Benefits of Degree Program Requirements For People With Hemophilia & bleeding Disorders

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1 Memorial Scholarship Programs At Matrix Health Group our Mission is to provide individualized, focused services to people with bleeding disorders nationwide. Our Vision is to enhance the lives of those we are privileged to serve by providing the best pharmacy and support services possible. Our Mission and Vision are met by the value we place in five Guiding Principles. One of these principles is Enrichment. We understand that in order to perform at our best, we must always seek to learn and grow, while using our knowledge to assist and empower others. In acknowledgement of our Guiding Principle of Enrichment, Matrix Health Group companies offers nine $1000 educational scholarship opportunities to students diagnosed with hemophilia, von Willebrand Disease or other bleeding disorders, and in the case of three of the scholarships, immediate family members may also apply. These scholarships are in memory of several amazing individuals who brought remarkable qualities and skills together in a way that truly touched the community they were dedicated to serving. Their efforts to make a difference in the lives of people with bleeding disorders will not be forgotten and shall be carried on with these scholarship opportunities. Awards are based on criteria including, but not limited to academic merit, reference letters and essay. A Scholarship Committee will review the applications and decide to whom the scholarships will be awarded. Applicants are not required to be past, current or future customers of Matrix Health Group or its companies. Scholarship Programs: Matrix Health - Joe Holibaugh Memorial Scholarship Two $1000 scholarships for MEN or WOMEN with hemophilia and an inhibitor Joe Holibaugh ( ) was one of the founding figures of Matrix Health Group. Living with severe hemophilia and an inhibitor, Joe met many challenges. He faced these difficulties as opportunities to grow, embracing life fully with his entire being. Joe worked hard to impart this approach to others, bringing many together with his unique style of wit and humor. Joe s work lives on in the hearts of his many friends and family who love him dearly. He will always be remembered for his strength, love and resolve to make a difference for the bleeding disorders community. Matrix Health - Tim Kennedy Memorial Scholarship Two $1000 scholarships for MEN with hemophilia Tim Kennedy ( ) was a tenured employee at Matrix Health Group, and a respected name in the bleeding disorders community. Those who knew Tim remember him for his ability to make most anyone smile and share a hearty laugh. Though life had dealt him a rough hand, Tim kept an air about him that was truly inspiring. As a father and husband, the love he showed his two children and wife knew no bounds. As a friend, he was always ready to listen, share and comfort - most often with his signature sense of humor. As a member of the bleeding disorders community, Tim was devoted to helping his peers look past their health conditions and enjoy every moment of life for all that it s worth.

2 Memorial Scholarship Programs Factor Support Network - Millie Gonzalez Memorial Scholarship Two $1000 scholarship for WOMEN with hemophilia or von Willebrand Disease Millie Gonzalez ( ) was a devoted wife and mother as well as a pioneer dedicated to advocacy, promoting the awareness of the unique struggles faced by women with bleeding disorders and those tasked with caring for an individual affected by a bleeding disorder. She was married to Papo Gonzalez, a person with severe hemophilia and well known advocate in his own right, who passed prior to Millie. She was a tireless advocate not only for women but also for persons of Hispanic heritage affected with bleeding disorders. She fought for the inclusion of all persons with bleeding disorders. Although her nature was loving, compassionate and gentle, Millie had the heart of a tiger and fought each day for her own survival while inspiring those around her to achieve and succeed. Factor Support Network - Mike Hylton Memorial Scholarship $1000 scholarship for MEN with hemophilia or von Willebrand Disease and their immediate family members Mike Hylton ( ) was a man of great character and steadiness. Mike faced some of the most physically daunting and mortal challenges that people with severe hemophilia could encounter. During the blood crisis of the 1980s, Mike met the challenges he faced with class and a concern for others not only in the bleeding disorder community, but also those affected with HIV. He was a thoughtful, analytical and spiritual individual - patient and tolerant of others, but certainly willing and capable to express his opinions and beliefs. While some felt it was more important to speak, he knew that it was more effective to listen. Mike found great comfort in his faith and family. Factor Support Network - Ron Niederman Memorial Scholarship $1000 scholarship for MEN with hemophilia or von Willebrand Disease and their immediate family members Ron Niederman ( ) was born when treatment for persons with bleeding disorders was nonexistent predisposing him as with many of his generation to a lifetime of pain, struggle for better care, and the fight against stigma and prejudice. Living with severe hemophilia, Ron endured challenges well beyond that of most and faced each with grace and an air of, I can handle that, no problem. He exemplified the meaning of compassion towards others, action in his words and deeds, and practiced more than preached what it meant to be an advocate locally and nationally. He was a great friend to all that knew him and always a trusted source of advice and wisdom. Ron s commitment to the bleeding disorder community was surpassed only by his love for his family. Homecare For The Cure - Mark Coats Memorial Scholarship $1000 scholarship for Men and Women with a bleeding disorder and their immediate family members Mark Coats ( ) was just a child when he passed from hemophilia-related issues. He was born in an entirely different era of bleeding disorder treatment and was not able to live a near normal life as most people with hemophilia do today. With his smiling eyes and sweet grin, we are reminded that every child deserves a chance to lead a full and happy life. We look to Mark as a reminder of what living with a bleeding disorder was like not that long ago, how blessed we are to have the treatments we have today and just how important it is that we continue our quest to find a cure for hemophilia.

