Confirmation of Interest Form

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

Nurse Corps (NC) Scholarship
Program (SP)
Confirmation of Interest (COI) User Guide
July 2022

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide
CONTENTS
Part 1 | Introduction......................................................................................................................................................4
NC SP Confirmation of Interest User Guide .............................................................................................................4
Part 2 | Applicant Confirms Interest and Accepts Award ..............................................................................................4
Welcome Screen .......................................................................................................................................................4
Steps ......................................................................................................................................................................4
Business Rules .......................................................................................................................................................5
Review Screen – Contact Information ......................................................................................................................5
Steps ......................................................................................................................................................................5
Business Rules .......................................................................................................................................................6
Review Screen – School Information ........................................................................................................................6
Steps ......................................................................................................................................................................6
Business Rules .......................................................................................................................................................6
Review Screen – Confirm Interest ............................................................................................................................7
Steps ......................................................................................................................................................................7
Business Rules .......................................................................................................................................................7
Review Screen – Banking Information .....................................................................................................................8
Steps ......................................................................................................................................................................8
Business Rules .......................................................................................................................................................8
Documents Screen ....................................................................................................................................................9
Steps ......................................................................................................................................................................9
Business Rules .....................................................................................................................................................10
Tax Withholdings Screen ........................................................................................................................................10
Steps ....................................................................................................................................................................11
Business Rules .....................................................................................................................................................12
Sign Contract Screen ...............................................................................................................................................13
Steps ....................................................................................................................................................................13
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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide
Business Rules .....................................................................................................................................................15
Part 3 | Applicant Declines Interest.............................................................................................................................16
Decline COI – Review Screen ..................................................................................................................................16
Steps ....................................................................................................................................................................16
Business Rules .....................................................................................................................................................17
Decline COI – Sign Contract Screen ........................................................................................................................17
Steps ....................................................................................................................................................................17
Business Rules .....................................................................................................................................................18

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

PART 1 | INTRODUCTION
NC SP CONFIRMATION OF INTEREST USER GUIDE
Purpose: The Nurse Corps (NC) Scholarship Program (SP) Confirmation of Interest (COI) user guide serves as the
main guide to answer analyst questions regarding issues applicants may face when completing their COI Process. In
addition to this user guide, applicants must be familiar with the NC SP Application Program & Guidance, as some of
the questions will be program based and will not be discussed in this user guide. The primary intent of this user
guide is to focus on the functionality developed for the NC SP COI.
Roles: There are no roles associated with the NC SP online application. The Confirmation of Interest (COI) is on the
applicant portal, and is only accessible to applicants that have been offered an award. Program will not have roles
or accounts for these screens.
Precondition: The applicant must be offered an Award and sent a Confirmation of Interest (COI).

PART 2 | APPLICANT CONFIRMS INTEREST AND ACCEPTS AWARD
WELCOME SCREEN
After application review and external review are complete, Program selects applicants to award and sends these
individuals the Confirmation of Interest (COI) email. The email provides the selected applicants a link to the portal
notifying them that there has been an update to their application. The applicant will need to log into his/her
application to view and complete the COI. The first page of COI is the Welcome Screen.

STEPS
1.
2.
3.
4.
5.

Applicant receives their Confirmation of Interest email.
Applicant logs into NC SP Application Portal.
Applicant is directed to the COI Welcome Screen.
Applicant reviews Welcome Screen content.
Applicant clicks “Start COI”.

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

BUSINESS RULES
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Applicants will have the ability to view the left-hand navigation.
o The Welcome screen will be enabled in the left-hand navigation.
o All additional screens will be disabled in the left-hand navigation until the current screen is
completed.
Applicants have the ability to view their application status.
Applicants have the ability to download their submitted application (PDF).
Applicants have the ability to view the Paperwork Reduction Act Public Burden Statement.
Applicants must complete all COI screens in one sitting. They will be directed to the Welcome screen each
time they open COI.

REVIEW SCREEN – CONTACT INFORMATION
The applicant will need to ensure that their contact information is up to date. NC SP uses the primary email
address to communicate application status changes and requests for additional information needed.

STEPS
1.
2.

Applicant clicks on the “Account Settings” link to navigate to the page and confirm their information. They
can make changes to the fields on this page if necessary.
Applicant clicks “Continue”.

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

BUSINESS RULES
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Applicant can make updates to account settings if necessary.

REVIEW SCREEN – SCHOOL INFORMATION
Applicants verify whether there are changes to the school the NC SP program expects them to attend.

STEPS
1.
2.

Applicant reviews the school listed as the Verified School.
Applicant responds to question regarding whether there is a change to the school listed in Step 1.
a. If an applicant has questions they may contact NC SP via email.

BUSINESS RULES
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Applicant sees name of school verified by analyst

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide
o

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Note: Analysts have the ability to update the school after the applicant’s submission during
application during review.
Applicant can respond to indicate whether there is a change to the school listed. However, the applicant
cannot directly make any updates to the school listed.

REVIEW SCREEN – CONFIRM INTEREST
The Confirm Interest card is where the applicant indicates their intention to either accept or decline the NC SP
Award.

STEPS
1.
2.

Applicant reviews statements.
Applicant selects response indicating their decision to either:
a. Confirm intention to accept award by clicking “I wish to be considered for the 2022 Nurse Corps
Scholarship Program Award.”
b. Decline their award by clicking “I am no longer interested in receiving the 2022 Nurse Corps
Scholarship Program award”.

BUSINESS RULES
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If applicant confirms their interest, the system will display the Banking Information card next
If applicant declines their interest, the Decline COI card is displayed (see Part 3: Applicant Declines
Interest).
The alert will notify the user of the date and time the COI expires.
o Important: The applicant is required to complete COI by the expiration date to continue to be
considered for an award.

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

REVIEW SCREEN – BANKING INFORMATION
On the Banking Information card the Applicant designates the account where funds from their award should be
deposited. Note: While the applicant indicates where they should receive the funds, they are not guaranteed an
award at this point.

STEPS
1.
2.
3.
4.
5.

Applicant enters the Bank Name.
Applicant selects the Account Type.
Applicant enters and confirms his/her bank’s Routing number.
Applicant enters and confirms his/her bank’s Account number
Applicant clicks Submit.

BUSINESS RULES
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Routing #’s must be:
o 9 digits
o Start with 0, 1, 2, or 3 digit.
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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide
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Applicant is required to complete all fields.
The Routing Number and Re-enter Routing number fields must match.
The Account Number and Re-enter Account number fields must match.

DOCUMENTS SCREEN
The Documents screen prompts the applicant to upload completed Enrollment Verification Form(s) for program to
review.

STEPS
1.
2.
3.
4.
5.
6.
7.

Applicant clicks “Select or Drop File Here” button or drags file to this button to begin upload process
Applicant selects document they want to upload using file explorer. This step is skipped if they dragged
the file into the box in Step 1.
Applicant selects the document type for the file upload
Applicant can enter an optional comment if desired
Applicant and clicks “Upload”
Applicant verifies file uploaded
Applicant clicks Continue to proceed to next screen.

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

BUSINESS RULES
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Applicants are required to upload a completed Fall Enrollment Verification form
Applicants should upload a completed Summer Enrollment Verification form if this term is required for
their program and they are requesting funding for it
System shall allow Applicant to remove document(s) they have previously uploaded

TAX WITHHOLDINGS SCREEN
The Tax Withholdings screen allows the applicant to provide their W4 tax information via the Electronic
Withholding Allowance Certificate. Applicants will verify the accuracy of their tax information and electronically
sign their certificate.
Applicants must indicate whether they wish to receive their tax documents electronically or by mail.
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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

STEPS
1.
2.
3.
4.
5.
6.

7.

Applicant reads the instructions and clicks Continue.
Applicant inputs their tax information (W4 Form information) on the Electronic Withholding Allowance
Certificate.
Applicant certifies that they have verified their tax information and declare that it is accurate to their
knowledge.
Applicant inputs their signature information.
Applicant reads Tax Document agreement
Applicant makes selection indicating their tax document delivery preference
a. Electronically via BHW portal account
b. By Mail
Applicant must click “Sign and Continue” to continue to the next section

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

BUSINESS RULES
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Applicants are required to input their tax withholding information. The following fields are included on
the form:
o Filing Status
o Exactly Two Jobs (Optional)
o Amount Claimed for Dependents (Optional)
o Other Income (Optional)
o Deductions (Optional)
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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

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o Extra Withholding Amount (Optional)
o Tax Exemp status
Applicants are required to certify they have provided correct tax withholding information.
After self-certification, applicants will be required to enter the following information, which will qualify as
signing the contract:
o SSN
o Confirm SSN
o Security Question
o Security answer
o Password
The SSN and Confirm SSN numbers must match for the applicant to sign. The SSN entered by the applicant
must also match the SSN used upon application submission.
o If the SSN entered on COI does not match the SSN entered on the application, the applicant can
either re-enter the SSN on COI, or contact the Call Center to reach out to Program if they believe
the SSN they have entered on COI is correct, and the SSN they had entered on their application is
incorrect
The system will generate and store an electronically signed electronic federal tax withholdings document
(W4) to the applicant profile upon full submission of the COI.
Once the applicant is converted to a participant, the PDF export of the W4 form information will be
accessible from the Participant profile, Tax information tab.
If the applicant does not complete the COI, or is deemed ineligible, the tax selections will not be saved.

