Apply For Scholarship

PO Box 168, Plainsboro
NJ 085365

hanaofgardenstate@gmail.com

The Haitian American Nurses Association of Garden State

Name*
First Last
Email*
Name of School*
Address*
Street Address Address Line 2 City State ZIP Code
Phone (Home)*
Phone (Cell)*
Date of Birth*
Citizenship Status*
- U.S. Citizen
- Resident
What languages do you speak?*
Please list any and all languages that you speak
What nursing degree are you pursuing?*
- LPN
- ADN
- BSN
Professional Organization(s) to which you belong*
Please list any and all organizations to which you belong
Community Involvement*
Please describe your community involvement
Essay Upload*
Max. file size: 256 MB.
Please attach a one-page essay, describing (1) why you have chosen nursing as a profession and (2) how you can make an impact within the Haitian American community.
What is 2x9*
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Email
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