Pennsylvania Association of PeriAnesthesia Nurses

                                    

      Student Nurse Scholarship to PeriAnesthesia PRIDE
                              Application Form


STEP TWO: To be completed by Sponsor
                 (please print clearly or type)

Candidate Name______________________________________

Sponsored by ________________________________________

Address ______________________________________________

City_________________________State ________ Zip ________

Phone (H) _____________________ (W) __________________

PAPAN/ASPAN membership number: ____________________

I recommend this candidate because: __________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
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Signature of Sponsor __________________________________
              Print Name __________________________________

CANDIDATE NOTE:
Please complete these forms and return them to the MEMBERSHIP CHAIRPERSON (Address will be provided by the Webmaster).  Applications must be postmarked no later than August 1.  You will be notified via letter and/or phone call before September 1.  This scholarship is non-transferable and must be used for the PAPAN PeriAnesthesia PRIDE for the calendar year of the application. 

Send application to Membership Chairperson
Address available from Webmaster
Info@papanonline.org


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