Clayton State University School of Nursing

Name
Address
City
State
Zip Code
How many hours per week do you have to work during the academic year?
Completed 2007-2008 FAFSA form?	Yes No
Nursing Program Status (Choose One)	1st semester junior
	2nd semester junior
	1st semester senior
	2nd semester senior
Enrollment Status	Full-time Part-time
Are you the first person in your immediate family to attend college?	Yes No
Overall GPA
Self identified Race/Ethnicity
Primary language
Primary language spoken at home
Amount of other grants and scholarships received
Explain in more than 500 words your financial need and how this scholarship could increase your success as a CSU nursing student.
Amount of Scholarship based on full time enrollment.

Nurture for Success Student Nurse Scholarship