3 Specific eligibility requirement per scholarship: Application Requirements: o Matrix Health - Joe Holibaugh Memorial Scholarship: For MEN or WOMEN with hemophilia and an inhibitor o Matrix Health - Tim Kennedy Memorial Scholarship: For MEN with hemophilia o Factor Support Network - Millie Gonzalez Memorial Scholarship: For WOMEN with hemophilia or von Willebrand Disease o Factor Support Network - Mike Hylton Memorial Scholarship: For MEN with hemophilia or von Willebrand Disease and immediate family members o Factor Support Network Ron Neiderman Memorial Scholarship: For MEN with hemophilia or von Willebrand Disease and immediate family members o Homecare For The Cure Mark Coats Memorial Scholarship: For MEN and WOMEN with a bleeding disorder and immediate family members Must be a United States resident Must have applied and been accepted to an accredited college, university or technical school in the United States on a full-time basis (12 credit hours or more) Must have a minimum grade point average of 2.0 on a 4.0 scale during entire senior year of high school or current year of college or graduate school Must submit copy of transcripts and ACT or SAT test scores Must submit two letters of recommendation (copies acceptable); one from a teacher, instructor, professor or school administrator and one from an employer, church leader, volunteer coordinator, or other professional person Outline of work experience Outline of school activities, class offices, band, athletics, clubs, school publications, civic organizations, volunteer work, etc. Outline may be substituted with a resume Signed Certification and Release Employees and family members affiliated with Matrix Health Group are not eligible to apply Please type or print in ink all information requested. Signed applications and supporting materials must be received by August 1 st. The Scholarship Award Committee will meet in early September to make a final decision. The applicants awarded the scholarships will be notified by the end of September. Late applications or those missing required information will not be considered. Please mail your complete scholarship application packet to: Matrix Health Group Memorial Scholarship Programs c/o Maria Vetter 2202 Brownstone Court; Champaign, IL For questions, please call, text or Maria Vetter: ; maria.vetter@matrixhealthgroup.com

4 Application Checklist! Completed, signed and dated Application! A recent, wallet-sized Photograph of yourself! Letter of Verification from hematologist, physician or treatment center. Treatment center or physician-signed hemophilia travel letter is acceptable! Copy of most recent Transcripts from high school and college/university/technical school (if already attending). Transcripts do not need to be certified copies! Copy of ACT or SAT scores (Required for incoming freshman only)! 300 to 400 word Essay! Letter of Recommendation from a teacher, instructor, professor or school administrator (Copy of recommendation letter acceptable)! Letter of Recommendation from employer, church leader, volunteer coordinator, etc. (Copy of recommendation letter acceptable)! Proof of Admission to the college/university/technical school (Required for incoming freshman only)! Signed and dated Release! Affix appropriate postage and submit. Must be postmarked before the August 1 st deadline Incomplete or late applications will not be eligible for consideration. Please mail your complete scholarship application packet to: Matrix Health Group Memorial Scholarship Programs c/o Maria Vetter 2202 Brownstone Court; Champaign, IL For questions, please call, text or Maria Vetter: ; maria.vetter@matrixhealthgroup.com

5 Application Form - page 1 Program Selection: Please review the scholarship requirements and indicate the program(s) for which you are applying. Check all that apply - no need to submit separate applications for each program.! Matrix Health - Joe Holibaugh Memorial Scholarship: For MEN or WOMEN with hemophilia and an inhibitor.! Matrix Health - Tim Kennedy Memorial Scholarship: For MEN with hemophilia! Factor Support Network - Millie Gonzalez Memorial Scholarship: For WOMEN with hemophilia or von Willebrand Disease! Factor Support Network - Mike Hylton Memorial Scholarship: For MEN with hemophilia or von Willebrand Disease and their immediate family members! Factor Support Network - Ron Niederman Memorial Scholarship: For MEN with hemophilia or von Willebrand Disease and their immediate family members! Homecare for the Cure Mark Coats Memorial Scholarship: For MEN and WOMEN with a bleeding disorder and their immediate family members Personal Information: Last Name First Name Middle Initial Address Home Phone Cell Phone Address Date of Birth! Male! Female Bleeding Disorder! Hemophilia A! Hemophilia B! von Willebrand Type! Other Severity! Mild! Moderate! Severe! Inhibitor Age at diagnosis Physician Name and Phone Number Hemophilia Treatment Center (if applicable)

6 Application Form - page 2 Educational Information: High School Attended City and State Graduation Date ACT or SAT Score (if incoming freshman) Cumulative High School (or current college/school) Grade Point Average Grading Scale What has been your favorite subject? What has been your least favorite subject? Plan on attending, or are attending:! Graduate School! University/College! Jr. College! Technical/Trade! Other School City, State Have you been formally accepted?! Yes! No Field of Study Major Minor (if applicable) At the beginning of the next school year, what year will you enter?! Freshman! Sophomore! Junior! Senior! Graduate Student Expected year of graduation or program completion Scholarship: How did you hear of the Matrix Health Group Memorial Scholarship programs?! Matrix Health Group News newsletter! Face Book! Direct mailing! Online Scholarship Listing (please name)! Matrix Health Group personnel (please name)! Chapter or Foundation (please specify) _! HTC Personnel (please name)! Other (please specify)

