2025 SCHOLARSHIP APPLICATION

SCHOLARSHIP APPLICATION

SPRING 2025
QUALIFICATIONS:

Applicant must be a high school graduate who plans to pursue a higher education in the medical field in the upcoming school year. Applicant's parent or guardian must be a member of Langdon Prairie Health Hospital & Clinic's, Inc.

(All persons who have been a patient of our Langdon Prairie Health, formerly Cavalier County Memorial Hospital or reside in service area shall be deemed a member of this Corporation)

*THIS IS AN ONLINE FILLABLE APPLICATION ONLY - YOU SHOULD NOT HAVE ANYTHING PRINTED*

Please fill in only applicable fields to the best of your ability. An application will be rejected if the instructions are not followed.

APPLICATION DUE DATE: Friday, April 25th, 2025
Statement of Non-Discrimination:
It is the policy of Langdon Prairie Health Foundation to prohibit discrimination on the basis of race, color, religion, sex, national origin, or disability.
SCHOLARSHIP APPLICATION
Full Name
Phone Number:
Date of Graduation

MonthDayYear
Date
Home Address

Street Address

Street Address Line 2

City, State ZipState / Province

Postal / Zip Code
Name of High School
Parents names
QUESTIONNAIRE
In one or two sentences, describe your career goal
What is your cumulative GPA?
Amount of volunteer hours?
How many credits does your school require for graduation?
Please attach your Transcript!
What two or four-year institution do you plan to attend?
What will be your major?
Please check one

I HAVE APPLIEDI HAVE BEEN ACCEPTED
Beginning with the school you currently attend, list all schools you attended in the last four years.
List any awards or honors you have received in the past four years.
List any programs and activities in school and the community in which you have participated such as clubs, publications, dramatics, music, church events, art, etc
List any jobs you have held in the past four years.
Describe a leadership experience in which you made a difference in your community.
Explain why you have a desire to pursue the career you have chosen.
Why and where do you see healthcare in your future?
What are your thoughts on rural healthcare?
CONFIDENTIAL STATEMENT: Please ask one teacher to write a confidential statement about YOUR general merit and have them email it to: foundation@lph.hospital

I have done this
STUDENT CHECKLIST:

FILL OUT APPLICATION & HIT SUBMITEMAIL TRANSCRIPT TO FOUNDATION@LPH.HOSPITALINDICATE IF THE CHOSEN TEACHER HAS EMAILED THE CONFIDENTIAL STATEMENT
Thank you for applying for this year’s scholarship.

If you are chosen for this award, we will notify you.

Good luck on your next journey and on all your future endeavors!

-Langdon Prairie Health Foundation Board of Directors
Should be Empty:

SCHOLARSHIP APPLICATION

Statement of Non-Discrimination:

SCHOLARSHIP APPLICATION

QUESTIONNAIRE