Carroll Hospital Foundation Scholarships

Carroll Hospital Foundation Scholarships
This form is to be used to apply for the following scholarships:

• The College Scholarship Fund for Dependents of Team Members
• The Virginia Minnick Auxiliary Scholarship
• Team Member Scholarship created by Physicians of Indian Origin

Please complete the below online application. All application materials must be submitted by April 12, 2024. Applicants MUST include:
- Transcript/4-Year accredited college acceptance letter
- Resume and completed list of extra-curricular activities
- Typed Letter of Recommendation
- 500-word Essay Requirement, Prompt: “What I Consider to be my Greatest Accomplishment” or “What I am Most Proud of”
- Financial Statement – Mail a detailed typed explanation of your financial need or your FAFSA form. This information will be kept confidential and used only in the evaluation of scholarships from Carroll Hospital.
If you need to email or mail any documentation:

Mail to:

Carroll Hospital Foundation
Attn: Darlene Britton
(Carroll Hospital Foundation Scholarships)
200 Memorial Ave.
Westminster, MD 21157

Email:

carrollfoundation@lifebridgehealth.org
Employee Name*

First NameLast Name
Employee Email*
example@example.com
Employee Phone Number*
Please enter a valid phone number.
Employee Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Name*

First NameLast Name
Student Home Address (if different from employee address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Email*
example@example.com
Student Phone Number*
Please enter a valid phone number.
Have you ever applied for or received this scholarship before?*

YesNo
Check all scholarships applied for:

Dependents of Team MembersTrumpowerVirginia MinnickPhysician of Indian Origin
Name of High School*
High School City, State, and Zip*
Dates Attended High School*
High School Weighted/Unweighted GPA*
Name of College/University*
City and State of College/University*
Dates attended (or intended) College/University*
College/University GPA*
List below all activities, both in and out of school, and dates participated. Include school, community, organizations, volunteerism, awards and recognition.
School/Community/Organization/Volunteerism
Awards/Recognitions

List all other scholarships or financial aid applied for or received

	$ Amount	Date	From
1
2
3
4
5

Essay
500-word Essay Requirement, Prompt: “What I Consider to be my Greatest Accomplishment” or “What I am Most Proud of”
Attach Essay Here

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Transcript
Upload college acceptance letter or if currently enrolled, most recent transcript. Scholarship award is contingent upon proof of acceptance into an accredited program. If applying for a certificate, add certification documentation.
Attach Transcript Here

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Typed Letter of Recommendation

One typed letter of recommendation for the student to be uploaded.
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Resume & Extra-Curricular Activities

Most recent resume to be uploaded
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Agreement and Signature*

I certify that the information on this application to the best of my knowledge is true, and I understand that any material misrepresentation will disqualify me for the scholarship.
Applicant Signature*
Date*

MonthDayYear
Date
Associate Signature*
Date*

MonthDayYear
Date
Should be Empty: