2015 Scholarship Points Application - Infusion Nurses of Oregon

Infusion Nurses of Oregon

Welcome
Membership Registration/Renewal
MAY INS ZOOM
Board Members
Scholarship Funds Request
Board Member Only

Form Due by 1/26/2021. All scholarships will be awarded at the 2020 IV Nurses Day Celebration January 26th, 2021
ALL memberships and attendance will be verified prior to awarding scholarship.
If you have questions please contact Marla at-503-544-6960 or spadafma@comcast.net

2020 Scholarship application

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Employer *

LCC INS Chapter Member - 5 points *

Yes No - STOP HERE - if NOT a member you cannot apply for scholarship points

Member of National Infusion Nurses Society - 5 points(will be verified) *

Yes No

Enter your National Membership Number here *

LCC INS Chapter Officer (1/4 of usual for 2020) *

President - 12 points Presidential Advisor - 5 President Elect - 5 Secretary - 5 Membership Coordinator - 5 Member at Large - 5

Attended National INS Conference - 2020 *

INS E-Learning Track (must be worth 10 CRNI units and MUST SUBMIT PROOF via completion certificate: 2 points per 10 CRNI unit track

National Involvement (NCOE, review committee for standards, CRNI exam review) - PLEASE DESCRIBE or say NONE- 10 points *

Meeting Attendance - ALL Meetings verified via sign in sheets - each 2 points *

January 28th, 2020 IV Nurse Day February 25, 2020 June 23rd, 2020

Submit

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