2025 Memorial Hospital Scholarship Application

2025 Memorial Hospital Scholarship Application

Memorial Hospital administers two scholarships opportunities for high school students.
Due date: Return application & documents by Tuesday, April 1, 2025
Please indicate which scholarship(s) you are applying for:*

Memorial Hospital/HIA Scholarship: A $500 scholarship will be for high school student(s) living in Hancock County and interested in pursuing further education in any health care profession or career.Memorial Hospital Medical Staff Scholarship: A $500 scholarship is given in honor of the medical staff at Memorial Hospital and Memorial Medical Clinics and will be for a high school student(s) interested in pursuing further education in any health care profession or career.
Personal Information
Your Full Name*

First NameLast Name
Parent's Name*

First NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com By providing your email, you agree to be added to our marketing list to receive updates, promotions, and news; you can unsubscribe at any time.
Educational Information
High School you attend:*
Cumulative grade point average*
ACT/SAT Score*
What honors (academic or otherwise) have you received and when? Please attach additional documentation if needed to list your achievements.*
Please attach additional documentation if needed to list your achievements.

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Future Plans
What school will you attend Fall 2025?*
School City and State*
What is your professional goal?*
What is your course of study?*
Full or Part-Time Student?*
Expected graduation date?*
What has inspired you to pursue a career in healthcare?*
You must attach your official high school transcript with your application.*

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Signature*

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For additional information, please contact

David Zanolla

dzanolla@mhtlc.org
Subject: 2025 Scholarship Application

Or feel free to call David at 217-357-6577
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2025 Memorial Hospital Scholarship Application

Personal Information

Educational Information

Future Plans