NYSSPA Scholarship Application

NYSSPA Scholarship Application
You must be able to answer YES to each of the following criteria in order to be eligible for the NYSSPA Scholarship.
Yes, I am a NYSSPA member.Yes, I currently attending an ARC-PA accredited PA program in New York.Yes, I am currently in the professional phase of a PA program.Yes, I have not received a NYSSPA scholarship before.Yes, I am not a NYSSPA Board Member or Committee Chair.
Section I: Demographic Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Permanent Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Present Address (If different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of PA Program*
Anticipated Graduation Date*

MonthDayYear
Date
Section II: Professional Program Academic History & Faculty Signature
Upload the completed Academic History Form with Faculty Signature*

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All scholarship forms can be found at https://www.nysspa.org/page/ApplyforScholarships Cancelof
Section III: Financial Information
Upload the completed Financial Information Form*

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All scholarship forms can be found at https://www.nysspa.org/page/ApplyforScholarships Cancelof
Upload a letter from your Financial Aid Department that verifies your tuition assistance and expenses for your PA Program. *

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Section IV: Community and Volunteer Services

The form can be found on the Scholarship page on www.nysspa.org.
Upload the completed Community and Volunteer Services Form*

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All scholarship forms can be found at https://www.nysspa.org/page/ApplyforScholarships Cancelof
Section V: Essay

Why did you choose the PA profession and what are your future goals?
Upload your 1-page, typed essay that answers the following questions: Why did you choose the PA profession and what are your future goals? *

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Section 6: Verification and Application Submission
Yes
Enter the message as it's shown*
Should be Empty:

NYSSPA Scholarship Application

Section I: Demographic Information

Section II: Professional Program Academic History & Faculty Signature

Section III: Financial Information

Section IV: Community and Volunteer Services

Section V: Essay

Section 6: Verification and Application Submission