Healthcare Scholarship Application 2025

Please complete each section of this form; Administrative Information; School Activities, Recognitions and Awards; Community Involvement; Work Experience; and Essay Submission. If something is not applicable indicate by entering N/A.

APPLICATION DEADLINE - MONDAY APRIL 1, 2025

For Chamber Use _ Applicant's ID

Submission Date *

Format: M/d/yyyy

Current School Attending *

ADMINISTRATIVE INFORMATION

First Name *

Last Name *

Address Line 1

Address Line 2

City

Zip/Postal Code

Field of Study *

Do you plan to attend a Michigan or Wisconsin college?

Yes No

*Please note this is a requirement for scholarship consideration.

ACTIVITIES, RECOGNITIONS and AWARDS

Please list below all ACTIVITIES, RECOGNITIONS and AWARDS beginning with 9th grade.

Please add the years participated in these activities.

COMMUNITY INVOLVEMENT

Please list community activities in which you have participated and note major accomplishments in each. Example Church groups, volunteer groups or community efforts.

Please add the years participated in these community activities.

WORK RELATED EXPERIENCE

Please list below all WORK RELATED EXPERIENCE

Employer Name, duties performed, length of employment.

Are you currently attending college or plan to return to college?

Yes No

Please list college attended and course of study

ESSAY SUBMISSION UPLOAD *

Why I have chosen healthcare as my field of study; Medical personnel are needed in our area, and around the world. Why have you chosen a field of study in the medical field and what impact do you feel you can make for the future of healthcare.

Transcripts UPLOAD *

Please upload High School and/or College transcript

APPLICATION DEADLINE - MONDAY APRIL 1, 2025

Healthcare Scholarship Application 2025

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