7 Application Form - page 3 Work Experience: Please list any jobs you have held, your job title, duties and dates of employment. A resume or additional sheet may be substituted for this section. Volunteer Experience: Please list any volunteer positions you have held. A resume or additional sheet may be substituted for this section. Hobbies and Activities: Please list any hobbies or activities you enjoy. Essay: Please choose one topic and submit a typed essay of words. Please attach as a separate sheet and sign your name at the bottom of your essay. 1.) Tell us about experiences that have influenced your decision to pursue your educational goals or career choice 2.) Tell us how you feel your life has been influenced by having a bleeding disorder (or by having a bleeding disorder in your family) 3.) What has been your biggest challenge in regards to having a bleeding disorder and how have you or are you working through it?

8 Application Form - page 4 Certification and Release Applications received by the Matrix Health Group Memorial Scholarship Programs will be reviewed and winners will be determined by a Scholarship Committee. All decisions made by the Scholarship Committee are final. It may be necessary for someone from the Scholarship Committee to contact you directly for a personal interview or to qualify any information contained in this application. I have personally signed this Matrix Health Group Memorial Scholarship Programs application. I certify that all statements contained in the foregoing application are true and correct. In consideration of my acceptance of this scholarship, should I be selected as an award recipient, I agree to all the conditions set forth, and further agree to grant all permission to Matrix Health Group, its companies and the Memorial Scholarship Programs, to any and all the foregoing, to use any photographs, quotes contained herein, and statements for use in social media, publications, website, promotional materials and advertising for any purpose of announcing the scholarship and its recipients. Printed Name Signed Name Date If applicant is under age 18, please include a parent or guardian s signature Parent or Guardian Printed Name Phone Number Parent or Guardian Signed Name Date Basis of Authorization

9 RECOMMENDATION FORM Teacher, Instructor, Professor or School Administrator Dear Applicant: Please fill out your name and address on this form and give it to the person you have requested to submit your recommendation. A signed letter of recommendation may be substituted for this form or attached as additional information. It is your responsibility to see that the recommendation is submitted by the August 1 st deadline. Recommendation: Name of Applicant Address of Applicant What is your relationship to the above applicant? How long have you known the applicant? _ What are the applicant s most significant talents? Please continue on reverse side or attach a letter. address Printed Name Signed Name Phone number Date Please return this form to the student for mailing by the August 1 st deadline. You may also mail your recommendation directly to the Scholarship Committee: Matrix Health Group Memorial Scholarships Program c/o Maria Vetter 2202 Brownstone Court; Champaign, IL For questions, please call, text or Maria Vetter: ; maria.vetter@matrixhealthgroup.com

10 RECOMMENDATION FORM Employer, Volunteer Coordinator, Church Leader, Etc. Dear Applicant: Please fill out your name and address on this form and give it to the person you have requested to submit your recommendation. A signed letter of recommendation may be substituted for this form or attached as additional information. It is your responsibility to see that the recommendation is submitted by the August 1 st deadline. Recommendation: Name of Applicant Address of Applicant What is your relationship to the above applicant? How long have you known the applicant? _ What are the applicant s most significant talents? Please continue on reverse side or attach a letter. address Printed Name Signed Name Phone number Date Please return this form to the student for mailing by the August 1 st deadline. You may also mail your recommendation directly to the Scholarship Committee: Matrix Health Group Memorial Scholarships Program c/o Maria Vetter 2202 Brownstone Court; Champaign, IL For questions, please call, text or Maria Vetter: ; maria.vetter@matrixhealthgroup.com

11 MEDICAL VERIFICATION FORM Physician or Treatment Center Dear Applicant: Please fill out your name and address and give this form to your physician or hemophilia treatment center. A copy of a letter signed by your physician or treatment center (such as a travel letter) verifying your bleeding disorder may be substituted for this form. It is your responsibility to see this form is submitted by the August 1 st deadline. Name of Applicant Address of Applicant To be completed by applicant s Physician or Nurse What type of bleeding disorder has this scholarship applicant been diagnosed with?! Hemophilia A! Hemophilia B Severity:! Mild! Moderate! Severe Inhibitor:! Yes! No! von Willebrand! Type 1! Type 2! Type 3 Severity! Other (please specify) Physician/Nurse Signed Name Date Physician/Nurse Printed Name Treatment Center or Medical Facility Phone number Treatment Center or Medical Facility Address Please return this form to the student for mailing by the August 1 st deadline. You may also mail the Medical Verification directly to the Scholarship Committee: Matrix Health Group Memorial Scholarship Programs c/o Maria Vetter 2202 Brownstone Court; Champaign, IL For questions, please call, text or Maria Vetter: ; maria.vetter@matrixhealthgroup.com