Matt Salmon Scholarship Application Matt Salmon Nurse Education Training Scholarship Application Your Contact Information First Name (required) Last Name (required) Your Email (required) Phone Number (required) Phone Type…MobileHomeWorkOther Street Address (required) City (required) State (required) Zipcode (required) Scholarship Questionnaire Date you started working for Hacienda HealthCare: Month...JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Day...12345678910111213141516171819202122232425262728293031, Year...197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017 What department do you currently work in at Hacienda HealthCare? What medical certification/degree level are you trying to achieve at the current time? Do you have at least one year left of school/training? YesNo Are you atteding school full-time or part-time? Full timePart time Will you be working at Hacienda HealthCare full-time or part-time while attending school? Full timePart time Are you currently attending school? YesNo If you are not currently attending school, have you been accepted? YesNoAttending What school are you attending or planning to attend? Describe your financial need in being able to manage school expenses. Are there any special personal or family circumstances affecting your need for financial assistance? How are you currently financing school? How are you planning to finance the remainder of your school expenses? Explain in 150 words or more why you chose nursing or the medical field? What are your career goals after you receive your nursing degree? "Perfection is our goal. Excellence will be tolerated." - What does that mean to you? Explain any experience that you have had working with a fragile population and/or individuals with disabilities? Tell us about a time when you advocated on behalf of a patient or family member. Matt Salmon’s commitment of time and energy has had a significant positive impact on the lives of Hacienda’s clients, patients and their families as well as Hacienda’s employees and supporters. What positive impact do you hope to make in the field of nursing? Send
