Dr. Susan Holstine Behavioral Health Professions Scholarship Application

Dr. Susan Holstine Behavioral Health Professions Scholarship Application
Scholarship Details:

The Dr. Susan Holstine Behavioral Health Scholarship is designed to remove financial barriers for local students working towards careers in behavioral health.

Eligibility Requirements:
- Students must reside in Whatcom County and be accepted into, or currently enrolled in a program for any of the following degrees
  
  Human Services, Psychology, Social Work, or Substance Use Disorder, Counseling, Marriage and Family Therapy, Mental Health Counseling, or Applied Behavior Analysis, or Psychiatry.
  
  2. Students pursuing the following certification and licensures:
  
  LICSW, LMHC, LMFT, SUDP, BCBA
Deadline: May 31st (Applications will be considered only when all required materials are received by the deadline.)

Selection Criteria: The Selection Committee aims to take a holistic approach that combines your academic goals, community involvement, and financial need.

If you are unsure if you meet any of the requirements, or need asistance with your application, please contact the Chuckanut Health Foundation at scholarships@chuckanuthealthfoundation.org
Personal Information
Name (first and last)

First NameLast NamePronouns
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Please tell us about yourself in your own words. (3-5 sentences)
Education
Current Degree/Program
Expected Graduation Date
Current School
Location
Other Post-High School Education

Degree/ProgramSchoolLocationGraduation Date
Other Post-High School Education

Degree/ProgramSchoolLocationGraduation Date
High School/GED Program

SchoolLocationGraduation Date
Community Experience
Please list any community/volunteer experience, work experience, or other relevant experiences.
If you do not have past or current community experience, please share how you plan to be engaged or what resources would help you achieve higher engagement.
Financial Need
Please describe your current financial need and any barriers you are facing in funding your education.
Short Response Prompts
Why have you chosen behavioral health as your future profession?
How do you see your education serving the community of Whatcom County?
Where do you see yourself in 5 to 10 years?
Is there anything else you wish the Selection Committee to know?
Please attach proof of enrollment

Examples: current class schedule, acceptance letter, transcript, etc.
Cancelof
Signature
Signature Date

MonthDayYear
Date
Should be Empty:

Dr. Susan Holstine Behavioral Health Professions Scholarship Application

Personal Information

Education

Community Experience

Financial Need

Short Response Prompts