Return to the office

by April 1

HOSPITAL AUXILIARY $1000 SCHOLARSHIP

($500 at beginning of 2nd Semester of the 1st year

and $500 at beginning of the 2nd year)

Health Related Field

Name __________________________________________________________________

Address_________________________________________________________________

Parent's Name___________________________________________________________

GPA____________

Class Rank__________________

Major Field of Study______________________________________________________

College or University______________________________________________________

Please write a paragraph or two telling us about yourself and what you hope to accomplish in life.

List and/or explain any involvement in community activities (4-H, scouts, church etc.)

List and/or explain any extra-curricular school activities and years of involvement.

Describe any special circumstances which may have limited your participation in school and community activities.