Mercer Health Medical Student Scholarship Application

Applications must be submitted by October 1st.

The purpose of this program is to support medical students from Mercer County and the surrounding counties as well as medical students who have participated in rotations at Mercer Health by offering scholarships to those individuals. Scholarships will be awarded based upon application. Criteria:

Applicant must be a United States Citizen.
Applicant must be a resident of Mercer County or one of the adjacent counties for at least 12 months before registering as a medical student or have participated in a rotation at Mercer Health.
Applicant must be enrolled full time in an accredited medical school.
Applicant must be enrolled in or entering his/her first, second, third or fourth year of medical school.
The Selection Committee will review all online applications.
Only online applications will be accepted. Paper applications will not be considered. A transcript of their medical school courses/grades is also required.
The Selection Committee does not discriminate on the basis of creed, race, color, religion, national origin, disability, age, sex, or sexual orientation in awarding scholarships.

Applicant must use the online application portal to submit the following:

Completed scholarship application
A letter, on school letterhead, verifying the applicant is enrolled full time as a medical student at that institution.
Recent transcript

Payment of Scholarship:

The scholarship will be for $2,000.
Scholarships will be awarded for a one-year period.
The payment of the designated amount will be made directly to the student.

Part I:

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Daytime Telephone Number(Required)

Email Address(Required)

High School Graduated From(Required)

Part II: Education

List in reverse chronological order, all colleges, universities, and professional schools attended. (Most recent first) Major and Minor Fields, Dates of Attendance, Degree Received or Pending Year, Name & Address of Institution(Required)

Part III

List below the professional employment you have held. (Most recent first) Institution, Dates, Nature of Duties(Required)

Part IV

Please list honors, grants, publications, special projects. (Most recent first)(Required)

Part V: Essay

In 500 words or less, please describe your reasons for pursing a medical career and how you hope to be involved in your community beyond clinical care of your patients.(Required)

Part VI: References

Please list two references with phone numbers who could be contacted by the committee.(Required)

In addition to the Scholarship Application, please submit:

Letter, on medical school letterhead, verifying the applicant is enrolled as a full time medical student at that institution
Recent school transcript

Verification Letter(Required)

Max. file size: 300 MB.

School Transcript(Required)

Max. file size: 300 MB.

ALL ITEMS MUST BE INCLUDED: Failure to include any of this information MAY result in not accepting the applicant for an interview. Applicant's Certification: I certify that the answers submitted to the foregoing questions and statements are true and correct. I hereby release from liability all representatives of the scholarship committee for their acts performed in good faith and without malice in connection with evaluating my Mercer Health Scholarship application. I hereby release from liability all individuals and organizations who provide information to the scholarship committee in good faith and without malice concerning my Mercer Health Scholarship application. I hereby consent to the release of such information.

Signature of Applicant:(Required)

Date:

Application must be submitted by October 1st.
Applicant will be notified of committee’s decision by December 1st.
Award checks will be mailed to recipient by December 31st.

Contact the MED Foundation at 419-678-5679 if you have any questions.

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