Clear Choice ER 2025 Application Form

Clear Choice ER's 4th Annual Academic Scholarship
Please read instructions carefully.
Clear Choice Emergency Room Application
Student's Full / Legal Name*

First NameLast Name
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Phone Number*
Student E-mail*
example@example.com
High School *
What high school are you graduating from?
Academics
Academic GPA of a 3.75*
University or College

Please upload proof of admission or proof of application. This is a requirement in order to be eligible.
School 1
Proof of Admissions

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School 2
Proof of Admissions

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School 3
Proof of Admissions

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Major(s) You Are Considering

In order of preference, list the major(s) you are considering (Very important for scholarship eligibility).
Major 1
Major 2
Resume Upload

Please upload a one-page resume. This a requirement for eligibility.
Resume

ONE PAGE RESUME
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Essay Topic

How do you plan to use your university education to help better the Laredo community?
Please upload 300-word essay

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I certify that my answers are true and completed to the best of my knowledge. I understand that false or misleading information in my application may result in my omission.
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Clear Choice ER's 4th Annual Academic Scholarship