Bachelor of Science in Nursing Years 2, 3 & 4 Scholarship Reference Form | NL Registered Nurses' Education & Research Trust

Please note: This reference form cannot be used for the Flo Hillyard Memorial Scholarship. If you were asked to provide a reference for the Flo Hillyard Memorial Scholarship, you must use this form.

If the student is applying for the Year 2 scholarship and the Flo Hillyard Memorial Scholarship, you must complete both reference forms.

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Thank you for agreeing to provide a reference to assist the applicant in obtaining this scholarship. If you are unable to meet the deadline for receipt of references, please notify the applicant. Failure to receive references will jeopardize the applicant's ability to meet the scholarship requirements.

A. Applicant Information

Please provide the following information about the applicant.

First Name:

Last Name:

Email:

Student Number:

School of Nursing:

MUN Faculty of Nursing

Centre for Nursing Studies

Western Regional School of Nursing

Satellite Site (Happy Valley-Goose Bay, Gander, or Grand Falls-Windsor)

Above information is provided by the applicant.

Please indicate:

(i) how you know the applicant

(ii) how long you've know the applicant (years)

B. Your Information

Please provide the following information about yourself.

First Name:

Last Name:

Position

Email:

Phone Number: