SCHOLARSHIP APPLICATION, 2019-2020 ACADEMIC YEAR ...

GADSDEN REGIONAL MEDICAL CENTER VOLUNTEERS SCHOLARSHIP APPLICATION, 2019-2020 ACADEMIC YEAR

(Medical Field Majors ONLY)

Send application/transcripts/essay to: GRMC VOLUNTEERS, Attn: Jenna Mullins, 1007 Goodyear Ave., Gadsden, AL 35903

FULL LEGAL NAME: ____________________________________________________

MAILING ADDRESS: _____________________________________________________

TELEPHONE NUMBER: _________________________________________________

DATE OF BIRTH: ____ /____ /____

SOC. SEC. NO.: _____ - _____ - _____

HIGH SCHOOL: ____________________________________________ GRADE POINT AVERAGE UPON HIGH SCHOOL GRADUATION: ______________ ACT or SAT SCORE (if applicable): __________________

FIELD OF STUDY: _____________________________________________ COLLEGE GRADE POINT AVERAGE (if applicable): _______________

MARITAL STATUS: _________________________________ NUMBER OF CHILDREN (if applicable): ______________ PLACE OF EMPLOYMENT (if applicable): ____________________________________ LENGTH OF EMPLOYMENT (if applicable): __________________________________ PLEASE LIST ANY HONORS, AWARDS, CLUB MEMBERSHIPS, ETC., YOU HAVE RECEIVED: ________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________

Please attach high school and/or college transcripts to this application. Unofficial copies will be accepted. Please attach a 1,500-word or less essay about your career goals.

SIGNATURE: ______________________________

DATE: _______________

Application packets must be postmarked by APRIL 12, 2019

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