A Registered 501(c)3 Public Charity

Jennifer Carter Scholarship Application

Name of the Memorial/Scholarship Fund for which you are applying:

Applicant's Name:

Applicant's Phone:

Applicant's Email:

Applicant's Address:

Applicant's City:

Applicant's State:

Applicant's Zip:

What is your GPA?

Where will you be attending nursing school?

Have you been accepted?

List any community service/activities:

Why do you want to be a nurse?

How will the applicant use the funding?

How do the goals and interests of the applicant mesh with the goals and interest of the person being memorialized?

Other Questions or Comments?