The Medical College of Virginia Alumni Association of Virginia
Commonwealth University is pleased to announce the availability
of the following scholarship.
The MCVAA Legacy Scholarship is for direct relatives (children/stepchildren, grandchildren/stepgrandchildren) of dues paying members of the MCV Alumni Association. This scholarship award will provide preference to an applicant whose eligible relative has given volunteer time and/or resources to the School and/or to the alumni association. This non-renewable one time award is being made available to first year students who are enrolled in an academic program on the MCV Campus and who have demonstrated leadership potential through their studies and through volunteer service. Resources for this scholarship were provided by private fund raising.
Medical College of Virginia
Alumni Association of VCU
Legacy Scholarship Application Form
All responses must be typed
______
Applicant Name: ______V# ______- _____ -_____
(Last) (First) (MI)
MCV Campus School/Program to which you have been acceptedor are currently enrolled:
______
Current Mailing Address: ______
(Number, Street and Apt. No.)
______Telephone: ( ) ______
(City) (State) (Zip)
E-mail Address: ______
Permanent Address:______
(Number, Street and Apt. No.)
( )
(City) (State)(Zip)(Telephone)
Gender ___ Male___ FemaleDate of Birth: _____/______/______
Month Day Year
Marital status______Number of dependents: ______
Education
NameLocationDates AttendedMajorDegrees
High School______
Undergraduate______
Graduate______
Other______
List all honors or awards received in undergraduate or graduate school.
(Use additional sheets if necessary)
Name of AwardCitationSchoolDate______
List in chronological order, major professional, social, civic and student organizations, in which you have participated. (Use additional sheets if necessary)
DateActivity______
______
PersonalStatement: Please provide a statement discussing your personal and professional goals over the next ten years. Please include how you fulfill the criteria for this award with emphasis on leadership roles and your potential for distinguished contributions.Statement should be no longer than one page in length. Your name and V number should appear at the top of the page.
MCV ALUMNI ASSOCIATION MEMBER INFORMATION
(Please include a statement of Association or School involvement – no longer than one page in length)
Name: ______Living ___ Deceased ____
(First)(Last) (MI)
Annual Member _____ Life Member ______
Applicants Relationship To Member ______
Graduated from Which MCVCampusSchool? ______Date of Graduation ______
Address: ______
Telephone # ( )______E-Mail Address ______
I authorize my undergraduate school to release information concerning my academic status and financial aid package to the MCV Alumni Association in support of my application for the MCVAA Legacy Scholarship. I understand this application will be reviewed by members of the program’s selection committee and give my permission for this application and supporting documentation to be copied and distributed for this purpose. I also give my undergraduate school permission to release information to MCVAA concerning future address information and postgraduate training plans for follow-up purposes.
Signature ______Date ______
Please send all required application materials to:
MCV Alumni Association Legacy Scholarship Program
MCV Alumni Association of VCU
P.O. Box 980156
Richmond, Va.23298-0156
(804) 828-3900
(800) 628-7799
Criteria for MCVAA Legacy Scholarship
Application requirements include:
- Two letters of recommendation from individuals who can address the required criteria (non-relative);
- Two official academic transcripts (to include undergraduate school grades as well as grades through Fall 2014 semester);
- A scholarship application in which the candidate provides personal and educational information;
- A personal essay no longer than one page in length, written by the student, that discusses his or her motivation for a career in health care and career plans over the next ten years. Essay should include how you fulfill the criteria for this award with emphasis on leadership roles and your potential for distinguished contributions.
- A copy of student’s resume.
Criteria forselection of the MCVAA Legacy Scholarship includes:
- Must be a child/stepchild, or grandchild/stepgrandchild of a dues paying member of the MCV Alumni Association. Preference will be given to eligible relative who has given volunteer time and/or resources to a School on the MCV Campus of VCU and/or to the MCV Alumni Association.
- Outstanding academic achievement as indicated in academic transcripts,
faculty evaluations, by receipt of special academic honors, fellowships, awards or induction into national honor societies.
- Leadership, indicated by active participation in community-based work or initiation of innovative projects in school or community.
- Potential for distinguished contributions to health care as indicated by participation in research, volunteer work, or unique clerkships or internships.
All application materials must be in the MCV Alumni Association office no later than June 15, 2015. The MCV Alumni Association cannot guarantee that applications received after the deadline date will be given consideration for awards. If you have any questions, contact Judy Frederick, MCV Alumni Associate Executive Director at (804) 804-628-0394, or
All applications should be mailed to:
MCVAA Legacy Scholarship Program
MCV Alumni Association of VCU
P.O. Box 980156
Richmond, Va.23298-0156
Attn: Judy Frederick
(804) 628-0394
OR hand delivered to: MCV Alumni Association of VCU
MCV Alumni House and PaulA.GrossConferenceCenter
1016 East Clay Street
Attn: Judy Frederick
(corner of 11th and Clay Streets)