Home Care Research and Education Foundation

Application Form

The Home Care Research and Education Foundation Scholarship has been established to encourage home care workers to pursue or further advance careers in nursing or therapy. The scholarship fund’s purpose is to address the shortage of home care nurses and therapists in our state, to increase opportunities for home care workers, and to assure high caliber care at home. Each member agency of the Missouri Alliance for Home Care may submit one application each year for this scholarship of up to $1,000.

PLEASE BE SURE TO FILL OUT ALL PARTS OF THIS FORM. Only completed applications will be considered.

Name

First Name

Last Name

Email

Phone

Country

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Care Agency

Current Position Held

School Term AND Year for which application is made

Scholarship Applicant is currently enrolled or has been accepted to

Name of Accredited School

Have you applied for or received other financial assistance including employer contributions?

Yes

No

The selection committee will choose the scholarship winners with criteria that include motivation to become a nurse or therapist or to further advance his/her nursing or therapy education, letters of support, and the strength of the application. To be eligible for the scholarship, the applicant must be accepted by or enrolled in an accredited school of nursing (LPN, RN, BSN, or MSN) or therapy program (PTA, COTA, entry level or Doctorate PT, OT, or SLP) in Missouri, a contiguous state, or an accredited online program regardless of state affiliation, be currently employed by a member agency of the Missouri Alliance for Care at Home, and must have a minimum of one year of home care experience. Application dead in JUNE 1, 2025. Scholarship checks are written to the school upon presentation of an invoice with a balance due to other costs directly related to educational expenses.

Home Care Applicant Narrative:

Your narrative is of primary importance in helping the selection committeee make their decision. You may use as much space and additional pieces of paper as needed to answer each of the following questions:

I would like to become a nurse or therapist OR I would like to further advance my nursing or therapy education because...

Describe how you will use your new or advanced education in nursing or therapy in your home care career.

Sponsor Narrative:

I am Nominating

Why I am Nominating

Sponsor Name

First Name

Last Name

Title

Agency

Email

Is the Applicant:

Full Time

Part Time

PRN

Date of Employment

MM

DD

YYYY

Current Position

Application Deadline: June 1, 2025