadline date.
b.
Funding of Part-Time School Attendance. Students attending school part-time are
eligible to apply; funds will be distributed by the school to the student only when the
student is actively participating in educational endeavors.
c.
Prior ANCA Scholarship Recipients.
1) Receipt of an ANCA scholarship in the past does not preclude an applicant from
receiving a scholarship in subsequent years. However, it is expected the personal
statement, as well as any endorsements/recommendations from those who had
submitted such in support of an applicant’s previous year’s submission, will be
rewritten to reflect current circumstances, progress in the present program, etc. Copies
of previously submitted items are not acceptable.
2) Include year(s) of prior award(s) and amount of each award in the application where
indicated.
Instructions for completing the application, along with required documentation are described in the
“Application for ANCA Scholarship.” All required documents supporting the application must be
received by March 31, 2016. Students are encouraged to submit applications prior to the deadline in
case further clarification or additional documentation needs to be obtained by ANCA Education
Committee members.
The Army Nurse Corps Association Scholarship Program is not a U.S. Army, Army Nurse Corps or
Reserve Officer Training Corps sponsored program. ANCA does not have an official affiliation with
the U.S. Army or the Army Nurse Corps and there is not a military service obligation incurred by the
student who receives scholarship funds through this program. Students with questions concerning
service in one of the components of the U.S. Army should contact Army recruiting personnel or the
school’s Army Military Science Department.
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This is a highly competitive scholarship program. The applicant will be represented only by information
contained in the application and supporting documentation. Please carefully review all required
material prior to submitting your application. Previous editions of the application are obsolete and will
not be accepted. Applications may be printed or typed.
APPLICATION CHECKLIST
Please include this checklist with your application
This checklist is provided for you to ensure that your application is complete. Prior to forwarding your
application, be sure the following documents are included or arrangements have been made for them
to be incorporated into your application:
 Army Nurse Corps Association Scholarship Application (pages 4-8 )
 Signature included on Certification Statement (page 8)
 Recommendation letter from the Academic Advisor or Dean, School of Nursing/School of Nurse
Anesthesia (page 9)
 Letter is included
 Arrangements have been made to send directly to ANCA
 School Financial Information Form (page 11)
 Included
 Arrangements have been made to send directly to ANCA
 Official College Transcripts (page9)
 Included
 Arrangements have been made to send directly to ANCA;
Anticipate transcripts from (specify name and address of
schools):
 Prior or present military service documents (page 9)
 Letter(s) of Recommendation, (Required) (page 10)
 Letter is included
 Arrangements have been made to send directly to ANCA;
Anticipate letters of recommendation from (specify
name(s)):
 Photograph, if desired (If selected for a scholarship, a photograph will be required.) (page 10)
Comments:
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Sections I & II: Applicant Information & Qualification Category
I.
Name & Current Mailing Address: (If you are in a temporary living arrangement, e.g., apartment or
dormitory at school, and may not be at the listed address in the coming year, you must also include
an alternative contact address.)
Other Applicant Contact Information:

E-Mail: (If you are using a temporary or school email address, you must also include an alternate
email address.):

Telephone:
Optional (For Statistical Purposes Only)

II.
Gender:  M  F
Ethnicity:
Qualifications Category (Check as applicable)
(Comment as Needed)
 I am currently enrolled in an accredited baccalaureate
nursing or advanced degree nursing, nurse anesthesia, or
related healthcare program and am serving or have
previously served in a branch, at any rank, of a component
of the U.S. Army (Active Army, Army National Guard
and/or Army Reserve).
I am not currently receiving funding by any
component of the U.S. Army, e.g., scholarship ROTC
student or student receiving full GI Bill benefits.
As applicable, I have received an “honorable” discharge
(as noted on a submitted DD214 or comparable qualified
document) from the component.
--------- OR ------- I am currently enrolled in an accredited baccalaureate
nursing or advanced degree nursing, nurse anesthesia, or
related healthcare program whose spouse, parent, or child
is serving or has served in a component of the US Army.
Previous ANCA Scholarship Winner
(Check one)  Yes
 No If yes, Date and amount of each award:
Current GPA (consistent with submitted transcripts): _______________
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2016 ARMY NURSE CORPS ASSOCIATION SCHOLARSHIP APPLICATION
Section III: School Information
Name & Address of School (Include applicable Department or Program (e.g., Nursing or Education):
If you are pursuing a nursing degree, specify which national nursing accrediting agency recognized
by the U.S. Department of Education accredits your program:
Degree Sought/Program of Study:
Expected Graduation Date (Month/Year):
Academic Advisor Information (Name, Address, E-Mail, Telephone):
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2016 ARMY NURSE CORPS ASSOCIATION SCHOLARSHIP APPLICATION
SECTION IV: TELL US ABOUT YOURSELF (In the space provided)
Scholastic, Academic or Military Honors:
Society, Organization, and/or Volunteer Activities:
Interests and Hobbies:
Current and Projected Financial Support Sources: Scholarships, GI Bill benefits, etc. Do not include
personal or other family financial support. Summarize actual costs of the program for the scholarship
period and the total amount of funding anticipated from other sources from the same academic year.
Personal Statement (Use the space provided on the next page or attach a separate document. It may
be hand written or typed): This section is an extremely important part of the application and should
be prepared carefully and legibly. Present any information you would like the Education Committee to
consider. Emphasize professional career objectives and reasons for applying for the ANCA scholarship,
e.g., need, special considerations. If your advanced degree is in a healthcare field other than nursing,
explain how this degree will advance your nursing career. Advise the committee of your personal
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and academic interests and why you are pursuing a nursing career. Address any prior or current service
with the U.S. Army, Army National Guard or Army Reserve including prior or current ROTC experience.
Speak specifically to how the Army has impacted or is impacting your life and professional aspirations.
PERSONAL STATEMENT
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CERTIFICATION STATEMENT
 The information contained in this application is true and correct.
 I understand I am under no obligation to serve in a component of the US Army as a result of
selection.
 If necessary, ANCA may contact the appropriate agency(s) to verify any or all of the
information submitted with this application.
 If I am selected to receive an ANCA Scholarship, I agree to provide a photograph of myself and
realize that my name and contact information may be shared with the U.S. Army nurse
recruiting personnel and my name and photograph may be used in ANCA publications and on
the ANCA website.
 I have provided an alternative contact address and email for future communication from
ANCA to me.
Student Signature________________________________________
Date _______________________
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2016 ARMY NURSE CORPS ASSOCIATION SCHOLARSHIP APPLICATION
SECTION V: INSTRUCTIONS FOR OTHER DOCUMENTS
e.g., Recommendations and Other Information
NOTE: Any of the material indicated as “*Required” must arrive before the application deadline of
March 31, 2016 or the application will be considered incomplete and will not be reviewed by the
ANCA Education Committee
Letter of Recommendation from Academic Advisor/Dean, School of Nursing or Nurse Anesthesia
Program (*Required)
 The letter of recommendation should outline the applicant’s degree program and discuss the
applicants current status and progress toward degree completion.
 If forwarded separately from the student’s application, the letter should be addressed to
Army Nurse Corps Association Scholarship Program, PO Box 458, Lisbon, MD 21765.
 The applicant should indicate on the “Application Checklist” that the letter is being sent
separately.
School Financial Information Form (*Required)
 ANCA does not disburse scholarship funds directly to the student. A scholarship recipient’s
monies will be sent in a one-time check to the person and office designated in the application
for the recipient’s use in defraying direct education costs.
 Applications must include the School Financial Information Form (Section VI) completed and
authenticated by the school. It reflects who should receive the scholarship funds and details
how the scholarship funds will be managed.
 If forwarded separately from the student’s application, the School Financial Information Form
should be mailed to Army Nurse Corps Association, Scholarship Program, PO Box 458, Lisbon,
MD 21765. An annotation that the form is being sent separately should be made on the
“Application Checklist” (page 3).
College Transcripts (*Required)
 Official college transcripts are required to demonstrate academic ability and successful
progress within the applicant’s current program. Credits or degrees obtained at other
schools in order to enroll in the current academic program are usually reflected in the
current school’s transcript. If not, transcripts reflecting performance in these courses or the
attaining a prerequisite degree must be included with the application. Unofficial transcripts
obtained by the student are not acceptable.
 Graduate students must include an official transcript documenting their last nursing degree.
 Official transcripts may be forwarded by the student with the application. If required by school
policy, transcripts may be sent by the school directly to the Army Nurse Corps Association
Scholarship Program, PO Box 458, Lisbon, MD 21765.
 The applicant should indicate on the “Application Checklist” whether transcripts are enclosed
with the application or being sent separately.
Previous or Current U.S. Army Service (*Required)
 If you previously served in some capacity in a component of the U.S. Army, please include
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documentation (i.e., DD Form 214 or other qualified documents) to substantiate this service.
 An individual currently in service must include either an Officer Record Brief or Enlisted Record
Brief, as applicable.
