Arlene Miles Scholarship Nomination Form

Scholarship Nominees Name(Required)

First Last

Facility Name(Required)

Are you currently a CNA or an LPN (choose one):(Required)

Are you enrolled at an educational institution:(Required)

At which education institution are you enrolled:(Required)

What degree are you pursuing:(Required)

How long have you worked in healthcare:(Required)

How long have you worked in Long-Term care:(Required)

What motivates you to work in Long-Term care:(Required)

Once you obtain your degree, do you intend to continue working in Long-Term Care?(Required)

Letters of Support(Required)

Drop files here or

Max. file size: 21 MB, Max. files: 2.

Please submit 2 letters of support: one from a co-worker and another from someone from your management. The letters should specifically address the following questions: What is it about this candidate that makes them stand out among the other caregivers in your care center? Why do you think this candidate is deserving of a scholarship?

Arlene Miles Scholarship Nomination Form

Arlene Miles Scholarship Nomination Form

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