NATIVE AMERICAN HEALTH EDUCATION FUND
APPLICATION FOR SCHOLARSHIP
2014/2015
January 31, 2014
Dear Applicant:
Please find attached the scholarship application for the Native American Health Education Fund. The completed application along with all transcripts, tribal documentation, letters of recommendation, and current semester grades must be submitted by June 15, 2014.
ONLY COMPLETE APPLICATIONS WILL BE CONSIDERED
Send completed applications to:
Native American Health Education Fund
1701 Pleasant Green Road
Durham, North Carolina 27705
(919) 383-1038
Recipients will be selected on the basis of scholastic achievement, financial need and personal qualifications. Scholarships up to $1000 will be awarded by September 1, 2014.
Thank you for applying for our scholarship.
For assistance email:
The Rev. Harriette H. Sturges
NATIVE AMERICAN HEALTH EDUCATION FUND
1701 Pleasant Green Road
Durham, NC 27705
The Native American Health Education Fund (NAHEF) provides financial aid to Native Americans who are pursuing careers in health related fields. Native Americans have multiple medical needs that are not being met by their communities or reservations. Native Americans experience higher rates of diabetes and its associated complications, infant mortality, and heart disease than any other population in the country. This fund was started in the hope that by providing help to Native American students pursuing careers in health related fields would benefit all Native Americans. NAHEF scholarships are awarded to students who show a desire to return to their communities and provide improvements in health care.
The fund began with a modest gift from the late Linda Hirschmann, an author, teacher and humanitarian who was especially concerned with the needs of indigenous peoples.Dr. Jacqueline C.Harris, a Duke University emeritus physician and professor, along with other friends of Linda, decided that establishing a scholarship fund for Native Americans planning careers in health related areas would be an appropriate use of Linda's bequest.
The NAHEF awarded its first scholarship in 1990. To date, over 147 scholarships have been awarded to students pursuing careers in medicine, nursing, dietetics and nutrition, medical technology, physical therapy, pharmacy, social work, medical research (biochemistry) and other applicable fields.
The fund is administered through a board of directors, which strives to include at least one Native American and one medical professional as members. The board works to help meet the increasing need for trained health care professionals in Native American communities. All contributions to the fund are tax exempt through our 501(c)(3) statuses.
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Name: ______
NATIVE AMERICAN HEALTH EDUCATION FUND
APPLICATION FOR SCHOLARSHIP
2014/2015
Name: ______
Street or P.O. Box: ______
City: ______State: ______Zip Code: ______
Phone Number: ______Student ID# ______
Date of Birth: ______Tribe: ______
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** PLEASE ENCLOSE WITH THIS APPLICATION A COPY OF A TRIBAL IDENTIFICATION CARD OR OTHER DOCUMEMTATION OF NATIVE AMERICAN IDENTITY.
Marital status: ______Married ______Single
Number of Dependents: ______Children: ______Other: (specify)
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Your email address: ______
Campus address: ______
Educational data:
1. Educational program; specific degree or certification you expect to earn:______
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2. Last school attended: ______
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(Please enclose transcripts)
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Name: ______
3. Please list SAT or ACTS scores if entering freshman year;
Verbal ______Math ______Total ______
4. Name and address of school you’ll be attending in 2014-2015 ______
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5. Will you attend the full academic year _____ or part time ______
Non-academic Activities:
1. School clubs and organizations: ______
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2. Other interests and hobbies: ______
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3. Sports: ______
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4. Community activities: ______
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5. Family support activities such as caring for children or other relatives:______
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5. Honors and Awards: (academic and others) ______
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Name: ______
Educational and Professional Goals:
1. Intended field of study: ______
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2. In 250 words or less please state your reasons for seeking a Health career education: ______
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Name: ______
3. Post graduate goals: (i.e. additional education or where you plan to ______
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Recommendations:
Please send separately or enclose with application two (2) current letters of recommendation from teachers, advisors or people in the community who know you well (such as employers, ministers, etc.).
FINANCIAL STATEMENT:
1. Total number of dependents ______. Those dependent upon your parents ______. Those dependent upon you ______. (include not only children, but other dependents such as
grandparents, parents and siblings.)
2. Please explain any extraordinary expenses (i.e. siblings in college; illness or disability in family; extra expenses needed for transportation; etc.______
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3. Cost for college 2014/2015 $ ______
4. Parent Contribution $ ______
5. Student Contribution $ ______
6. Spouses contribution $ ______
7. Calculated Need for 2014/2015 $ ______
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Name: ______
Financial Expenses 2014-2015:
1. Tuition $ ______
2. Fees $ ______
3. Activity fees $ ______
4. Housing and food $ ______
5. Book/Supplies $ ______
6. Childcare $ ______
7. Transportation $ ______
8. Other $ ______
9. Total Expenses $ ______
FINANCIAL RESOURCE 2014-2015
1. Grants $______
2. Tuition Waivers $______
3. Scholarships $______
4. Pell Grant $______
5. SEOG $______
6. Loans (subsidized) $______
7. Loans (non-subsidized) $______
8. Work-Study (FWS) $______
9. Other $______
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Name: ______
10. Please enclose financial need analysis from your university.
PLEASE NOTE: THIS APPLICATION WILL BE CONSIDERED INCOMPLETE IF IT IS RECEIVED AFTER JUNE 15TH; IF LETTERS OF RECOMMENDATION ARE NOT RECEIVED OR CURRENT; IF TRANSCRIPTS AND CURRENT SEMESTER GRADES AREN’T RECEIVED; IF FINANCIAL INFORMATION IS NOT TOTALLY COMPLETED AND IF ANY SECTION OF THIS APPLICATION IS LEFT BLANK WITHOUT AN EXPLANTATION.
Signature of student ______
Date completed ______