HEALTHCARE VOLUNTEERS

Transcription

1 HEALTHCARE VOLUNTEERS Scholarship Application Academic Year Deadline to Apply: at 4:00 p.m. The St. David s Medical Center Healthcare Volunteers award scholarships to students pursuing healthcare related fields at Texas colleges and universities. Eligibility Information: Attached is the application for St. David s Medical Center Healthcare Volunteers Scholarships for the academic school year. Students must have (1) been accepted or (2) be currently enrolled in a degreed healthcare program such as but not limited to medicine, nursing or physical therapy. Unfortunately, if you are still waiting on acceptance by the required received date then you are not eligible for this cycle. The awarded scholarships will be $3,000 per semester. Eligibility requirements are as follows: 1. Accepted at a Texas college or university 2. Actively pursuing a degree in nursing or other graduate level healthcare program 3. Attend school as a full-time student or full time equivalent 4. Provide proof of US Citizenship or legal non-citizen resident 5. Pass a background investigation 6. Able to participate in an interview with the Scholarship Committee on a designated date in April 2016; interviews will be conducted via conference call

2 Application Requirements: All requirements listed below must be completed and submitted together. If the application is incomplete or not received in the format requested, the application will be denied. No exceptions. Applications must be received no later than 4:00 p.m. on February 19, Application packets must contain the following: 1. Complete application form 2. One-page essay as described is Section III of the application 3. Official transcript from current school 4. First year students must include your acceptance letter for the school year 5. Copy of proof of US Citizenship (birth certificate, US passport, or US Citizenship papers) or legal non-citizen resident status 6. A current resume including all medically related work and volunteer experience for the previous three (3) years; be specific and descriptive of the duration of your experiences, hours worked per week and total hours completed (for volunteer experience) 7. Two completed recommendation forms, in signature-sealed envelopes; see below: a. One recommendation form must come from a current teacher, counselor or advisor b. One recommendation form must come from a community member such as an employer, coach, volunteer coordinator, church leader, etc. Recommendations may not be from family members including extended family.

3 Scholarship Timeline for February 19, 2016 Completed application package must be received by 4:00 p.m. on this date. Applications will not be considered without ALL required documents. Applications received after February 19, 2016 will not be considered. April 4, 2016 June 1, 2016 Finalist will receive notification of acceptance for interview. Interviews will be held during April via conference call. Scholarship recipients will be notified. Award Information Applicants who are awarded a scholarship will be notified by June 1, Scholarship recipients will have additional reporting requirements which will be outlined in the notification letter. Scholarship funds will be sent directly to your college or university. Questions & Application Delivery Please mail complete application packets to: For questions, please contact: St. David s Medical Center Carolyn Bartlett, Scholarship Chair Healthcare Volunteers Scholarship cb@austin.rr.com 919 East 32 nd Street Austin, TX ed or faxed applications will not be accepted; all elements must be included in completed packet to be considered.

4 HEALTHCARE VOLUNTEERS Scholarship Application Packet Cover Page / Checklist Please utilize this checklist to assist you while compiling your application. Complete application legibly. Name Applicant Checklist Application Packet Requirements Complete application form with all supporting documentation. Section I Personal Information Section II Financial Information Section III Essay Section IV Other Required Documentation 1. Letters of Recommendation: i. One completed recommendation form from a faculty member (in a signature-sealed envelope) ii. One completed recommendation form from a community member (in a signature-sealed envelope) 2. Most recent official school transcript Committee USE ONLY 3. Copy of proof of US Citizenship or legal non-citizen status 4. Current resume including all medically relevant work and volunteer experience Committee Use Only: Date Received: Reviewer s Initials:

5 HEALTHCARE VOLUNTEERS Scholarship Application Academic Year Deadline to Apply: by 4:00 pm SECTION I Personal Information* Name Address Mailing Address City State Zip Phone Number DOB School/University Major Anticipated Graduation Date Proof of US Citizenship Provide a copy of one of the following: Birth Certificate Passport US Citizenship Papers Legal Residency * You are responsible for updating your personal information so that the Scholarship Committee is able to communicate with you in a timely manner.

6 SECTION II Financial Information This section should be as detailed as possible and include all points indicated. Use the Financial Information included with this application to answer the following questions and explain all means of financing your education. 1. Briefly state how you funded your school year including total tuition and fees charged. TYPE AMOUNT DETAILS Employment (Anticipated income/ hours worked per week) Personal Savings (cash on hand) Student Loans (included whether subsidized or unsubsidized) Grants (amount/type of grants) Scholarship(s) (list name of scholarship and amounts) $ $ $ $ $ Family Support $ Spousal Support $ Other $ 2. Briefly summarize how you plan to fund your school year:

7 SECTION III Essay (not to exceed one typed page) St. David s partnership hospitals have a unifying vision and mission that includes ICARE values (Integrity, Compassion, Accountability, Respect and Excellence). St. David s Medical Center (SDMC) employees and volunteers alike seek to consistently emulate these values in completing their tasks and assigned duties. Consequently, SDMC has been recognized as one of the TOP 100 Hospitals in the nation for the past six years and received the Malcolm Baldrige National Quality Award in Write an original essay not to exceed one page that explains why you were inspired to enter your field and how your education and experience to date have prepared you to emulate the ICARE values in your work ethic and career. SECTION IV - Other Required Documentation 1. Letters of Recommendation The following pages are the blank forms to be used for obtaining the letters of recommendation. Provide one blank form to each type of reference required. Your reference is to complete his/her recommendation of you, and return the letter to you in a signature-sealed envelope. One completed recommendation form from a faculty member One completed recommendation form from a community member 2. Include your most recent official school transcript 3. Include proof of US Citizenship or legal non-citizen status 4. Include your current resume including all medically relevant work and volunteer experience Questions & Application Delivery Please mail compete application packets to: For questions, please contact: St. David s Medical Center Carolyn Bartlett, Scholarship Chair Healthcare Volunteers Scholarship cb@austin.rr.com 919 East 32 nd Street Austin, TX ed or faxed applications will not be accepted; all elements must be included in completed packet to be considered. Applications packets must be received no later than 4:00 p.m. on February 19, 2016

8 Student Scholarship Reference Request References must be returned to student in a signature-sealed envelope Please provide the full name of the applicant: Evaluator Information: Name: Company: Job Title: Address: Phone Number: How long have you known the applicant? In what capacity? Student Professional Personal Other If other, please specify Based on your personal knowledge of this candidate, please pick a rating which BEST describes the applicant s character and qualification. 1. Interpersonal skills: Effectively works with others; develops positive working relationships; tactful, diplomatic, courteous and poised 2. Initiative: Excels in self-directed and self-paced work activities; requires minimal supervision 3. Reliability: Completes assignments and tasks within set time frames; honors commitments; honest and dependable 4. Communication skills: Demonstrates verbal coherence, confidence in conversation; writes clearly and concisely; keeps superiors and appropriate others informed of work activity 5. Leadership: Inspires confidence, respect and cooperation of others; shows appreciation for contributions and achievements of others 6. Motivation and passion for service: Demonstrates community involvement

9 7. Capacity for independent thinking: Demonstrates the ability to problem solve; exhibits curiosity and creativity 8. Quality of work: Works in an accurate and thorough manner; demonstrates resourcefulness and the ability to organize; self-disciplined and conscientious Please elaborate; comments are very beneficial when evaluating scholarship candidates. Overall Recommendation: Highly recommend Recommend Recommend with reservation Do not recommend Please explain why you chose a recommendation of "Recommend with reservation" or "Do not recommend". By signing your name below, you agree that the information provided about the applicant is accurate and truthful to the best of your knowledge. Signature

10 Student Scholarship Reference Request References must be returned to student in a signature-sealed envelope Please provide the full name of the applicant: Evaluator Information: Name: Company: Job Title: Address: Phone Number: How long have you known the applicant? In what capacity? Student Professional Personal Other If other, please specify Based on your personal knowledge of this candidate, please pick a rating which BEST describes the applicant s character and qualification. 1. Interpersonal skills: Effectively works with others; develops positive working relationships; tactful, diplomatic, courteous and poised 2. Initiative: Excels in self-directed and self-paced work activities; requires minimal supervision 3. Reliability: Completes assignments and tasks within set time frames; honors commitments; honest and dependable 4. Communication skills: Demonstrates verbal coherence, confidence in conversation; writes clearly and concisely; keeps superiors and appropriate others informed of work activity 5. Leadership: Inspires confidence, respect and cooperation of others; shows appreciation for contributions and achievements of others 6. Motivation and passion for service: Demonstrates community involvement

11 7. Capacity for independent thinking: Demonstrates the ability to problem solve; exhibits curiosity and creativity 8. Quality of work: Works in an accurate and thorough manner; demonstrates resourcefulness and the ability to organize; self-disciplined and conscientious Please elaborate; comments are very beneficial when evaluating scholarship candidates. Overall Recommendation: Highly recommend Recommend Recommend with reservation Do not recommend Please explain why you chose a recommendation of "Recommend with reservation" or "Do not recommend". By signing your name below, you agree that the information provided about the applicant is accurate and truthful to the best of your knowledge. Signature