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■ Candidates must be in their second year of study in a health-related program, having completed at least one year. Exception: General science majors must have completed two years and are currently in their third year of study.

Candidates must reside in Holmes, Stark, Tuscarawas or Wayne counties.

Candidates must have a GPA of 3.0 or higher.

Part-time students must maintain a minimum of six (6) credit hours.

Selection will be based on academic performance and financial need.

Graduate students are also eligible for a scholarship.

Scholarship dollars may be used to help defray the cost of tuition and fees, books, supplies, and licensure fees.

The Foundation has a preference for supporting non-traditional students. If such a student is not available, the school may recommend a deserving traditional student that meets our criteria.

$4,000 will be awarded to the college or university in August of each year.

It is our preference that two equal scholarships be awarded at each school.

Prior to awarding the scholarship, the Foundation asks that our scholarship committee be permitted to review the applications of the students selected by the school.

■ School shall advise the Foundation and request input if all grant funds are not expended.

Students may reapply for this scholarship. The school will determine whether or not the scholarship is to be continued with a particular student up to a maximum of three years.

HEALTH AND WELLNESS FOUNDATION

PERSONAL INFORMATION:

Name:

Home Address:

ACADEMIC INFORMATION:

School:

Current Class Year: ☐ Sophomore ☐ Junior ☐ Senior ☐ Graduate Student

Course of Study or Major:

Expected year of graduation: Cumulative GPA:

Expected enrollment status for next semester: Full-time Part-time hrs.

EXTRA-CURRICULAR ACTIVITIES: Please list activities in which you have participated and any awards or honors received.

YOUR ASPIRATIONS: Please tell us why you have chosen to major in a health-related program. Demonstrate or describe financial need or exceptional circumstances and explain how receiving this scholarship will assist you in achieving your goals.

RELEASE OF INFORMATION: 1 authorize the financial Aid Office to exchange financial, academic and other information deemed necessary in determining my eligibility for this scholarship. I agree to allow the Scholarship Committee to verify any and all information with the appropriate campus offices. I also agree to the release of my information for public relations and/or news releases in conjunction with this scholarship. In signing this application, I certify that the information given is complete and correct.

Date