2024 IHCA Member Employee Scholarship Application Form

This scholarship is for employees of IHCA, ICAL and ICHC member organizations seeking to advance their health care education. Thirteen scholarships will be offered to provide for up to $1,500 toward tuition for nursing, health care administration, physical or occupational therapy programs. This scholarship is made possible by Iowa Post Acute Long-Term Care (IPALTC), IHCA Districts and Nurse Connect. Scholarship applications are due by May 31, 2024.

Applicant Information

Applicant Name(Required)

First Last

Applicant Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Applicant Phone(Required)

Applicant Personal Email(Required)

Applicant Work Email

Employer Information

Employer Company Name(Required)

Employer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Administrator/Director Name(Required)

First Last

Administrator/Director Phone(Required)

Administrator/Director Email(Required)

Applicant's Job Title(Required)

Number of Years Applicant Has Worked in Long-Term Care(Required)

Month/Year of Hire at Current Employer(Required)

Educational Institution Information

Applicants must be enrolled or accepted in an accredited school of nursing, long-term care or health care administration program, physical or occupational therapy program, AA/AS/ADM, BA/BS/BSN, MS/MA or MHA/MSN program, and taking classes during the 2024-2025 academic year.

Enrollment Status(Required)

Yes, I am enrolled or accepted in an eligible educational program for 2024-2025

No, I am NOT enrolled or accepted in an eligible educational program for 2024-2025

College Name(Required)

College Financial Aid Mailing Address(Required)

Please provide the address of your college's financial aid department mailing address. If selected as a 2024 scholarship recipient, awarded scholarship funds are placed in the care of the recipient’s approved educational institution by the end of August to be credited to the recipient’s tuition and/or fees in the 2024-2025 academic year.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Degree program in which you are enrolled and degree is being sought for which the scholarship is desired:(Required)

If you selected "Other" please state the name of your degree program here:

Student ID Number (a number that can be used to ensure scholarship is properly credited at your college)(Required)

Expected Graduation Date (Semester/Year)(Required)

Other IHCA Foundation Scholarship Applications

If you are applying for additional IHCA Foundation scholarships this year, please select all of the scholarship types for which you are applying for:

John W. and Kimberly D. Grubb RN SCHOLARSHIP

MolinaCares HIGH SCHOOL SCHOLARSHIP

Iowa Total Care LEADERSHIP INSTITUTE SCHOLARSHIP

Care Initiatives DIRECTOR OF NURSING (DON) SCHOLARSHIP

Linda Juckette Family RURAL AND VETERAN SCHOLARSHIP

Required Documents

Essay(Required)

Compose and upload an essay of no more than 500 words. It must be your own work and include discussion on the following: 1) Your work history in long-term or post-acute care (i.e., nursing facility, continuing care retirement community, assisted living facility or home health agency) and why you have selected long-term care as your career field, 2) the personal qualities that enable you to fulfill the responsibility of providing quality care to residents/tenants/clients. Give specific examples of ways you provide quality care, 3) The rewards you gain from working in long-term care, and 4) Your career plans specific to long-term care (i.e., nursing facility, continuing care retirement community, assisted living facility, or home health agency) once your education goal is achieved.

Max. file size: 50 MB.

Acceptance Letter or Transcript(Required)

Applicants currently enrolled in a college must submit a copy of their most recent grades transcript. (A transcript printed from the college's official website is acceptable.) Applicants who are newly enrolled students (without an established college transcript) must submit a copy of their program acceptance letter from the college.

Max. file size: 50 MB.

Recommendation Letter(Required)

Upload a recommendation letter from your administrator/director or nursing supervisor. Please ask them to include your name, their name, organization name, telephone and email address in the letter. Also in the letter, ask them to describe why they believe you would be a worthy recipient of an IHCA Foundation scholarship. Please limit letters to 200 words or less.

Max. file size: 50 MB.

Scholarship Award Terms, Conditions + Terms of Agreement

Terms and Conditions(Required)

Upon being awarded the scholarship, a recipient is required to execute any and all documents IHCA determines are necessary, including but not limited to a promissory note. If the scholarship recipient does not complete the educational program during the time frame for which scholarship funds are provided, any unused funds are to be returned to the IHCA Foundation. This scholarship is not intended nor in any way should it be construed as an obligation by the IHCA member organization to employ or continue to employ the recipient. If awarded the scholarship, the scholarship recipient grants IHCA permission to publish any information provided in the scholarship application for scholarship fundraising purposes and to use the recipient’s likeness in any photograph or video in any and all of its publications, including television commercials, print advertisements, website and social media entries without payment or any other consideration.

Yes, I agree to the terms and conditions.

No, I do not agree to the terms and conditions.

Terms of Agreement(Required)

I certify with my initials below that I meet all the requirements for a student in good standing at an approved educational institution and that I meet all the eligibility requirements for the scholarship for which I am applying. I certify that all the information contained herein is true and correct. I further certify that I have read, understand and agree to the Scholarship Award Terms and Conditions.

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