Scholarship Application

AMT SCHOLARSHIP APPLICATION
AMT awards scholarships annually to members attending undergraduate/graduate programs and to high school graduates pursuing medical technology, medical assisting, dental assisting or phlebotomy studies.

Eligibility Requirements
- Be a graduate of, or a senior in, an accredited high school (G.E.D., is also acceptable) or an active AMT member.
- Be enrolled in a school accredited by an accrediting agency recognized by the U.S. Department of Education. Course of study must lead to a career in one of the disciplines certified by American Medical Technologists.
Application
- Complete this online form in its entirety. Incomplete submissions will not be submitted for review.
- Provide a minimum 500 word essay stating why you have chosen your field of study.
- Submit two letters of personal reference (may NOT be relatives).
- Submit prior to April 1.
Application Review
- The AMT Scholarship Committee reviews and makes final determinations on the scholarship recipients and the amount received. Only the recipients will be notified.
- Announcements of those selected to receive a scholarship will occur at AMT's Annual Meeting held mid-summer each year.
NOTES:
- Applicants pursuing careers other than those certified by American Medical Technologists will NOT be considered.
- Applications that are incomplete or received after April 1, 2025 will NOT be considered.
- Scholarship checks will be mailed directly to the recipients school. If receiving a scholarship will displace financial aid, recipients may be disqualified.

SCHOLARSHIP APPLICATION FORM
PERSONAL DATA
Full Name*

First NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Phone Number*
E-mail*
Have you applied for certification with AMT?*
Applying for certification not required
Provide your AMT ID Number*
Are you an active AMT member?*
Who do you plan to certify with?*

EDUCATION AND SCHOOL ACTIVITIES
High School where you graduated or now attend (or G.E.D.)*

School Name

Street Address

CityState / Province

Postal / Zip Code
Graduation or G.E.D. Date of Certificate*

MonthDayYear
Date
Did you participate in any extracurricular activities?*
Includes offices held, honors, scholarships, certifications, community involvement, etc
List activities*
Are you currently enrolled in an educational program?*
Name of Institution*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Enrollment Date*

MonthDayYear
Date
Graduation Date*

MonthDayYear
Date
Please select your field of study*
Please indicate your field of study*

CAREER
Describe in 500 words why you have chosen your career

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ADDITIONAL INFORMATION
Two (2) Letters of Reference*

This cannot be supplied by relatives
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Head-shot (Optional)

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I grant to American Medical Technologists (AMT), its representatives and employees the right to publish photographs of me and my property in connection with the above-identified subject. I authorize AMT to copyright, use, and publish the same in print and/or electronically. I agree that AMT may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.
I have read and understand the above.
If you would like to be tagged on social media when your photo is posted please let us know the following:
Please provide an E-Signature*

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AMT SCHOLARSHIP APPLICATION

SCHOLARSHIP APPLICATION FORM

PERSONAL DATA

EDUCATION AND SCHOOL ACTIVITIES

CAREER

ADDITIONAL INFORMATION