Scholarship Programs

and

Application Packet

February 10, 2015

Dear Scholarship Applicant:

Thank you for your interest in applying for a Northern Hospital of Surry County Scholarship. We receive a large number of applicants for the limited number of scholarships that are available each year. The attached application packet has been prepared to assist you with the scholarship application.

Please note that the Scholarship Application Packet must be completed in its entirety as indicated. Any application that has not been completed as indicated will be disqualified from the selection process. Each individual is encouraged to carefully review the requirements and to send all completed applications to Northern Hospital Human Resources by April 15th.

Again, thank you for your interest in the scholarship programs provided by Northern Hospital of Surry County. We wish you the best.

Angela H Collins

Compensation & Benefits Analyst


SCHOLARSHIP PROGRAMS

The following scholarships are available for high school seniors:

·  NHSC General Scholarship-$500 per year, renewable for up to 3 years based on satisfactory academic progress (Total $2,000).

Open to all children of NHSC employees who are seniors in high school in any state.

Only one scholarship will be awarded from all applications received. Selection criteria will be based on application, academic excellence, extracurricular activities, community service, leadership experience, and short essay. There are no restrictions regarding field of study to be pursued in college with this scholarship.

·  Nancy Moncus Memorial Scholarship (1 Awarded) - -$500 per year, renewable for up to 3 years based on satisfactory academic progress (Total $2,000).

Open to all children of NHSC employees who are seniors in high school in any state.

Selection criteria will be based on application, a healthcare major, academic excellence,

extracurricular activities, community service, leadership experience, and short essay.

·  Martha Wilkins Memorial Scholarship (1 Awarded) - -$500 per year, renewable for up to 3 years based on satisfactory academic progress (Total $2,000).

Open to all children of NHSC employees who are seniors in high school in any state.

Selection criteria will be based on application, a healthcare major, academic excellence,

extracurricular activities, community service, leadership experience, and short essay.

NHSC SCHOLARSHIP

APPLICATION PACKET

COVERSHEET

Name: ______

Data to be submitted for consideration of NHSC’s scholarships include:

Note: Completed items should be attached in the following order.

______Coversheet

______Application Form

______Short Essay (one page, double spaced) describing your chosen field of study

and why you chose it.

______High School Transcripts

______Letter of Acceptance to College

______Two (2) Letters of Recommendation

Procedure for applying is as follows:

·  Must meet eligibility requirements

·  Application Packets must be completed in their entirety and in the order listed above

(Note: Late or incomplete packets will be disqualified from committee review and selection)

·  Agree to report for interview, if so requested

·  Agree for NHSC to use photo for publicity purposes only

·  Submit all requested information by deadline to Guidance Counselor or directly to NHSC at:

Northern Hospital of Surry County

Human Resources-Angela Collins

Post Office Box 1101

830 Rockford Street

Mount Airy, North Carolina 27030

Note: All completed applications must be received by NHSC no later than April 15th to be considered.

Northern Hospital of Surry County is an Equal Opportunity Employer.

SCHOLARSHIP APPLICATION FORM

Name: ______Social Security Number: ______

Address: ______County: ______

City: ______Phone Number: ( )______

State: ______Zip: ______Expected Graduation Date: ______

Mother’s Name: ______Father’s Name: ______

Scholarship applying for: (check all that you are eligible for)

NHSC General Scholarship (name of employee: ______)

Nancy Moncus Memorial Scholarship (name of employee: ______)

Martha Wilkins Memorial Scholarship (name of employee: ______)

High School Currently Attending: ______

High School Address: ______

Name of college to which you have been accepted: ______

Degree Program/Field of Study you have selected: ______

List other scholarships or financial aid for which you have applied/accepted and amounts:

______

______

Extracurricular Activities: ______

______

______

______

Community Service Activities: ______

______

______

______

Honors/Awards Received: ______

______

______

______

Leadership Roles: ______

______

______

______

Experience in your chosen field of study: ______

______

______

______

Explain why this scholarship would be helpful to you: ______

______

______

______

I certify that the above information is true and correct to the best of my knowledge. I authorize NHSC to use my photograph for publicity purposes only and understand that it will not be used in the selection process.

Applicant Signature: ______Date: ______

Office use only

Date received: ______Received by: ______

Packet Complete: Yes No, disqualified - application late or incomplete