SIGN CONTRACT SCREEN
The Sign Contract screen is the final step of the applicant’s COI process. The applicant will download the contract,
self-certify that they have read the contract, and electronically sign the contract. Note: The applicant’s signature
only indicates their agreement, and the contract still needs to be countersigned by the NC SP program.

STEPS

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide
1.
2.
3.

4.

5.

Applicant downloads their NC SP contract for review.
Applicant confirms or updates Years of Funding Requested.
Applicant completes the self-certification question.
a. If applicant declines certification by answering “No”, the Decline COI card is displayed (see Part 3:
Applicant Declines Interest).
After self-certification, applicants will be required to enter the following information, which will qualify as
signing the contract:
a. SSN
b. Confirm SSN
c. Security answer
d. Password
Applicant selects Submit.

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide
6.

System displays Accepted Award landing page.

BUSINESS RULES
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Applicants are required to confirm the number of Years of Funding Requested
Applicants are required to certify that they have read the contract and agree to the statements.

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide
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If the applicant indicates “No” to having read the contract, they will be directed to the Ineligible landing
page upon selecting Sign and Submit
If the applicant indicates “Yes” to having read the contract, they will be required to enter the following
information, which will qualify as signing the contract:
o SSN
o Confirm SSN
o Security answer
o Password
The SSN and Confirm SSN numbers must match for the applicant to sign. The SSN entered by the applicant
must also match the SSN used upon application submission.
o If the SSN entered on COI does not match the SSN entered on the application, the applicant can
either re-enter the SSN on COI, or contact the Call Center to reach out to Program if they believe
the SSN they have entered on COI is correct, and the SSN they had entered on their application is
incorrect.
Accepted Award landing page will display a link to applicant’s submitted application
Applicants have the ability to view their application status from the Accepted Award landing page.
Applicants have the ability to download their submitted application (PDF) from the Accepted Award
landing page.
Applicants have the ability to download their signed contract from the Accepted Award landing page.

PART 3 | APPLICANT DECLINES INTEREST
The previous sections outlined the steps taken if the applicant accepts COI and the offer for an award. This section
details the two steps an applicant can take to decline their award.

DECLINE COI – REVIEW SCREEN
The first opportunity to decline COI is on the Review screen on the Confirm Interest card. The user will complete
COI with decision to decline their award if they respond that they decline or do not accept the certification
statements. Upon declining, the applicant will be directed to the Declined Award landing page.

STEPS
1.
2.
3.
4.
5.
6.

Applicant completes the Welcome Screen and is taken to the Review Screen.
Applicant completes Steps 1-3 on the Review Screen.
Applicant selects “I am no longer interested…” and sees the Decline COI card.
Applicant enters reason why he/she is declining award.
Applicant selects Decline.
Applicant is navigated to the Declined Award landing page.

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

BUSINESS RULES
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

Once COI is declined, the COI process will end and the system updates applicant’s external and internal
status to Declined Award.
Applicants have the ability to download their submitted application (PDF) from the Declined Award
landing page.

DECLINE COI – SIGN CONTRACT SCREEN
The second opportunity to decline COI is on the Sign Contract screen, certification question. The user will end their
COI process here if they choose to decline and will be navigated to the Declined Award landing page.

STEPS
1.
2.
3.
4.
5.
6.
7.

Applicant completes the Welcome Screen and is taken to the Review Screen.
Applicant completes Steps 1-4 on the Review Screen.
Applicant completes and signs the Tax Withholdings screen.
Applicant selects “No” to the self-certification question on the Sign Contract screen.
Applicant enters reason why he/she is declining award.
Applicant selects Decline.
Applicant is navigated to the Declined Award landing page.

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Bureau of Health Workforce
NC SP Confirmation of Interest (COI) User Guide

BUSINESS RULES
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Once Applicants Decline, they complete the COI process and the system updates applicant’s external and
internal status to Declined Award.
Applicants can download the PDF export of their submitted application from the Declined Award landing
page.

Public Burden Statement: The purpose of the Nurse Corps Scholarship Program (Nurse Corps SP) is to provide scholarships to nursing students in exchange for a minimum
two-year full-time service commitment (or part-time equivalent), at an eligible health care facility with a critical shortage of nurses. The information that applicants supply is used
to evaluate their eligibility, qualifications and to assess their continued compliance with the applicable standards for participation in the Nurse Corps SP. The OMB control
number for this information collection is 0915-0301 and it is valid until xx/xx/xx. This information collection is required to obtain a benefit (Section 846(d) of the Public Health
Service Act (42 United States Code 297n (d)), as amended). Data will be private to the extent permitted by the law. Public reporting burden for this collection of information is
estimated to average approximately 36 minutes per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the
collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to
HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14NWH04, Rockville, Maryland, 20857.
Form Approved| OMB No. 0915-0301| Expires xx/xx/xxxx

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