Scholarship Application
Association of Perioperative Registered Nurses


Date:
First Name: Middle Initial:
Last Name:
Address:
City: State: Zip:
Country:
Home Phone:   Work Phone:
E-Mail Address:
 
AORN Chapter #   AORN Passcode#
Dates of AORN meetings attended:
 
Select program applying for: Seminar
Conference
CE Program
Title:
Date:
Cost:


Eligibility: Award is open to all chapter members who attend at least two business meetings in the designated time frames. (September - November and January - May)

Process: $50.00 will be given at December and the June meeting. Funds must be used within one year of issuance. Member will give a 5-10 minute verbal report at a chapter meeting reguarding the experience.

Eligible member completes this form and submits to committee member prior to Dec. 1 and June 1. Drawing to be held during dinner meetings in December and June.

     


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