Application for Nursing Incentives Scholarship Program

The deadline to apply for the Summer 2024 semester/quarter scholarship is May 31st. The deadline to apply for the Fall 2024 semester/quarter scholarship is July 30^th. Please email dhhs.nursingscholarship@nebraska.gov with any questions or concerns.

The American Rescue Plan Act (ARPA) granted $5,000,000 to Nebraska DHHS to distribute in the form of scholarships to eligible Nebraska nursing students in approved nursing programs up to $5,000/semester or $3,500/quarter. This scholarship will fulfill two primary goals: to reduce barriers to entry in the nursing field and to grow Nebraska's public health workforce. Upon completion of their nursing programs, these students will be obligated to practice nursing in Nebraska for a minimum of two years. Each of these students will play a vital supporting role in rebuilding Nebraska's public health infrastructure and will advance the state's recovery from COVID-induced nursing shortages.

Any Nebraska resident currently enrolled or intending to enroll in a Nebraskan LPN, ADN, accelerated BSN, or traditional BSN program is eligible to apply. These scholarships will be distributed on a first-come, first-served basis to qualified applicants. Please complete the application below to determine your eligibility. You will enter your personal information, demographic information, and nursing program information. You will also be required to attach proof of enrollment as well as complete the W9/ACH Banking Enrollment form. See https://dhhs.ne.gov/Pages/Nursing-Incentives-Scholarship-Program.aspx for information about eligibility, the scholarship terms, and the disbursement process.

First Name:
Middle Name:
Last Name:
Maiden name:
Date of birth:

Email address:
Phone number:
Address:
City:
State:
Zip code:

Race:
Ethnicity:
Gender:

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Nursing program name:
Nursing program location:
Does your program operate in semesters or quarters?
Student identification number:
Have you finished all program pre-requisites?
Degree being pursued:
State date in program:
Anticipated graduation date:
Remaining ______s:
Full or part time:
Credit hours per ______:
Does the ______ tuition exceed ______?

You will need to upload documentation from your school indicating your name and proof of enrollment for the current ______. Document should clearly specify that you are enrolled for the coming ______ in an LPN, ADN, or accelerated BSN program.

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Please click on this link to open W-9 & ACH enrollment form:

W9/ACH Enrollment Form

To complete the W9/ACH form, you will need to download the file, fill it out digitally with your personal banking information, then upload the completed version. You can also print it out, complete it by hand, and upload a scan or clear picture. Please ensure that your ACH form has both necessary signatures, one in the middle and one in the bottom left. Please merge your W9/ACH form and banking verification into one file before you upload it to the application. The banking verification must include your name, your bank's name, and your full routing and account numbers.

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Nebraska Resident Attestation

I attest as follows:

United States Citizenship Attestation Form

For the purpose of complying with Neb Rev. Stat. SS 4-108 through 4-114, I attest as follows:

I understand that this form will determine my eligibility for this scholarship. This scholarship is up to $5,000 a semester or $3,500 a quarter and if semester or quarter fees are less than $5,000 or $3,500, respectively, it will pay the amount in full. I understand that to receive funds each ______, I will be required to submit proof of enrollment each ______. I attest that I will practice in Nebraska for at least two years after completing school. Throughout these two years I will be required to provide proof of employment at DHHS' request. I understand that failure to practice in Nebraska for at least two years after graduation means that I will be required to repay the full scholarship amount.

I hereby attest that my response and the information provided on this form and any related application for public benefits are true, complete, and accurate and I understand that this information may be used to verify my lawful presence in the United States.

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