The LGMC Auxiliary has designated one $2000.00 scholarship in honor of Valta & Gerald Heffley for their dedication and volunteer service to LGMC.

  1. Applicant must be:

a.A resident of Hood County or Pecan Plantation or a current employee of LGMC.

b.Pursuing a career in the health care field.

c.Demonstrate financial status.

d.Aware that preference will be given to past recipients who have completed one year of college.

  1. Applicant must return the completed application and all requested documentation by April 13, 2018. Incomplete applications and failing to submit requested documentation will invalidate the process.
  2. Applicant is subject to a personal interview.
  3. All applicantswill be notified by the Scholarship Committee regarding the committee’s decision.
  4. A scholarship of $2000.00 ($1000.00 per semester) will be paid directly to the institution you will be attending. It is to be used in the fall and spring semesters.
  5. A transcript of grades is required before money for each semester will be issued. Failing grades will automatically cancel the remainder of the scholarship. A recipient is expected to maintain a “C” average in order to receive funds.
  6. Recipient may be asked to speak to the Auxiliary once during the year.
  7. Should the recipient fail to complete the semester covered by the award, the recipient shall be required to repay LGMCA the amount awarded. A signed agreement will be required at the time the scholarship is granted.
  8. The applicant shall be required to enroll as a full-time student in an accredited University (12 hours is considered to be full-time.)
  9. Scholarships are not automatically renewed. You must re-apply yearly.
  10. Scholarship money is to be used for tuition and/or book purchases only.

To be considered a viable applicant, it is vital that all documentation be turned in at one time.Please Print Legibly.

Documentation required:

  1. Official application
  2. A letter stating the reason you are applying for the scholarship and the goals you have set.
  3. Three (3) letters of recommendation (Example: employer, teacher, and personal friend.) Past recipients are only required to furnish one letter of recommendation: preferably from a professor or employer.
  4. Current photograph
  5. Copy of driver’s license
  6. The last semester transcript for high school seniors and college students.

Seal all the above in an envelope marked “Scholarship Committee” and return to the LGMC Gift Shop or mail to:

LGMC Auxiliary

C/O Tink Tuggle

Scholarship Committee; Gift Shop

1310 Paluxy Road

Granbury, TX 76048

Please Print Legibly

LIMITED TO STUDENTS ENROLLED OR PLANNING TO ENROLL AS A FULL-TIME STUDENT IN A HEALTH CARE FIELD – DEADLINE IS APRIL 13, 2018

Check List:

Application_____ Photo _____ Students Letter ______Transcript_____

Recommendations______DL _____ Enter your College Student ID# ______

Name______

Address______City / Zip______

Students Cell # ______SS # ______

Students Email address______

Alternate phone Number and Name of Owner ______

Age______Date of Birth ______U.S. Citizen ------Yes------No------

Marital Status ( ) Single ( ) Married ( ) Divorced ( ) Widowed

Graduated From ______

Year Graduated High School______

If high school student, please give SAT/ACT Scores______

College or Institute you are attending or plan to attend: ______

______

Address______

City______State______Zip______

Current Classification ______GPA ______

( ) High School ( ) College

Degree or Program you plan to pursue ______

List your most recent extra-curricular and/or community activities (If additional space is needed, please attach to the last page) ______

Financial need is a determining factor in selecting candidates for scholarship. This information will be kept in strict confidence. Please list the income of the responsible party(s) as listed on last year’s tax return.

___ $0 - $50,000 ___$50,000 - $75,000 ___ $75,000 - $100,000 ___ Above $100,000

Are you currently receiving financial aid in the form of scholarships, student loans or grants? ______If yes, please print name of aid andamount:

______

______

______

______

______

Do you have siblings currently attending a college or university? ( ) Yes ( ) No

If so, how many?______

Signature______Date______

If you currently do not have your college ID #, we must receive it before funds will be issued. Please forward it to us as soon as you receive it.

Lake Granbury Medical Center Auxiliary Scholarship

From______

Printed Name

I understand the provisions of the scholarship I am receiving from your organization as stated below:

1)The scholarship of 2,000.00 (1,000.00 per semester) will be paid directly to the institution I attend. It is to be used in the fall and spring semesters.

2)I will be enrolling in an accredited institution as a full time student pursuing a career in a health care field. (12 hours is considered to be a full time)

A transcript of grades will be required at the end of each semester. I am required to maintain no lower than a “C” average. Failing grades will automatically cancel the scholarship. Funding for the next semester will be cancelled if compliance is not met.

3)If this is my final college semester, I understand that my transcript must be forwarded to the Auxiliary as required.

4)I understand that this scholarship is to be used for tuition and/or college book purchases only.

5)Should I fail to complete the semester covered by the award, have failing grades or fail to produce my transcript, I shall be required to repay LGMC Auxiliary the amount awarded.

My signature below indicates that I understand and agree to these provisions.

Signed:______Date______

I am requesting scholarship funds for: (Check the semesters that apply)

______Fall Semester: 2018

______Spring Semester: 2019

Please make a copy of this information for your records!