HAWARDEN COMMUNITY HOSPITAL FOUNDATION SCHOLARSHIP

Student Scholarship for $500

The Scholarship will be available to students pursuing an education in the medical field. The Scholarship will be available for students attending the following area schools: West Sioux, Akron-Westfield, Alcester-Hudson, and Unity Christian.

The Hawarden Community Hospital Foundation will grant one $500 scholarship. This will be paid to the scholarship receiver at the beginning of the second semester upon successful completion of the first semester.

The application must be completed and submitted by March 1, 2005.

Name __________________________________________________________________

Address ________________________________________________________________

Parent’s Name ___________________________________________________________

GPA _____________________

Class Rank ___________________

Major Field of Study ______________________________________________________

College or University ______________________________________________________

________________________________________________________________________

• Please write a paragraph or two telling us about your goals for the future.

• Tell us about how you hope to enhance the health care services in your community.

• List and explain the activities that you have been involved in through the years of school

• Describe any special circumstance or events that have influenced your life.

• What plans have you made for financing your college education?

• Name the institutions where you have applied.

• Describe the qualities of the individual you would select to receive this scholarship (other than yourself).

Please attach your typewritten responses to the above questions to this application.