SBAMH AUXILIARY VOLUNTEER OF THE YEAR NOMINATION

SBAMH AUXILIARY & FOUNDATION SCHOLARSHIP APPLICATION
Application Outline

The Foundation and Auxiliary proudly serve as the philanthropic arms of Susan B. Allen Memorial Hospital. We are deeply grateful for our dedicated Auxiliary members, volunteers, and generous donors whose passion and commitment continue to support and uplift our hometown hospital. Because of their generosity, funds raised through the Foundation and Auxiliary are returned directly to the hospital to provide essential equipment, support meaningful programs and projects, and offer scholarships that help shape the future of healthcare. We believe strongly in investing in people—especially our up‑and‑coming healthcare professionals—and are honored to support students as they pursue a calling in medicine and service to others.
Scholarship Requirements:

-----Student must complete this application AND send current transcript for this past semester to SBAMH Auxiliary Scholarship Chair, Eddie Stackley at stackleye@gmail.com.

-----Student must submit: one letter of recommendation (via separate link provided)

IF I am selected as a scholarship recipient, I understand I am required to:
1. Complete the entire application and submit supporting documents requested, and be classified as a full-time student in the healthcare field (and successfully complete at least 12 credit hours).
2. Submit proof of registration to Eddie Stackley in order to receive scholarship amount for the semester.
3. Maintain a GPA of 3.0.
4. Submit a copy of updated transcript upon completion of each semester to Auxiliary Scholarship Chair, Eddie Stackley at stackleye@gmail.com.
5. Notify the Auxiliary via email if a course is dropped or incomplete and reasons why.
6. Reimburse the SBAMH Auxiliary for all scholarship funds advanced in the event the student does not meet the criteria of the scholarship agreement.

-----If you have any questions, please contact SBAMH Auxiliary Scholarship Chair, Eddie Stackley at stackleye@gmail.com.
Your First & Last Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Current Occupation
Current Employer
Have you ever been employed or volunteered at Susan B. Allen?
Semester for Requested Scholarship
Desired Degree
College/University/School Attending & Year
Overall GPA
Anticipated Graduation Date
Number of Hours Enrolled for Requested Semester
Tell us about you!
What things do you do, have done or have accomplished in your life that have given you the greatest personal joy?
What are your summer/fall break plans? What do you like to do in your leisure time?
Letter of Recommendation Required
I will send the separate link (provided by the Auxiliary) seeking a letter of recommendation from an employer (former or current), or someone who knows me in a professional setting (i.e. teacher, pastor, mentor, coach, etc.) endorsing me as a candidate to receive this scholarship.
Transcript
I agree to send my current and an updated transcript upon completion of each semester to SBAMH Auxiliary Scholarship Chair at 720 W. Central El Dorado, KS 67042
Proof of Registration
I agree to send my proof of registration to SBAMH Auxiliary Scholarship Chair at 720 W. Central El Dorado, KS 67042
Credit Hours
I agree to notify the SBAMH Auxiliary Scholarship Chair, Eddie Stackley if I don't maintain 12 credit hours or more, due to a course being dropped or being incomplete. *12 credit hours are required for scholarship eligibility.
Reimbursement
I agree to reimburse the SBAMH Auxiliary for all scholarship funds awarded if I don't meet the criteria of the scholarship agreement.
Submit Application
I certify that I have provided complete and accurate information on this application. I have reviewed the eligibility requirements and understand the obligation associated with this scholarship. I also agree to comply with all the provision stated in this agreement.
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SBAMH AUXILIARY & FOUNDATION SCHOLARSHIP APPLICATION

Application Outline

Tell us about you!

Letter of Recommendation Required

Transcript

Proof of Registration

Credit Hours

Reimbursement

Submit Application