Benevolence Grant Application

ALL INFORMATION CONFIDENTIAL

Applications must be received by July 24, 2017. Please ensure to complete this form in its entirety. Returning to this form to complete it at a later time will not save your changes.

Through fund raising efforts, CSNN has a modest amount of funding for need based assistance with a preference to non-Journal-listed Christian Science nurses. Funds may be requested for: 1) CedarS Plan A Housing, 2) travel or 3) ICSNC fee.

Receipt of any funding from CSNN is with the expectation that the recipient will to be housed in Plan A Housing (cabins) at CedarS, attend all sessions of the conference and send a post-conference letter of gratitude to CSNN that may be shared with those donors who have provided these invaluable contributions. Any letters we share will have identifying information removed.

Application Instructions: Fully complete each question. Submit by July 24, 2017.

For questions about the conference, please contact Esther Joscelyn via email at: eljoscelyn@csnnetwork.org.

Contact Information
First Name: 
Last Name: 
Address: 
City: 
 
State: 
Zip/Postal Code: 
Country: 
Telephone (area code first): 
Email Address: 
 
I am requesting assistance with:
Housing $  (Only Plan A Housing of $275 will be considered)
Travel $  (In US Dollars – reimbursed by check or PayPal - receipts required)
Conference Fee $  ($300 Maximum)
 
Will you receive other assistance for this conference? If yes, please list source and amount ($) below.
 
1). Briefly tell us about your Christian Science nursing practice. How many hours per month are you actively Christian Science nursing?
 
2). If you are a member of a Branch Church/Society please share where and how you are serving
 
3). In regard to the blessings of attendance, please share what you hope to give and to receive at the conference.
 
4). Briefly, describe your reasons for applying to CSNN for assistance.
 

Please supply information about a reference we may contact that is a Journal-listed Christian Science nurse:

Reference Name: 
Reference Phone Number: 
Reference Email: 
Reference City, State, Country : 
 

By submitting this application, I accept and will adhere to the following:

  1. I shall not discuss the details of this application with anyone other than a member of the CSNN Board.
  2. I will NOT disclose the amount(s) I was granted.

Signature:  
 

Fully complete each question and submit so received by: July 24, 2017

 

The CSNN Board will meet shortly after the benevolence submission cut off date of July 24th. Applicants will be notified beginning July 31st.