2024 John W. & Kimberly D. Grubb RN Scholarship Application Form

This scholarship, made possible thanks to the John R. and Zelda Z. Grubb Charitable Foundation, is for employees of IHCA, ICAL and ICHC member organizations seeking to advance their nursing education. This year we are offering 40 scholarships, at $4,000 each, for employees interested in pursuing an accredited registered nurse (RN) degree. Scholarships are for the 2024-2025 academic year. 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

Employer County Location(Required)

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 RN degree program for the 2024-2025 academic year to be eligible.

I am enrolled or accepted in an accredited registered nurse (RN) degree program for the 2024-2025 academic year. (Check one)(Required)

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

No, I am not enrolled or accepted in an RN program for 2024-2025

College Name(Required)

College Financial Aid Mailing Address(Required)

Please provide the address of your college's financial aid 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

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. (Check all that apply)

IHCA Member EMPLOYEE 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, 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, assisted living facility, or home health agency) once your education goal is achieved. If you work in a rural Iowa county, explain your career goals specific to supporting long-term care needs in rural Iowa.

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 TWO recommendation letters, with one being from your administrator or director and one being from your nursing supervisor. Please ask them to include your name, their name, organization name, telephone and email address in the letter. In the letter, they should 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.

Recommendation Letter 2(Required)

Max. file size: 50 MB.

Scholarship Awards 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. If awarded the scholarship, the scholarship recipient agrees to remain employed with an IHCA member organization and to complete 2,240 hours of work for that organization following the completion of the educational program funded by this scholarship. If the scholarship recipient voluntarily terminates employment with an IHCA member organization, or is terminated by the IHCA member organization for cause, before working the required number of hours, the recipient agrees that within 30 days of termination the recipient will reimburse the IHCA Foundation in the amount of the scholarship on a prorated basis based on the number of work hours actually completed following the completion of the education program as follows: * 2,240+ hours completed = no reimbursement required * 1,680-2,239 hours completed = Reimbursement required in an amount equal to 25% of the total scholarship awarded to the recipient * 1,140-1,679 hours completed = Reimbursement required in an amount equal to 50% of the total scholarship awarded to the recipient * 560-1,139 hours completed = Reimbursement required in an amount equal to 75% of the total scholarship awarded to the recipient * Less than 560 hours completed = Reimbursement required in an amount equal to 100% of the total scholarship awarded to the recipient. 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, including but not limited to the reimbursement requirements set forth therein in the event that I fail to complete the required number of work hours following the completion of the education program.

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