UnityPoint Health Grinnell Regional Medical Center Auxiliary Healthcare Career Scholarship

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Auxiliary UnityPint Health Grinnell Reginal Medical Center Auxiliary 2019-2020 Healthcare Career Schlarship The Auxiliary f Grinnell Reginal Medical Center, recgnizing the cntinuing need fr qualified healthcare prfessinals, annunces $2,000 wrth f schlarships t be awarded fr the 2019-2020 schl year. Prerequisites fr cnsideratin f schlarship applicants are: 1. These schlarships will be awarded t persns planning t pursue an educatin r further educatin in the healthcare field. 2. The applicant shuld be a permanent resident f the Grinnell Reginal Medical Center service area. 3. The applicant shuld be f high character and emtinal stability as attested by tw letters f recmmendatin frm the applicant s schl principal r guidance cunselr, a healthcare prfessinal, minister, emplyer r ther reputable persns in the applicant s cmmunity. 4. The applicant must cmplete an applicatin (including persnal statement-typed) and submit a letter f acceptance r prgress frm an academic institutin. 5. Recmmendatin frms may be included with the applicatin r sent directly t the Auxiliary Schlarship Cmmittee. 6. The Auxiliary Schlarship Cmmittee will review the applicatins and may, if pssible, arrange fr a persnal interview with the applicant. The selectin f schlarship recipients will be based n a cmbinatin f the applicant s desire fr a healthcare career, financial need, schlastic ability, and character. Cnditins f the Schlarship: These are ne-year schlarships t be used fr tuitin, bard, rm, bks and related expenses. Schlarship fund payments will be made upn receipt f prf f enrllment. Schlarship funds will be paid t the recipient in ne installment within the year f the grant, the date depending n the beginning f the recipient s classes fr each term r semester. If the recipient des nt enrll in schl, repayment is due the Auxiliary. If recipient withdraws frm schl, part r all f the schlarship mney is refunded. That mney shall be due the Auxiliary. The schlarship is an utright grant, nt a lan. Applicatins and letters f recmmendatins must be received by Friday, March 15, 2019, t be eligible fr 2019-2020 schlarship cnsideratin. Incmplete r late applicatins will nt be cnsidered. Review the checklist abve Sectin A befre submitting yur applicatin. Fr additinal infrmatin, cntact: Cara Kenkel, 641-236-2043 r cara.kenkel@unitypint.rg

Please cmplete all parts f this applicatin where applicable. Check sectin B OR C nly, nt bth. Cmpleted Sectin Descriptin A Applicant infrmatin. B C D E F T be filled ut by applicant wh is entering cllege frm high schl r wh is financially dependent. T be filled ut by applicant wh is a returning student r an adult cntinuing his/her educatin. A shrt essay (200 wrds r less) describing why yu chse t majr in a healthcare field f study, and what yu hpe t accmplish with yur degree. Yur reasn fr wanting and needing this schlarship. Why yu hpe t win this schlarship frm the Auxiliary; What this gift wuld mean t yu financially; and Hw it will help yu accmplish yur gals? Have tw Schlarship Recmmendatin frms cmpleted and returned t Vlunteer Crdinatr, Schlarship Cmmittee by March 15, 2019. Return this applicatin by Friday, March 15, 2019 t: GRMC Auxiliary Schlarship Cmmittee c/ Cara Kenkel 210 Furth Avenue Grinnell, Iwa 50112 Sectin A: Applicant Infrmatin Applicant s Name: Hme Phne: Email: High Schl: GPA: Graduatin Date: Cell Phne: Cllege Chice: GPA: Majr: Ttal annual prjected financial needs fr the schl year (include tuitin, rm, bard, bks etc.): $ G Letter f acceptance by the cllege. 01 Applicant Infrmatin

Sectin B: Dependent Applicatin T be filled ut by applicant entering cllege frm high schl r wh is financially dependent n parent/caregiver/guardian. Father s/guardian s Name: Hme Phne: Cell Phne: Emplyment: Phne: Mther s/guardian s Name: Hme Phne: Cell Phne: Emplyment: Phne: Name and ages f siblings/ther dependents living under same rf: Hw many dependents are parents supprting in cllege? Parent s incme per year: (please check ne) $15,000-$25,000 $25,001-$35,000 $35,001-$50,000 $50,001-$80,000 Were yu a dependent n yur parent s current incme tax filing? Yes N Applicant s incme per year if abve answer is N. $5,000-$15,000 $15,001-$25,000 $25,001-$30,000+ Please list leadership rles, cmmunity invlvement, memberships, and hnrs yu have received: Please include any ther things abut yurself that may be f interest t the selectin cmmittee, such as internships r additinal experiences yu have had. 02 Dependent Applicatin

Sectin C: Returning Student/Adult Applicatin T be filled ut by applicant wh is a returning student r an adult cntinuing his/her educatin. APPLICANT S EMPLOYMENT HISTORY Current Emplyer Address Phne Number Years Previus Emplyers Spuse s Name (if applicable): Hme Phne: Cell Phne: Emplyment: Phne: Name and relatinship f dependents living under same rf: Ttal family incme per year: (please check ne) $15,000-$25,000 $25,001-$35,000 $35,001-$50,000 $50,001-$80,000 Please list leadership rles, cmmunity invlvement, memberships and hnrs yu have received. Please include any ther things abut yurself that may be f interest t the selectin cmmittee, such as internships r additinal experiences yu have had. 03 Returning/Adult Applicatin

Sectin D A typed essay (200 wrds r less) describing: Why yu chse t majr in a healthcare field f study, and what yu hpe t accmplish with yur degree? 04 Essay

Sectin E A typed essay (200 wrds r less) describing: Why yu hpe t win this schlarship frm the Auxiliary; what this gift wuld mean t yu financially; and hw it will help yu accmplish yur gals? 05 Essay

Sectin F: Schlarship Recmmendatins Character References: It is the respnsibility f the applicant t ensure the schlarship cmmittee receives the references frm the fllwing persns. Please list belw the persns yu have asked t make a schlarship recmmendatin n yur behalf. Name: Cmpany: Phne: Name: Cmpany: Phne: 06 Schlarship Recmmendatin

Sectin F: Schlarship Recmmendatins Grinnell Reginal Medical Center Auxiliary 2019-2020 Schlarship Recmmendatin Name f applicant: Name: Address: Phne: Date: Signature: Applicatin deadline is March 15, 2019. Please return yur recmmendatin t the applicant r mail direct t: GRMC Auxiliary Schlarship Cmmittee c/ Cara Kenkel Grinnell Reginal Medical Center 210 Furth Avenue Grinnell, IA 50112 r email: cara.kenkel@unitypint.rg 07 Schlarship Recmmendatin

Sectin F: Schlarship Recmmendatins Grinnell Reginal Medical Center Auxiliary 2019-2020 Schlarship Recmmendatin Name f applicant: Name: Address: Phne: ( ) Date: Signature: Applicatin deadline is March 15, 2019. Please return yur recmmendatin t the applicant r mail direct t: GRMC Auxiliary Schlarship Cmmittee c/ Cara Kenkel Grinnell Reginal Medical Center 210 Furth Avenue Grinnell, IA 50112 08 Schlarship Recmmendatin