General Scholarship Application

The Joe Atkins Memorial Scholarship is designed to provide professional and personal development for continuous growth, advancement, and success through education, community involvement and mentoring. The scholarship provides financial support to Veteran transplant recipient(s) or candidates attending establishment(s) of higher learning.

Eligibility.

Applicants must be either be a Solid Organ (heart) Transplant Recipient or Waiting for a Solid Organ (heart) Transplant in Stage D or Class IV heart failure (HF).

Requirements.

Applicants must be able to submit a letter from their physician stating their congestive heart failure (CHF) stage that includes the physicians name and phone number. A letter of service in the form a DD214 or a letter from the Commander from NG or Reserve members whom may not have a DD214 for validation of military service.

Monetary Amount.

Veterans Transplantation Association will award a monetary amount not to exceed $500 directly to said institution in which was submitted by applicant in the application process.

Submission.

Open 1 Sept 2024 | Deadline: 11 Nov 2024

*All awardees will be notified on or before the 1st of Dec 2024.

SPECIAL NOTE - THIS APPLICATION WILL NEED TO BE COMPLETED IN ONE SESSION. YOU WILL NOT BE ABLE TO SAVE WORK AND COMPLETE LATER. BEFORE YOU START, PLEASE HAVE ALL THE NECESSARY INFORMATION READY TO COMPLETE THE APPLICATION.
Joe Atkins Scholarship Application 2024

For Solid Organ (Heart) Transplant Recipients
Personal Information*

First NameMiddle NameLast Name
Mobile Phone Number*

Area CodePhone Number
Home Phone Number*

Area CodePhone Number
Home Address*

Street Address

Apt/Unit #

CityState

Zip Code
E-mail*
Enter E-mail Here
College Information*
College/University where you've been accepted
Diagnosed Date*
Diagnosed Hospital/Clinic Name*
Organ(s)/Tissue Received (if applicable)*
Branch of Service*
End of Service*
Current LES
(For active duty applicants)
With CHF, what two sleeping positions should you avoid?*
What are the types of treatment offered for Stage IV CHF?*
What was the measurement of your ejection fraction “EF”?*
What are the location options for a continuous inotropic infusion?*
In a heart failure diet, are you allowed to eat whole grains?*
Complete an essay (at least 2 paragraphs) detailing “What does it mean to you, to be a veteran transplant recipient or candidate”?*
Upload*

Upload a File
Upload Physician's Letter Cancelof
Upload*

Upload a File
Upload Letter of Service/DD214 Cancelof
Upload*

Upload a File
Letter of acceptance to college/university Cancelof
If you have questions regarding any part of this application, how to complete it, or the requirements for its submission, please contact bljohnsonvta@gmail.com, subject: Scholarship.
E-Signature*
By signing (typing your legal name) in the space below, you are agreeing to have read and understood the application requirements, and that you are certifying that all information is correct and you are in fact the person completing this application. Please print for your records and retain as verification of your application.
Should be Empty:

Joe Atkins Scholarship Application 2024