The CNO Institute™

Application

Complete this application form and, if applying for a scholarship, please include a letter from your organization indicating the financial support they can provide.

Scholarships are awarded on a rolling basis, so early submissions are encouraged.

I am applying for admission to the following program:
Name Name First Last
Please tell us your credentials
What is the name of the Organization you currently work for?
What is your title?
Please confirm which category best describes which requirement for attendance you meet:

Please confirm which category best describes which requirement for attendance you meet: New CNO less than 3 years of experience Experienced CNO Assistant CNO Currently in a director role or higher and aspire to be a CNO
What is the title of the person you report to?
How many FTEs do you manage?
How many beds does your organization have?
Work Email
Personal Email
Phone Phone - ### - ### ####
What is your business mailing address of your organization? What is your business mailing address of your organization?
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
What is your current gender identity? (Check all that apply)

What is your current gender identity? (Check all that apply) Male Female Non-binary I prefer not to say Different identity (please state) Different identity (please state)
What age category are you in?

What age category are you in? 18-30 31-40 41-50 51-60 61-70 70+ Prefer not to say
Which group do you identify with?
Note: The term Hispanic or Latino or Spanish Origin is defined as a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.)

Which group do you identify with?
Note: The term Hispanic or Latino or Spanish Origin is defined as a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.) American Indian or Alaskan Native Asian or Pacific Islander Black or African American Hispanic or Latino or Spanish Origin of any race White, non-Hispanic Race and Ethnicity unknown Other Other
Do you have any of the follow national Specialty certifications?

Do you have any of the follow national Specialty certifications? Administrative/Leadership Clinical Both Administrative/Leadership and Clinical None
What is the highest level of nursing education that you have achieved?

What is the highest level of nursing education that you have achieved? Associate Degree Bachelor’s degree Master’s degree Doctoral degree I prefer not to say
Do you hold an MBA?

Do you hold an MBA? Yes No
Location of employing organization

Location of employing organization Urban Rural Suburban
Length of time in current role

Length of time in current role 1 month -1 year 13 months – under 3 years 3- under 5 years 5- under 7 years 7- under10 years 10 plus
Name of person who referred you. (How did you hear about us?)
Please tell us why you would like to attend The CNO Institute by TNLI.
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Scholarship Support

At The Nurses Legacy Institute, we believe the most meaningful leadership development happens when the room reflects the richness and complexity of today’s healthcare landscape. That’s why we’re committed to making this experience accessible to those who might not otherwise have the opportunity to attend. To help remove financial barriers, we are proud to offer several levels of scholarship support designed to ensure that cost is not a limiting factor for participation.

Applicants are eligible to apply for scholarship support if they meet one or more of the following criteria:

1. Currently serve in a nurse leadership role or are on the pathway to becoming a Chief Nursing Officer (CNO).

2. Work in a rural hospital, community health setting, or for an organization with limited financial capacity to support professional development.

3.Bring a background or perspective that is not often well-represented in traditional leadership development settings.
Please select the option that best reflects how your participation would be funded. You may select more than one (i.e. your organization can help pay but you also would like to apply for a scholarship for additional support):

Please select the option that best reflects how your participation would be funded. You may select more than one (i.e. your organization can help pay but you also would like to apply for a scholarship for additional support): My organization will fund my registration I will self-fund my registration I am requesting a full or partial scholarship
Scholarship Award Information

Scholarships apply to program registration only. Travel and hotel expenses are the responsibility of the participant or their organization. TNLI will begin notifying applicants of their acceptance and/or scholarship status via email in two months prior to each event.
PLEASE NOTE: If you're applying for a full or partial scholarship, please include a letter from your organization indicating what financial support, if any, they can provide.

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Questions

Please contact:
events@thenurseslegacyinstitute.org

The CNO Institute™

The CNO Institute™

Application

Scholarship Support

Scholarship Award Information

Questions