Mae W. Langan Scholarship Application

Mae W. Langan Scholarship Application
Scholarship Eligibility Criteria:
- Students must be enrolling in the Phlebotomy or Nurse Aide Program at RACC.
- Students must complete a current FAFSA (Free Application for Federal Student Aid).
- Students must meet the federal guidelines for eligibility for financial aid (citizenship, no default on student loans, etc).
- Students must have financial need for tuition and fees.
- Students must apply at least 2 weeks prior to your program start date.
Note: Only complete this application after you have filed your FAFSA and you have 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
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 *

Nurse Aid Phlebotomy
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.
Write and attach a thank you letter to the Langan Family. Please start with Dear Langan Family. Then include the following:
1. Paragraph One - thank the donors, tell them a little about yourself (family, job, etc) and why you want to pursue this career.
2. Paragraph Two - briefly explain your financial need, what this scholarship means to you personally and thank them one last time.
The thank you letter should be no more than one page, typed and single spaced.
Please attach your thank you letter. *

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