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* 1. Contact Information

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* 2. Have you been a member of ANPA for at least the past 6 months? (This is a requirement of eligibility).

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* 3. Are you a family member of a current ANPA Board of Directors member? (If you answer yes, you are ineligible).

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* 4. Are you a US Citizen or legal resident residing in Arkansas? (This is a requirement of eligibility).

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* 5. Select the program you are currently enrolled - select all that apply

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* 6. What is your student enrollment status?

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* 7. What is your total program hours?

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* 8. Number of graduate/doctoral hours completed?

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* 9. Number of graduate/doctoral hours enrolled for upcoming semester

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* 10. Submit a verification letter from your Nurse Practitioner program director stating your current enrollment status and number of hours for upcoming semester enrollment.

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* 11. Provide a copy of your most recent transcript (you must have a current GPA of 3.2 or greater)

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* 12. Provide copy of your Nurse Practitioner Program course requirements

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* 13. Provide two letters of professional reference.  If your reference prefers, they may submit their letter of reference to membership@anpassociation.org.  The letter must received by the deadline for your application to be considered.

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* 14. Submit a typed essay describing your overall educational and career goals.  Include why you want to become a Nurse Practitioner or attain a new Nurse Practitioner concentration certification.  Be sure to include why you should be considered for this grant.  (Your essay must be 500 words or less.)

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* 15. By checking this box, you attest you have met the criteria and answered all questions honestly and accurately.  You agree to use the grant from the Arkansas Nurse Practitioner Association to accomplish your Nurse Practitioner education goals.

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* 16. Thank you for submitting an application for ANPA's education grant.  The committee will review all completed applications.  The candidate selected for the award will be notified by January 6, 2020.

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 100% of survey complete.

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