Applicant Checklist and Instructions for Submission
There are items that should be electronically submitted and others that will necessitate submission as hard copies. Please carefully follow these instructions.
Please complete and electronically submit these items to janet.jackson@ana.org :
(1) Completed Application Form
(2) Scientifically Based Essay
(3) Curriculum Vita
Documents that must be forwarded to MFP from individuals and institutions:
(4) Three Letters of Recommendation that are signed, sealed, and mailed to MFP by individuals completing the Recommendations
(5) Official Copy of sealed transcripts mailed from the institution(s) to MFP
Please complete and assemble in one package the following items:
(6) Signature and Social Security Form
(7) Copy of Active RN License
(8) Published Articles or Sample of Scholarly Writing
(9) Official Evidence of Admittance to PhD Program
(10) Copy of Permanent Residency Card or proof of U.S. Citizenship
[If Applicable].
(11) Copy of Current ANA Membership Card
MAIL TO:
SAMHSA Minority Fellowship Program
American Nurses Association
8515 Georgia Avenue, Suite 400
Silver Spring, MD 20910-3492
Attn: Janet Jackson, Program Manager
Fax: 301.628.5339
Phone: 301.628.5247