Winona Health Auxiliary Carol Hill Scholarship - College of Allied ...

Winona Health Auxiliary Carol Hill ScholarshipIn honor of her long-standing service to the Winona Health Auxiliary, this scholarship is named forCarol Hill, retired Director of Winona Health Volunteer Services. Individual scholarship awards willbe made in amounts of at least $500. The scholarship will be awarded only if there is a qualifiedcandidate as determined by the Winona Health Auxiliary Scholarship Committee.*It is the applicant’s responsibility to make sure the application is complete.*Only completed applications will be considered.General Requirements for All Applicants:• Applicants will have applied and been accepted to a health care program, of their choice. This mayinclude but is not limited to programs for Registered Nurse, Licensed Practical Nurse, RadiologyTechnician, and the like. Please attach to this application form, your letter or another type ofacknowledgement of acceptance into the health care program from the college or university you willbe attending.• Applicants must be a permanent resident of the Winona Health service region as defined by WinonaHealth (map available) or be working as an employee of Winona Health.• Applicants must furnish official high school and/or college transcripts.• Applicants must submit a one-page narrative stating academic and career goals and what s/he hasdone up to this point toward achieving those goals.• Applicants must express a desire and/or commitment to work for Winona Health after completionof his/her program of study.First-time Applicants Only:• Submit two references (forms attached) from individuals qualified to comment on your characterand/or academic abilities. Qualified individuals may include, but are not limited to a teacher or otherschool professional, an immediate employment supervisor or peer, or volunteer supervisor or peer.LegalPreviousName: ______________________________________ Name: _________________________________PermanentAddress: ___________________________________________ E-mail: __________________________CityPermanentState ZIP __________________________________________ Phone: __________________________Current Address:(if different from above): ________________________________________________________________CityState ZIP: _________________________________________CurrentPhone __________________________College/University attending Fall 2010: ______________________________________________________AnticipatedMajor: _______________________________________ Date of Graduation: ______________________Applicant Status Enrollment Status 2010-2011____ First-time applicant____ Renewal applicant____ Full-time ____ Part-Time (______credits)_____# of previous awards (4 Scholarship Award limit)

Please list high school and all post-secondary schools previously attended and degrees granted:Name Dates Degree/Major GPAApplicant’sSignature: _________________________________________________ Date: _____________________Before turning this in have you:____ signed the application?____ included a one page narrative?____ is you permanent resident in the Winona Health service region?____ included a copy of your formal letter of acceptance to your program?____ included your transcripts or requested that they be sent to the Winona Health Auxiliary?____ requested references from two individuals? (First time applicants only)APPLICATION AND ALL SUPPORTING MATERIALS MUST BERECEIVED BY THE WINONA HEALTH AUXILIARY ON OR BEFOREMARCH 19, 2010(this is not a postmark date)Winona Health Auxiliary855 Mankato AvenuePO Box 5600Winona MN 55987-0600

WINONA HEALTH AUXILIARYCAROL HILL SCHOLARSHIPREFERENCE FORMRequired for first time applicants onlyAPPLICANT: Fill out the first three lines and give this form to your reference. References mayinclude and are not limited to any of the following: high school counselor, high school teacher,college advisor, college teacher or employer. Applicant may return reference forms in person tothe Winona Health Auxiliary Office. Deadline is March 19, 2010.Student’s Name ___________________________________________ Date ________________Student’sAddress_______________________________________________________________________Student’s Phone ___________________________________Please evaluate the applicant’s (1) current performance, and (2) potential for success in ahealthcare profession.Name___________________________________Title__________________________________Phone _____________________________ Date ______________Signature _____________________________________________PLEASE RETURN FORMS BY MARCH 19, 2010 TO: ScholarshipsWinona Health Auxiliary OfficePO Box 5600855 Mankato AvenueWinona MN 55987