RHA Scholarship Application Form

Future Nurses Scholarship Application Form

Application Deadline - May 31st of current year
Read and follow the instructions carefully prior to submitting your application. If you emailed an Essay, please attach it to this form by copying and pasting your Essay below.
Read and Understand the instructions.*

Yes, I have
Scholarships are awarded in May. If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.
I. Personal Data:

Tell us about yourself
Full Name*

First NameLast Name
Birthdate:*

MonthDayYear
Mobile No. :*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Optional Informations : Information regarding gender, ethnic origin and race are optional. The information is requested for post-scholarship report generation only and in no way affects your selection for scholarship awards. However, providing this information may increase your opportunities for scholarships where donors have asked that priority consideration be given to students meeting certain demographic criteria (such as minority status, parent's place of employment, area of study, etc.)
Gender:

MaleFemale
Are you a US citizen?

YesNo
Ethnic Origin:

HispanicNon-HispanicNot Indicated
Race? (Choose one or more):

WhiteBlack or African AmericanAsianAmerican Indian or Alaskan Native Hawaiian or Other Pacific IslanderNon-Resident Alien
Status at the time of application:

I will graduate in MayI have attended college but have less than 32 college credit hoursI will be enrolling into college within the next 6 monthsI am a GED graduate with no college credit hours
Are you a first generation college student ?

Yes, I am the first among my parents or grandparents to attend college.No, either my parents or grandparents have attended college.
Major Area of Study:
Please indicate what is your major are of study
II. High School Information:
Are you or will you be a May of the current year high school graduate?

YesNo
High School Attended:
Year of High School Graduation or GED:
Most recent cumulative GPA:
High School activities, community activities, volunteer work, honors, offices held:
VI. Extras:
Resilient Healthcare Academy administers many scholarships designed to offer aid to students that represent unique characteristics. Please check each of the qualifiers below that apply to you. This data may increase your likelihood of qualifying for selected scholarships. Please note, if you are awarded a scholarship based on any of these qualifiers, you will be asked to produce documentation verifying your unique eligibility.
Have you ever received a scholarship at Resilient Healthcare Academy?

YesNo
Do you have a disability?

YesNo
Are you a GED recipient?

YesNo
Do you have an Highschool Diploma or a Highschool senior?

YesNo
Are you pursuing a Career in Nursing or Healthcare?

YesNo
Do you plan on working as a CNA for any amount of time

YesNo
Were you born outside the USA?

YesNo
If so, what country?
Were your parents born outside the USA?

YesNo
If so, what country?
In addition to a scholarship, would you like to be considered for co-op opportunities (working part-time for tuition support with company relevant to your major)?

YesNo
Will you be working while attending Resilient Healthcare Academy?*

YesNo
If so, will you work:

Full-timePart-time
VII. Essay
Your essay should be 150-300 words. You should address in your essay: Why you are pursuing a career in Nursing. Your career goals and why a scholarship is important to you. Include any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of scholarship consideration.
Essay:

0/500
VIII. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:*
Resilient Healthcare Academy is committed to equal opportunity in employment and education. The School does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

Future Nurses Scholarship Application Form

I. Personal Data:

II. High School Information:

VI. Extras:

VII. Essay

VIII. Applicant's E-Signature