Application must be postmarked by Wednesday, March 31
Auxiliary
to the Charleston
County
Medical,
Dental and Pharmaceutical Association
2010 SCHOLARSHIP PROGRAM
The Auxiliary
to the Charleston County Medical, Dental and Pharmaceutical Association is
committed to creating and reinforcing the importance of an inclusive, creative
and productive health care environment. The purpose of the scholarship program is to encourage and reward
academic excellence to a Medical, Dental or Pharmacy student. This
scholarship will help defray educational expenses to students by providing a $1,000
scholarship.
To be
eligible, students must be a medical, dental or pharmacy student whose
background or experience would otherwise contribute to the diversity. In
accordance with the scholarship criteria, you must be enrolled full time for
the academic year of 2010-2011.
Applicants
should be aware that any information provided in this application may be
subject to verification the scholarship committee. Also, each scholarship
recipient’s name and school may be published on our website, in our recruiting
materials, in marketing materials or in press releases. Your signature on the
application provides consent to such publication. All information provided in
connection with this application will be kept strictly confidential and will be
used only for purposes related to your consideration for the scholarship.
Criteria
Applicants
must have an overall GPA of 2.75 or above.
Applicants
must be an African American student enrolled in the College of Medicine,
Dentistry, Pharmacy, or Nursing.
Applicants
must apply yearly to be eligible for the annual $1,000.00 scholarship award.
General Information
Scholarships
are awarded for the regular academic year and are not available in the summer.
Students
selected for scholarships must be enrolled at the Medical University of South
Carolina as a full-time student.
The
Scholarship Committee welcomes letter of recommendation from any of the MUSC
staff or faculty.
This
application must be received by March 31,
2010.
2010 SCHOLARSHIP
APPLICATION
Personal
Information
Name:
________________________________________________________________________________
Current Address:
_______________________________________________________________________
Daytime Phone:
__________________________Evening Phone:
___________ Date of Birth ________________
Marital Status:
Single___________Married_____________Number of Dependents____________
Spouse’s
Occupation______________________________________________________________________
Father’s
Occupation________________________Mother’s Occupation___________________________
Cell Phone:
_____________________________________
E-mail Address: ________________________
Education
Name of
College(s)
Attended and
Address
Years of
Attendance
Degree
Diploma
_____________________________________________________________________________________
_____________________________________________________________________________________
Graduate School(s), if applicable:
___________________________________________________________
Name any scholastic awards and/or honors
received in college.
______________________________________________________________________________________
______________________________________________________________________________________
Occupational
Objective___________________________________________________________________
Academic
Objective______________________________________________________________________
Are you enrolled in the Medical University
of South Carolina Yes___________ No____________________
GPA last
semester_______________________
Overall GPA____________________________________
Activities and Achievements
Please list
any significant activities you have participated in and achievements you have
made since entering your graduate education that you want us to consider along
with your scholarship application
1) Activity/Achievement
Dates Involved
Description of Activity/Achievement
References
List the names and contact information for
your references (no more than three). At least one of your references must be a
professor or instructor.
2 ) Activity/Achievement
Dates Involved
Description of Activity/Achievement
References
List the names and contact information for
your references (no more than three). At least one of your references must be a
professor or instructor.
3) Activity/Achievement
Dates Involved
Description of Activity/Achievement
References
List the names and contact information for
your references (no more than three). At least one of your references must be a
professor or instructor.
Employment
Experiences
Name:
Title:
Employer/Institution:
Relationship:
Address:
Phone Number:
E-mail Address:
Name:
Title:
Employer/Institution:
Relationship:
Address:
Phone Number:
E-mail Address:
On a separate page, type a brief essay
(200-500 words maximum) on one of the following topics:
1.
Autobiographical Essay
2.
My Future Plans
3.
Reason(s) for seeking Scholarship
CERTIFICATION
I certify
that the information on this application and on all accompanying materials is
true and accurate to the best of my knowledge. I understand that Misrepresentation
of application information may result in the revocation of a scholarship and/or
termination of any offer of employment.
Signed:
___________________________________________________ Date: ___________________________
Required Documentation
ü
Please
attach the following documents to this application:
ü
A
copy of your resume;
ü
Sealed
letter(s) of recommendation from at least one of your references;
ü
Describe
any other pertinent information you wish to share with Scholarship Committee.
You may attach a supplemental statement if necessary.
APPLICATION SUBMISSION
To be
considered for the scholarship, all required documents must be submitted in one
complete package. Partial applications will not be given consideration.
APPLICATIONS MUST BE POSTMARKED BY MARCH
31, 2010.
Please submit your complete
application package to:
Ms. Sshune Rhodes
1912 Hialeah Ct.
Charleston, SC 29414
If you have any questions regarding
your application, please direct them to
Mrs. Sshune Rhodes at: sshune.rhodes@rsfh.com
