Note: This is not an application form Fill out and submit this form to connect with resources in the KP Nurse Scholars Academy. Thank you for your interest in furthering your education through the Kaiser Permanente Nurse Scholars Academy. The programs offered by the Nurse Scholars Academy are currently only for Kaiser Permanente employees from the NCAL region. Sign up today to receive more information on how to become a Kaiser Permanente Nurse Scholar. If you have any questions not directly related to the programs listed below, use the Comments box at the bottom to ask your questions.Personal InformationNUID*This is the same as your windows logon or your MyHR logon. One letter, followed by six numbers. Name* First Last Email* Enter Email Confirm Email Phone*May we text you at this number? Yes No Please provide a telephone number and/or email address that you check frequently, so we may reach you immediately when we have important updates!Work InformationKaiser Foundation Hospitals (KFH/HP) or Medical Group (TPMG)*Who pays your paycheck? Does the department that pays you fall under KFH/HP or TPMG? This is not necessarily the same as the location you work in. KFH/HP TPMG What Service Area do you work in?*Select the primary area where you are physically locatedCentral ValleyDiabloEast BayFresnoGSAA (Greater Southern Alameda Area)Marin/SonomaNapa/SolanoNorth Valley (Sacramento Area)Regional Offices NCALSan FranciscoSan JoseSan MateoSanta ClaraOther Region (not NCAL)What is your home facility?* Tell Us MoreI am interested in the following program(s)Select one or more of the available programs. RN to BSN Program at Samuel Merritt University Choice Program (for non-represented nurses) TPMG Choice Program (for non-represented nurses) MSN Program Nurse Residency Program Leadership for Executive Advancement & Development Nurse Executive Fellowship Program Professional Certification Program CommentsCommentsThis field is for validation purposes and should be left unchanged.