Education / Scholarships

GUIDELINES FOR APPLICATION OF
SCHOLARSHIP FUNDS

POLICY

One scholarship will be awarded annually to cover course registration to the Spring, Fall, and Multi-regional courses in the amount equal to that of an SGNA member. One scholarship to cover the early bird registration fee to the SGNA Annual Conference. One scholarship to cover certification and re-certification exam costs annually.

PROCEDURE

An announcement of the scholarship availability and applications will be included in the newsletter and website.

Criteria for eligibility shall be limited to INSGNA/SGNA members in good standing for a minimum of one year.

Scholarship applications will be completed and forwarded to the chair of the Scholarship Committee prior to the deadline.

a. Deadline for Spring INSGNA education course is February
15th.

b. Deadline for the Fall and Multi-regional education courses is August 15th.

c. Deadline for certification and re-certification reimbursement, after successful passing of exam or re-certification, is December1st.

d. Deadline for SGNA Annual Education Course is February 1st.

NOTE: Applications will not be considered if received after published deadline

The scholarship committee will review applications and the winner will be selected based on preset criteria on the application form.

All applicants will be notified of decision by mail

An alternate shall be selected in the event that the winner is unable to attend the course.

The winner may choose to apply the monies toward the registration fee, at which time a check will be made out to SGNA. Or upon receipt of proof of registration, be reimbursed in the amount of a member fee.

A member is not eligible to win two consecutive years.

Each scholarship winner will be assisted by a mentor with writing an article for the newsletter or preparing a 15 minute presentation at the INSGNA education course.

a. Must be written within 60 days of attending the
INSGNA/SGNA course.
b. Article may be about practice issues or a specific topic of
interest.
c. Oral presentation will be at least 15 minutes and be presented
at the next scheduled INSGNA course.

INSGNA Education Scholarship Application Form

CGRN written exam or Re-certification by exam or contact hours

1. Name________________________________________ Date _____________

2. Address ______________________________________________________________

3. Present Position ________________________________________________________

4. Years in Endoscopy __________ 5. Degree/License __________________________

6. Member of SGNA/INSGNA Yes____ No______

7. What does being a certified gastroenterology nurse mean to you? ________________

_______________________________________________________________________

8. List the INSGNA meetings you have attended in the last three years: _____________

_______________________________________________________________________

9. What does INSGNA offer you? ___________________________________________

_______________________________________________________________________

10. What do you have to offer INSGNA? ______________________________________

________________________________________________________________________

11. What committee are you interested in serving on? ____________________________

(education, program planning, scholarship, membership)

12. What suggestions do you have to help strengthen INSGNA? ___________________

________________________________________________________________________

13. What suggestions do you have to recruit new members? _______________________

________________________________________________________________________

Please mail form to: (Attach address label for Education Committee Chair)

INSGNA Spring, Fall, Multi-regional, and SGNA Annual Conference Application Form

Name _________________________________________ Date ______________

Degree/Title _______________________ Present Position/Title _________________

Address ________________________________________________________________

Home Phone ______________________ Work Phone _________________________

Employer Name __________________________________________________________

Work Address ___________________________________________________________

Name of Supervisor _______________________________________________________

Mail preference: Home ________ Work ___________

1. Have you been an active member of INSGNA/SGNA for ≥ one year? Yes ____ No ____

Year INSGNA/SGNA joined __________

2. List all INSGNA/SGNA meetings and activities you have attended in the last three years.

____________________________________________________________________________________________________________________

3. What are your goals and objectives for attending an SGNA education course? __________________

___________________________________________________________________________________________________________________

4. I support INSGNA’s goals and objectives as demonstrated by my involvement in: _________

___________________________________________________________________________________________________________________

5. Please list any INSGNA/SGNA offices or committee positions you have held: _________________

____________________________________________________________________________________________________________________

Complete this form and return to Scholarship Chair (Attach address label for Scholarship Chair)

I understand that if I receive an educational course scholarship, I am required to apply funds received toward tuition of that course. I agree to return to INSGNA any unused portion of the scholarship. You will be required to write an article for the newsletter or do a presentation at an INSGNA meeting within 60 days of attending the course.

Signature _________________________________________ Date __________________