Nursing Scholarship Application

If you are interested in building a career in healthcare, we welcome you to apply for a JTD Hospital Foundation nursing scholarship. Each year we give scholarships to worthy individuals who are interested in pursuing a nursing career. The JTD Hospital Foundation will be offering two $1,000 scholarships to local residents studying nursing for the 2023-2024 academic years.

Both the JTD Hospital Foundation Nursing Scholarship and the Landen Phlipot Nursing Scholarship are held by the JTD Hospital Foundation. It is through the support of the community, Grand Lake Health System employees, the annual Landen’s 5K that these scholarships are made available to qualified individuals pursuing their educational goals.

To be eligible for either of these scholarships, the individuals must be a high school senior, current college student or adult returning to school who is a resident of Auglaize or Mercer counties or graduate of a high school in those counties. Joint Township District Memorial Hospital and Grand Lake Health System employees are not eligible. Final applicants will be chosen and must be available for an interview on Saturday, June 10 between 8:00 a.m. and 12:00 noon.

Applications must be submitted electronically by April 14, 2023. For more information call (419) 394-3335, ext. 3567. The JTD Hospital Foundation is the fundraising arm of Joint Township District Memorial Hospital.

Please submit a paper application to: JTD Hospital Foundation at jujacobs@jtdmh.org.

Name:

Address:

City:

State:

Zip:

Mobile Phone:

Preferred Phone:

Email:

Birth Date:

Education: (High School and College Transcripts must be submitted with this application.)

Current School:

Academic Status:

High School attended if in college:

City/State:

Major Study Program:

College you attend or plan to attend:

Major and Minor (if applicable) Courses of Study:

School and Community Service:

School clubs, programs, athletics:

_{List school clubs, programs, athletics in which you have participated in the past or are currently participating. Note any positions held}

Service activities:

_{List service activities in the community and positions held or obtained. Examples: scouting, 4-H, church, service clubs in the community.}

Awards and honors:

_{List awards and honors you have earned in High School and College. (Do NOT include scholarships or college financial assistance in this section.)}

Personal Traits:

Briefly describe yourself.

_{Address such things as: what you like to do, how you interact with people, what goals you have for the next few years, what in life is important to you, why you are or are not involved in various activities. Please be brief, but give us a good idea of your overall personality.}

All information will remain confidential by the Scholarship Committee.

Essay Topic: "Why I am Making this My Career Choice"

Please attach your 500 word essay here:

Accepted file types are doc,docx,txt and pdf.

High School Transcripts

College Transcripts

Reference Letter Guidelines:

Please upload two (2) letters of reference. One speaking to your character and one speaking to your work ethic. It is strongly recommended to limit one (1) letter to a coach or teacher and to include a community member (pastor, employer, volunteer director, advisor, etc.) as a reference.

Letter of Reference

I am available for interviews on Saturday, June 10, 2023

I understand that verification of college registration must be received by the Scholarship Committee prior to payment of the scholarship award. *

Electronic Signature *

By typing your name, you are electronically signing this form.

Nursing Scholarship Application

Reference Letter Guidelines:

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