 If your eligibility to apply is based on current or previous service of a parent, spouse, or child in
the Active Army, Army National Guard or Army Reserve, documentation to substantiate this
service must be included in the application. This can be military orders, DD Form 214, or
other qualified documents attesting to the fact that the individual is serving or has served.
 Please provide documentation of any name changes.
Additional Letter of Recommendation (Required)
 At least one additional letter of recommendation from a professional such as an employer or
faculty member. The letter (s) of recommendation should be current. If you are a former
ANCA scholarship recipient, please have any previously used reference rewrite the
recommendation to reflect your current situation.
 Any affiliations with ROTC or other components of the Active Army, Army National Guard
and/or Army Reserve should be addressed whenever possible through letters from leaders of
these departments, units, and/or organizations and would qualify as the required additional
letter or recommendation.
 Please indicate on the “Application Checklist” if recommendations are being included or sent
separately to the Army Nurse Corps Association Scholarship Program, PO Box 458, Lisbon, MD
21765.
Photograph (Optional)
 A photograph is not required until you are notified of your selection to receive an ANCA
Scholarship.
 If you desire to enclose a photograph with the application, it should be suitable for possible
publication in the ANCA documents.
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2016 ARMY NURSE CORPS ASSOCIATION SCHOLARSHIP APPLICATION
SECTION VI: SCHOOL FINANCIAL INFORMATION FORM
This document is to be completed by the school. It will provide information about the general
management of the student’s Army Nurse Corps Association (ANCA) scholarship funds. If the student
is selected, the scholarship funds will be sent in the student’s name to the appropriate department
at the school as indicated on this form. This form should be included in the student’s application or
sent directly to Army Nurse Corps Association Scholarship Program, PO Box 458, Lisbon, MD 21765045. The student should annotate the “Application Checklist” to reflect whether this document is
enclosed with the applications or will arrive separately. It is due by March 31, 2016. If further
information is needed, please e-mail ANCA at education@e-anca.org.
Name of Student:
Student’s ID Number __________________________________
The responsible department at the school is:
How will the scholarship funds be managed? Under IRS provisions, ANCA Scholarship Funds can only
be used for tuition, fees, and course-related expenses (books, supplies and required equipment).
Please indicate how the school will manage the scholarship funds and outline allowed usages.
“Pay to the Order of…” If the student is selected for a scholarship, what information is required in the
“Pay to the Order of” section of the check? (Please clearly print or type):
School Financial Contact Information. If selected, the student’s check is to be mailed to the attention of
the following:
Name:
Position:
Contact Information (Mailing Address; Email; Telephone):
____________________________________
Authorized Department Signature
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2016 ARMY NURSE CORPS ASSOCIATION SCHOLARSHIP APPLICATION
SECTION VII: APPLICATION DUE DATE
A complete application must be received by 31 March 2016
This date is firm unless changed by the ANCA Board of Directors. Extensions will not be granted.
Applicants should take into consideration the time necessary for documents to reach ANCA by the
deadline. If the applicant is selected by the ANCA Education Committee, written notification will be
sent to the student, his/her academic advisor/dean, and the department designated by the school to
be responsible for the scholarship funds. Notification will be sent within 4 to 6 weeks after the
application deadline. Please be sure that ANCA has current addresses to contact the applicant and the
school.
SECTION VIII: MISCELLANEOUS INFORMATION
Questions about the Application Process
 Questions concerning the application process should be sent to education@e-anca.org or the
“Contact Us” form on the ANCA Scholarship web page, https://e-anca.org/Scholarships.
 Army Recruiters and/or ROTC Detachments may not have specific information about this
program; therefore, you should address your questions directly to the Army Nurse Corps
Association.
Applicant Name Variation
 Any applicant name variations in documents submitted should be explained and
substantiated as necessary for clarity.
Sending the Application to the Army Nurse Corps Association
 All correspondence must be sent to the postal or Email address.
 United Parcel Service or FedEx letters and packages are unable to be received.
 Applications may be forwarded as email attachments to ANCA@umfamily.net . (transdigital)
in Microsoft Word format is necessary)
What Happens to Your Information
 If selected to receive an ANCA scholarship, the applicant’s contact information may be
provided to appropriate Army Nurse Corps Recruiting personnel. Otherwise none of the
information in the application will be shared with anyone outside of ANCA.
 If you are not selected for a scholarship, your information will not be shared with any other
entity. Identifying information, e.g., SSAN, will be redacted (blocked out).
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