C.A. "Butch" Shelton III Healthcare Scholarship (Class of '65)

C.A. "Butch" Shelton III Healthcare Scholarship (Class of '65)
This scholarship was established to support students in the Practical Nursing program. It is based on academic merit, aptitude, and financial need with priority for heads of household supporting children. The maximum amount of the award is $2,000. It may be used to assist with tuition, books, and other fees assessed by the school and will not be disbursed to the selectee(s) directly.

If a selectee leaves the nursing profession, the Selection Committee may require the recipient to reimburse the Fund the amount that was awarded to them.
Applicant Name*

First NameLast Name
I am a current student in the SoMoTech Practical Nursing Program.*

Yes
I have completed at least three months of the SoMoTech Practical Nursing Program.*

Yes
I am a "head of household supporting children."*

YesNo
I am a veteran that received an honorable discharge.*

YesNo
Why do you believe you should receive this scholarship?
Emphasis should be placed on academic merit, aptitude, and financial need.
I authorize the scholarship committee to obtain and review information such as my current grade point average and any other academic, personal, or financial information that may be available to the school to make a determination of eligibility for this scholarship.

Furthermore, I understand that the scholarship award, if any, will be disbursed to the school to satisfy charges on my student account and will not be distributed to me personally.
Applicant Signature

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