Future Leaders Scholarship Application

Future Leaders Scholarship Application

This scholarship application is specifically for BIPOC candidates pursuing studies or careers in health and or wellness for up to $2,000.
Eligibility Requirements:
- Be a high school senior, undergrad, or graduate student at an accredited institution.
- Proof of enrollment (e.g., enrollment verification letter from the college’s registration office, tuition invoice or bill issued by the school’s billing or registration office, and transcript (Official or Unofficial)).
- Identify as a person of color (e.g., Black/African American, Native American, Native Hawaiian/ Pacific Islander, Alaskan Native, Asian, Hispanic/Latino).
- Be pursuing or planning to pursue a degree in a health and/or wellness-related field (e.g., Nursing, Public Health, Pre-Med, Health Administration, Medical Assistant, Nutrition, Mental Health, Counseling, etc.).
- Have a cumulative GPA of 2.5 or higher on a 4.0 scale.
- Demonstrate a commitment to improving healthcare outcomes in underserved communities.
- Must attend the BIPOC Health & Wellness Fair on 07/26/25 from 11 am to 2 pm at Eastside Community Center: 1721 E 56th St. Tacoma, WA, 98404.
- The scholarship application deadline: Friday, June 27th, 2025 at 11:59 pm.
Your Name*

First NameLast Name
Your Email*
example@example.com
Date of Birth

MonthDayYear
Date
Your Phone Number*
Format: (000) 000-0000.
Education Level*
Accredited School Name*
(Currently Enrolled or Pending Enrollment)
Current GPA (or GPA when you were last enrolled in school)*
Intended major or field of study*
Date of Enrollment or Pending Enrollment*

MonthDayYear
Date
Accepted Documents for Proof of Enrollment (Please submit two out of three documents listed below):

1) Enrollment verification letter official letter from the college registrar’s office should include: student’s name, student ID, enrollment status (full-time/part-time), and institution name. 2)Tuition invoice or bill issued by the school’s billing or registration office should show the student’s name, current term, and tuition charges. 3)Transcript (Official or Unofficial).
Transcript*

Cancelof
Proof of Enrollment*

Cancelof
Proof of Enrollment (additional documentation, if needed)

Cancelof
Proof of Enrollment (additional documentation, if needed)

Cancelof
Black/African AmericanPacific Asian/Pacific IslanderNative Hawaiian/Other Pacific IslanderAlaskan NativeHispanic/LatinoAsianOther
If other, please indicate below:
Tell us about yourself. What are your academic and career goals in the field of health and/or wellness?*

0/250
What inspired you to pursue a career in health and/or wellness? Share a personal story or pivotal moment that shaped your interest.*

0/250
How does your cultural background influence your interest in health and/or wellness?*

0/250
What challenges have you overcome in your educational or personal journey, and how have they prepared you for a career in health and/or wellness?*

0/250
I hereby declare that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any false or misleading information may result in disqualification from the scholarship selection process or revocation of any award granted.

I also certify that I am in good health and do not have any medical condition that would prevent my full participation in the activities required by this scholarship program.

By submitting this application, I give my consent for the scholarship committee to verify any of the information provided and to contact relevant individuals or institutions for references or documentation, if necessary.
Candidate Signature*

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This application is designed to evaluate applicants' passion, lived experience, leadership, and commitment to serving the community.
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Future Leaders Scholarship Application

Accepted Documents for Proof of Enrollment (Please submit two out of three documents listed below):