HENRY R. BELL M.D. SCHOLARSHIP
Requirements and Application Information
The Medical
Staff and Board of Jennie Stuart Medical Center have established a Henry R.
Bell, M.D., Scholarship Fund consisting of two $2,000 scholarships. These
scholarships will be awarded each year to two students planning a career in a healthcare field who demonstrate motivation to complete his or her
education and who are in need of financial assistance (dependents of Medical
Staff members are excluded from applying).
Eligibility for a Henry R. Bell, M.D.,
scholarship is based on the following:
a. Applicant
must be a resident of Christian or Todd Counties, Kentucky, and a senior in high school.
b. Grades,
character, potential and motivation to continue his or her education in the
field of medical science must be demonstrated. (A transcript of grades from the
last school attended must be submitted along with three letters of
recommendation from non-relatives.)
Applications for Henry R. BeII, M.D.,
scholarships are made available by downloading the application information from
the Jennie Stuart Medical Center website at www.jsmc.org. Click here to download the application.
Applications need to be returned by mail to Jennie Stuart Medical Center Medical
Staff Office, P.O. Box 2400,
Hopkinsville, KY 42241-2400.
These
applications, along with the other required materials listed above, must be
submitted to the Jennie Stuart Medical Center Medical Staff Office NO LATER THAN APRIL 1. APPLICATIONS
RECEIVED AFTER THAT DATE WILL NOT BE CONSIDERED.
Scholarship
awards are determined in May of each year.
A recipient of
the HENRY R. BELL, M.D., SCHOLARSHIP will be notified by letter. The recipient
must be willing to sign a publicity
release.
The recipient
will receive this monetary award through the Financial Aid Office of the
College or University of their choice. The Financial Aid Office of each school
must be given specific instructions as to how this money is to be used. The
schools will be asked to return any unused funds to JSMC for future scholarship
awards. No funds are to be given directly to any student. Funds cannot be
designated by a student for his/her future use but must be used in the school year received.
Recipients
shall not be eligible for renewal of scholarships and prior recipients may not
apply.
Applications must be submitted to the
Jennie Stuart Medical Center Medical Staff Office by April 1. NO APPLICATIONS RECEIVED AFTER APRIL 1 WILL BE CONSIDERED.
To Apply for a Henry R. Bell, M.D.,
Scholarship
Complete the
following information in its entirety and attach a brief essay (one page)
describing why you feel you should be awarded this scholarship.
SCHOLARSHIP APPLICATION INFORMATION BELOW
MUST ACCOMPANY YOUR ESSAY, YOUR TRANSCRIPT OF GRADES, AND THREE LETTERS OF
RECOMMENDATION FROM NON-RELATIVES
APPLICANT'S
INFORMATION
Name:
Marital
Status: Single, Separated, Divorced, Married
Name of Spouse (if married):
Date of Birth:
Number of
Dependents:
Social Security
Number:
Home Address
(Mailing Address with City and Zip Code):
Phone Number
where you can be reached:
Home Phone
Number:
PARENTS'
INFORMATION
Father's/Guardian's
Name:
Mother's/Guardian's
Name:
Number of
additional children in family if applicant lives with family/guardian:
And their ages:
REQUIRED
INFORMATION
List Colleges, Universities, or Medically-Related
Programs to which you have applied:
What Medically-Related
Program have you chosen?
Estimated
education expenses per year:
Amount
available from parents:
Exact amount
available from savings:
*Money earned
(summer-, part-, or full-time employment):
Grants or
scholarships received (from where and how much):
List all
scholarships you have applied for (from where and how much):
*List your
employment record (Please provide the name and address of your employer, as
well as your duties, dates of employment, and your supervisor):
List all
school activities and offices held throughout high school (Please provide the
high school offices you have held and the years):
List community
activities in which you have been involved (Please provide the activity, location,
sponsoring organization, and your supervisor):
Type the
following statement, sign and date your application information and essay, and
return to the address listed above.
By signing below, I acknowledge that I
have read and that I meet the qualifications, as outlined in the Henry Bell,
M.D., Scholarship policy.
Applicant's
Printed Name:
Applicant's
Signature and Date:
