Scholarship Application
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Preferred Mailing Address
*
Mailing Address 1
Address Line 2
City
State / Province
Postal / Zip Code
Biographical Information
Please attach (or use the text box below) a brief biographical sketch describing yourself, your interests, your school and community activities. Be sure to touch on your plans for the future and how you hope to improve the practice of environmental health in this state.
Biographical Information (if not attached)
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Education
Name of University/College presently attending:
*
School and/or Department:
Academic Program (e.g. BS in Environmental Health)
*
Dates of Attendance
*
mm/yyyy - mm/yyyy
Cumulative GPA
*
Expected Date of Graduation
*
Advisor Information
Name of Advisor
*
First Name
Last Name
Position
*
Email
*
example@example.com
Is this the same person from whom you are seeking a recommendation?
*
Yes
No
If you answered "no" above, please provide the name, position, and email of the person you are seeking a recommendation
Other Education
Complete if you've attended other colleges or universities while seeking your degree
I have not attended other colleges or universities.
Name of University/College
School and/or Department
Academic Program
Dates of Attendance
mm/yyyy to mm/yyyy
Cumulative GPA
Financial Information
How would this scholarship help you achieve your educational goas?
Internships
I have participated in an internship.
*
Yes
No
Organization providing the internship
Your Position/Title
Date of Internship
Campus and Community Involvement
Please describe your campus and community involvement.
Awards and Honors
Please list any awards or honors you have received and the awarding body
Career Commitment/Goal
Are you an active member of the Washington State Environmental Health Association (WSEHA)?
*
Yes
No
Are you an active member of the National Environmental Health Association (NEHA)?
*
Yes
No
Please describe your ideal first professional position upon graduation, including attendance at a professional or graduate school program, if appropriate
*
Upload a copy of your transcript(s) below.
Upload transcripts here.
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Don't forget to tell the person recommending you to complete their form! Applications will only be considered with a corresponding Scholarship Recommendation Form (completed by your advisor or other qualified individual).
Submit Your Application!
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