Memorial Fund Scholarship Application

About the Memorial FundThe Winchester Medical Center Auxiliary Memorial Fund was established as an endowment to provide merit awards to individuals pursuing advanced training and degrees in nursing and healthcare curriculums. Awards are based on outstanding achievement, scholarship, career choice, quality recommendations, and financial need.

To QualifyTo qualify for a Winchester Medical Center Auxiliary Memorial Fund Scholarship you must:

• Have a grade point average of B (3.0 out of 4.0 scale) or better. Please indicate your school’s grading scale

• Be a local resident or attend a local school

• Have successfully completed your first year of the program

• Be accepted into an accredited healthcare career program; such programs may include but are not limit-ed to: Nursing, Doctor of Medicine, Pharmacy, Physical/Occupational Therapy, Physician Assistant, Healthcare Management, Cardiac Technology, Surgical Technology, Radiology Technology

• Employees or volunteers of Winchester Medical Center receive special consideration

To ApplyComplete the application form in this brochure. Additional forms are available on the Valley Health website (www.valleyhealthlink.com); in the Winchester Medical Center Volunteer Office; and in your school’s career center.

Return the completed application by April 1 to:Jenny Powers

1389 Apple Pie Ridge RoadWinchester, VA 22603

Applications received after April 1 will not be considered for awards.

About Winchester Medical

Center Auxiliary

The mission of the Winchester Medical Center Auxiliary shall be to serve as an extension of Winchester Medical Center in the promotion and improvement of the general health of the community through education, service and goodwill.

Auxiliary ProjectsAnimal Assisted Therapy

Auxiliary AtticBenefit Golf Classic Hostess Committee

Breakfast with SantaChildren’s Resources

Clothes ClosetGift Shops

Helping HandsHurst Hospitality House

Lights of LoveMemorial FundWilliam the Cat

WiNCHESTER MEDiCAL CENTER AuxiLiARy

For more information, call WMC Volunteer Services at 540-536-8156.

What to include with your application:• A statement with your reasons for applying for the

scholarship along with your career goals. (if you are a re-applicant, please also state the year(s) and the amount of each award.);

• your work resume and the name of your current immediate supervisor or employer;

• At least two letters of recommendation. One must be from a professor or instructor at your school. One must be from your immediate supervisor or employer. if you are not employed, you may include a letter from another professor or a character reference from a non-relative;

• A letter of acceptance from an accredited college, school or university in your healthcare career program;

• An official college transcript;

• A list of personal, local, state, or national awards that you have received;

• A list of sources of your financial support, such as outstanding loans, other scholarships, grants and aid;

• A copy of your entire current Federal Student Aid report (FAFSA). This copy must include your EFC# that is assigned to your financial summary by the government. The entire FAFSA application with the assigned EFC# must be a part of this application to be considered. Download the application at www.fafsa.ed.gov.

In the event that this application is incomplete, consideration will be denied.

High School Student Information: Graduating high school students just entering college or programs are not eligible for Memorial Fund Scholarships. if you are entering a nursing curriculum straight from high school, please contact your guidance department for information on the Auxiliary’s $500 Nursing Scholarship that is awarded to one student from each of the five area high schools.

i certify that all the statements made in this application are true, complete and correct to my knowledge and belief.

__________________________________________ APPLiCANT’S SiGNATuRE

__________________________________________DATE

__________________________________________COLLEGE OR uNiVERSiTy

Student iD# _________________________________

EFC# ______________________________________

Memorial Fund ScholarShip application

__________________________________________NAME Last First Middle__________________________________________ADDRESS__________________________________________TELEPHONE__________________________________________EMAiL

Male Female ________________________ DATE OF BiRTH______________________ __________________SOCiAL SECuRiTy NuMBER STuDENT iD#

Marital Status: Married Single Divorced

Do you have any children? yes No if yes, how many? ____ Are any of them in college? ____

Are you a u.S. citizen? yes No

Please list all prior schools attended__________________________________________NAME

__________________________________________ADDRESS_____________ ____________________________DATE OF GRADuATiON DEGREE AWARDED

Name the college or school into which you have been accepted into a healthcare curriculum__________________________________________

__________________________________________ADDRESS__________________________________________PHONE NuMBER

When do you anticipate graduating from this program? __________________________________________

How many hours, if any, have you completed towards this degree? ____________________________________

What is your current GPA?_______________________

Anticipated annual costs at that college/program: _______

is your family helping you financially? yes No your EFC# is: _______________________________