General Scholarship: Application - Wisconsin Medical Society

Foundation General Scholarship Application
Note: You can save your application and continue later at the bottom of the page. However, all required fields need a drafted response.

Learn more about Foundation scholarships here.
Are you currently enrolled and will you continue to be enrolled full-time in the next academic year beginning after July?
Do you wish to practice in Wisconsin when you complete your training?
Are you a student member of the Wisconsin Medical Society?
What is your anticipated year of graduation?
What is your Student ID for financial aid at your school
This is the number that is used to tie your scholarship to your own financial aid packet. It is not a social security number or FAFSA School ID.
Full-time enrollment and affiliations in the next academic year. (Check all that apply.)
Name of School:
Financial aid office of your school:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Section Two: Background Information
Name

First NameMiddle NameLast Name
Preferred Name
How would you like to be addressed in correspondence
Pronouns
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Email

Confirmation EmailA copy of your responses will be sent to this address.
Non-school Email

Confirmation Email
Phone Number

Area CodePhone Number
If you graduated from high school in Wisconsin, from which Wisconsin County did you attend high school?
Number of dependents under the age of 18
Please enter a number from 0 to 20.
What is your total school debt; including undergraduate and student loans?
What is your total unmet financial need for next year?
This number should include all expected out-of-pocket expenses and all loans you plan to take out.
Are you the first person in your family to obtain a bachelors degree or higher?
Award Determination: This section helps to determine which named scholarships you will be considered for. If you answer "yes" to any of the questions below, please explain in your personal narrative. Select all that apply.

Presidential Scholar Award: I am entering my final real of medical school and am actively involved with the Wisconsin Medical Society, AMA or county medical society. Preference is given to students from Wisconsin who wish to practice in Wisconsin. You must have a letter of recommendation from a Wisconsin Medical Society member or County Medical Society officer who has worked with during your involvement.
List the major or specialty you are considering:
List any Wisconsin Medical Society committees you have participated in or have been a member of:
For the Presidential Scholar Award only - Please affirm the following:
Personal Statement

In the text box provided below, please type or cut and paste your personal statement. Your personal statement is an important aspect of the application and is the equivalent of an interview. Please make sure you address the following:

Brief family background; achievements; current higher education status; career goals including practice type(s) of most interest (specialty, primary care, urban, rural, academic, etc.); financial need for this scholarship; examples of your leadership including with the Wisconsin Medical Society, AMA, your county medical society or your school; examples of your volunteerism; unusual circumstances; any other information relevant to this application.
Personal Statement:

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Certification: By checking this box I certify all of the information provided is complete and accurate to the best of my knowledge. I hereby give the Wisconsin Medical Society Foundation Scholarship Selection Committee permission to share this information, with the exception of my financial information, for the purpose of recruitment and public relations. I further certify that I am currently enrolled in a medical school or in a nursing or related health career program at an accredited college or university for the upcoming academic year, and will use the Foundation scholarship award toward expenses related to my education. Falsification of information may result in termination of any scholarship granted. All application materials become the property of the Wisconsin Medical Society Foundation.
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Would you like to save and continue later? After clicking Submit, a link to your responses will appear on the screen and be emailed to your school email. Save this link to continue your responses later. Note: all required questions must have a drafted response before clicking Submit.
At this time all Wisconsin Medical Society Foundation Awards can only be made to students currently enrolled full time as well as in the next academic year. If you have questions, please contact Jaime Craig. We wish you all the best in your career. Thank you.
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Foundation General Scholarship Application