2025 Resident and Fellows Debt Relief Award Application

Resident & Fellows Debt Relief Award

The Rainbow Chamber Foundation’s Resident & Fellows Debt Relief Award was established, in collaboration with UC Davis Health, to provide financial relief to LGBTQ+ and LGTBQ+ supportive resident and fellow physicians actively in a healthcare training program.
Award Application Form

Application Deadline - August 15th, 2025 Please submit your questions to: scholarships@rainbowchamber.com
General Award Information

• Funds are available to LGBTQ+ and LGBTQ+ allied resident and fellow physicians in an active healthcare training program.• LGBTQ+ identifying and LGBTQ+ allied resident and fellow physicians actively in a healthcare training program are welcome to apply.• The award value is $1,500. Based on the number of applications received, there may be up to two (2) awards provided for two (2) separate selected applicants.• Scholarships are paid in one installment and will be awarded at our annual Boas and Bow Ties Gala.• Applications will be accepted April 1st, 2025, through August 15th, 2025.• SAVE THE DATE – October 9th, 2025: All selected recipients, plus one guest, will be invited to attend the Sacramento Rainbow Chamber of Commerce Annual Boas & Bow Ties Gala.
Requirements

• Must be in an “active” status of a current resident or fellow physician training program; OR have been offered, accepted, or matched to a residency or fellowship training program by August 15, 2025.• Must reside in and attend an active resident or fellow physicians training program in the following counties: Sacramento, Amador, Butte, Calaveras, Colusa, El Dorado, Nevada, Placer, Plumas, San Joaquin, Sierra, Solano, Stanislaus, Sutter, Tuolumne, Yolo, or Yuba.
Read and Understand the instructions.*

Yes, I have

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
Fellowship - Residency Training Program Year (Mark N/A if not applicable)*
Residency - Fellowship Program Year (Mark N/A if not applicable)*
Residency - Fellowship Training Program Specialty Areas (Mark N/A if not applicable)*
Name of residency/fellowship training program school, or college:*
Graduate Medical Education Program Coordinator Name:*
Graduate Medical Education Program Coordinator Email:*
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you previously received a scholarship from the Rainbow Chamber?*

YesNo
How did you hear about this scholarship opportunity?*
Confidential Application Disclosure:

An applicant may, without any adverse impact on the consideration of their application, indicate in writing on the application that any award remain confidential. In such an event, attendance at the dinner will not be required, the recipient will not be identified by name at the dinner, and the Foundation will not place that recipient’s information on the Foundation website. However, the Foundation cannot further guarantee confidentiality.
Do you request your application to be confidential?*

YesNo

Extracurricular and/or Community Service Activities

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1. Name of Organization

NameName
Position Held within Organization
Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Upload Description of Duties Performed
Upload a Description or Duties Performed

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Name

First NameLast Name
Phone Number

Area CodePhone Number
2. Name of Organization

NameName
Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position Held within Organization
Upload Description of Duties Performed
Upload a Description or Duties Performed

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Reference Name

First NameLast Name
Phone Number

Area CodePhone Number
3. Name of Organization

NameName
Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position Held within Organization
Upload Description of Duties Performed
Upload a Description or Duties Performed

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Reference Name *

First NameLast Name
Phone Number

Area CodePhone Number
4. Name of Organization

NameName
Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position Held within Organization
Upload Description of Duties Performed
Upload a Description or Duties Performed

Browse Files

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Reference Name

First NameLast Name
Phone Number

Area CodePhone Number

Additional Requirement

• Short Bio: Please tell us about yourself and include why you are pursuing medicine? Please also include the following information: Phonetic spelling of your name, Pronouns, & School name and course of study
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Additional Documents

Please upload a minimum of one letter of recommendation
L.O.R. 1 (Recommended but not required)

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L.O.R. 2 (Recommended but not required)

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Additional Requirement

Email/Letter confirming resident or fellow physician training program status. Must include training program start date and contact information for validation of “active” status.
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Additional Requirement

Personal Essay (500 words minimum; 2-page maximum) responding to the following prompt: Describe a time when your identity as an LGBTQ+ individual or ally shaped your perspective, resilience, or aspirations. Reflect on how this experience influenced your personal growth, community involvement, and goals. Additionally, explain how the LGBTQ+ community has impacted your journey toward higher education and what inspired you to pursue a career in healthcare. Discuss why you are applying for this scholarship, how you've made a difference within the LGBTQ+ community, and how you plan to advocate for and support the LGBTQ+ community in your future healthcare career.
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Additional Requirement

Personal reflection statement: Please provide a brief statement (250 words or less) to one (or both) of the following prompts: 1) If you could have dinner with any LGBTQ+ icon (past or present) who would it be and why? OR 2) What was a small act of kindness that had a big impact on you?
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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:*
We highly encourage printing a copy of your submitted scholarship application. For any questions regarding your application, please contact scholarships@rainbowchamber.com.
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Resident & Fellows Debt Relief Award

Award Application Form

General Award Information

Requirements

I. Personal Data:

Extracurricular and/or Community Service Activities

Additional Requirement

Additional Documents

Additional Requirement

Additional Requirement

Additional Requirement

VIII. Applicant's E-Signature