Healthcare Professional Scholarship

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Personal Information

First Name

Middle Initial

Last Name

Home Address

City

State

Zip Code

Primary Phone Number

Email Address

School Information

College/University Currently Attending During the Next Academic Year.

Address

City

State

Zip Code

What college degree are you currently (or will you be) working towards?

What year will you be completing your degree?

Expected graduation date

List other colleges attended — Names and Date(s)

Work Experience

Are you currently a UPMC in Central Pa. employee?

Yes

If no, where do you work?

If yes, what is your employee number?

Current position

What hospital/practice. Including location and department.

Date of Employment

FTE Status or hr/week worked

Extracurricular Activities

Have you previously received a scholarship award from the Pinnacle Health Foundation/UPMC Pinnacle Foundation?

Yes

If yes, what scholarships, dates, and amount received?

Current Recommendation Letter

Please attach one professional letter of reference when you submit your application. If you are a previous scholarship winner, please submit an updated letter of recommendation. Please upload a pdf, word or text file. The file size must be under 5MB.

Current Transcript

Please attach a current copy of your transcript when you submit your application. Please upload a pdf, word or text file. The file size must be under 5MB.

Personal Statement