2025 SGF Scholarship Fund Application

Scholarship Application Form

Application Deadline: Monday, May 5th, 2025
If selected, you may asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. Please use proper spelling, capitalization, and punctuation.
Personal Data:

Tell us about yourself
Full Name:*

First NameLast Name
Birth date:*

MonthDayYear
Phone Number:*

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
What best describes your education level:

I am a current high school senior planning to attend undergrad in Fall 2025I am an undergrad college studentI will be starting grad school in Fall 2025I am currently enrolled as a grad student
Major Area of Study:
What is your career objective:

0/300
Where will you be attending school in Fall 2025? If currently undecided, please provide schools which you have applied.
High School Education:
Year of High School Graduation or GED:
High School Attended:
Most recent cumulative GPA (on a 4.0 scale):
Please list any high school activities, community activities, volunteer work, honors, offices held:
For Students Currently Enrolled at a College or University:
Which college or university are you currently enrolled?
Current GPA:
School activities, honors, offices held, etc.:
Extras:
At which of the following centers was treatment received?

Shady Grove FertilityGreater Baltimore Medical CenterUniversity of MarylandReproductive Science InstituteGeorgia Reproductive SpecialistsVirginia Fertility AssociatesJones InstituteCenter of Reproductive Medicine (Houston)
What type of treatment cycle was used (if you have questions, please contact SGF)?

Timed IntercourseIntrauterine InseminationIn Vitro FertilizationFrozen Embryo TransferOther
Name of the Parent(s):
Date of Birth for Parent(s):
Name of Physician at Fertility Center:
Essay
We want to learn more about you! In this essay, please share some of your experiences that make you uniquiely you as well as your future goals and dreams. In your essay, please include:
- your college goals and choice of major
- what you intend to do with your education
- why a scholarship is important to you
- any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of scholarship consideration
Maximum length: 1,000 words
Essay:

0/1000
How do you embody the Shady Grove Fertility core values? Please discuss in detail how you exhibit one of the following core values:
- excellence
- patient focus
- integrity
- compassion
- commitment
Recommended length: 300-500 words
0/500
Please upload one letter of recommendation. The letter must be written by a teacher, coach, or guidance counselor that can speak to your character.

For those with confidential letters of recommendation, please have your teacher, counselor, etc email the letter to megan.augustine@usfertility.com.
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Please upload a letter from your parent(s) indicating their experience with Shady Grove Fertility or their affiliates (as listed above).
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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:*
Should be Empty:

Scholarship Application Form

Personal Data:

High School Education:

For Students Currently Enrolled at a College or University:

Extras:

Essay

Applicant's E-Signature