Kiel Foundation Scholarship

Applications close by 11:59 pm AEST, Wednesday 23 April 2025

Personal details

Preferred title*

First name*

Last name*

Mailing address

Street address line 1*

Street address line 2

City*

State*

Select

Postcode*

Contact details

Email*

Contact number*

Phone

Qualifications

Qualifications*

Date of completion of your nursing studies*

AHPRA Nurse registration number*

Are you a member of ACN?*

*You do not need to be a member to apply, this is for statistical purposes only.

Yes

Employer details

Name*

Your current position*

Street address*

City*

State*

Postcode*

Phone*

Phone

Email*

Referees

The names of two nursing referees are required. The ACN review committee may contact these referees as part of the assessment process for the scholarships.

Referee 1

First name*

Last name*

Employer

Current position*

Relationship to you

Phone*

Phone

Email*

Referee 2

First name

Last name

Employer

Current position

Relationship to you

Phone

Selection Questions

Q1. Discuss what you hope to achieve by attending the National Nursing Forum.*

It is recommended that you write between 200-300 words.

Q2. Identify how the National Nursing Forum will benefit your professional growth and nursing practice.*

It is recommended that you write between 200-300 words.

Q3. Explain how you are going disseminate the information you obtain from the National Nursing Forum.*

It is recommended that you write between 200-300 words.

Documents required

To apply you will need:

current AHPRA nurse registration
proof of Australian citizenship or permanent resident of Australia (birth certificate, passport or visa papers)
current resume or CV (detailing professional achievements in a clinical, education, leadership, or academic setting within the past two years)

Please upload your documents here:*

NOTE: Please attach in .doc, .pdf, .jpg or .png format. There is a limit of 10 files for this form. You may need to Zip documents.

Drag and drop files here or

Confirmation of documents provided*

Select all that has been uploaded

Select

ACN Grants and Awards Terms and Conditions

ACN strongly recommends that you thoroughly read and save a copy of the Grants and Awards Terms and Conditions before you accept the offer. The Terms and Conditions is a legally binding document and by accepting the offer the scholarship you are agreeing to abide by the terms and any future amendments for the life of the scholarship.

ACN Grants and Awards terms and conditions

Declaration

The Declaration is legally binding and indicates that you have, to the best of your knowledge, provided true and correct information. There are penalties for knowingly giving false or misleading information.

A. I declare that:*

The information that I have supplied in this application form is true and correct in every particular.

The responses to the selection questions have been completed by myself.

I will advise ACN, in writing, within 14 days of any change in my circumstances.

B. I understand that:*

I will be required to accept the Terms and Conditions of the ACN Grants and Awards if my application is successful.

I have read and understood ACN Foundation Privacy Collection Notice.

Read the ACN Foundation Privacy Collection Notice.

If you have any questions regarding this scholarship please contact ACN Foundation on 1800 117 262 or email acngrants@acn.edu.au

Lodgement

Once you submit your application an acknowledgement message will pop up to confirm it has been submitted successfully, this means we have received your application. Once the ACN Foundation team processes your application you will receive an email confirming the status of your application.

Send me a copy of my responses

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