Scholarship Application


PERSONAL INFORMATION
Full Name*
Date of Application*
Date of Birth*
Gender* Male Female
Home Address*
City*
State*
Zip*
Phone Number*
Email*
Mailing Address (if different from above)
ENROLLMENT INFORMATION
Have you applied for this scholarship before? Yes No
How did you hear about the scholarship program?
Scholarship Name & Sponsor Year Financial or Academic
Provide the name and address of the schools and training programs you have completed (including high school)
School and/or program (1) Date of attendance
City / State Degree or certificate earned
School and/or program (2) Date of attendance
City / State Degree or certificate earned
School and/or program (3) Date of attendance
City / State Degree or certificate earned
PROGRAM INFORMATON
Name of the school in the healthcare field you are requesting a scholarship for
Name of program or course of study you are requesting a scholarship for
Required time to complete your course of study
How are tuition payments structured? (check one) Per Semester Per Year
  Entire Course Other
What is the approximate tuition for the program or course of study the scholarship will be applied to:
Have you already been accepted into this program or course of study? Yes No
Date program will begin (Month/Year)
Date diploma or certificate will be received (Month/Year)
Attending program full time or part time? Full time Part time
Besides the Enright Scholarship, how is your education being funded?
EMPLOYMENT INFORMATION
Who is your current employer?
City
Position or title:
Years of employment:
Please list your work experience over the past 5 years
Employer Employment dates Title
Please list any volunteer work you have been involved with
Organization Volunteer dates Work Done
Please list any academic achievements, honors or awards you have received in the past
Month/year Award name Sponsor Award received for
OTHER INFORMATION
Please feel free to provide additional information
***ESSAY: Please tell us in 500 words or less why you chose a career in healthcare.*
Scholarships are sent directly to the educational facility. What is the exact name and address of the office where tuition payments are sent?*
         
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