Career Program Scholarship Application

Career Program Scholarship Application
Scholarship Eligibility Criteria:
- Students must be enrolling in the Home Health Aide, Phlebotomy, Pharmacy Technician or Nurse Aide Program at RACC.
- Students must complete a current FAFSA (Free Application for Federal Student Aid) or state why this is not possible.
- Students must show financial need and not be default of a student loan.
- Students must complete all the admission requirements prior to applying for scholarships.
- Students must apply at least 2 weeks prior to orientation.
Note: Only complete this application after you have filed your FAFSA and completed ALL your admission requirements. You will need official start and end dates for your program of study from Career Programs.
Date of Submission: *

Month Day Year
Date Hour Minutes AM/PM Option
Date you filed your FAFSA *

Month Day Year
What Date did you file your FASFA
If you were not able to file your FAFSA, please state why.
Date you completed all your admission requirements *

Month Day Year
NOTE: Please use official name used on FAFSA, no nicknames.
Name: *

First Name Last Name
Maiden Name if Applicable
Student ID# (if known)
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
High School *
Year of graduation from high school. *
Which class are you planning to enroll *

Home Health Aide Nurse Aide Phlebotomy Pharmacy Technician
Do you have a need for a laptop to help you complete the Pharmacy Tech Program?
Ex. No computer, outdated computer, or no need for a laptop.
Class Start Date *

Month Day Year
Check with Career Programs for official dates
Class End Date *

Month Day Year
Check with Career Programs for official dates
Will any of your costs be paid by OVR, CareerLink, scholarships or an employer? *

Yes No
Please list the source and the amount.
Do not include PELL, PHEAA, and loans.
Explain your current financial need. *
Can we share your scholarship application and essay with our Foundation Board and the Community? *

Yes No
Are you a current military member, a former military member or direct family member of active or retired military (with an honorable discharge)? *

Yes No
Explain your relationship with the military (current member, veteran, child of a veteran, etc.)
Write and attach a thank you letter to your donor in 300 words or more.
- For the Phlebotomy, Nurse Aide and Home Health Aide Programs, please start with Dear Langan Family.
- For the Pharmacy Technician Program, start with Dear Truist Foundation.
You should thank your donor, include a little about you (education and jobs you had), family, explain your financial need, why you chose this career, explain what receiving this scholarship meant to you personally and thank you donor one last time.
Please attach your thank you letter. *

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Let us know you are a human. *
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