Scholarship Application - RUCADEV - Rural Cameroon Self Reliance Development Organization

RUCADEV/ARIZONA-CORP Education Scholarship Seed Funds Application

Welcome to the scholarship application page.

The RUCADEV/ARIZONA-CORP Education Fund was established to support students of exceptional promise in the medical field. This partnership between RUCADEV and medical professionals is intended for high school, or college students with strong math and science credentials and plans to enroll in an undergraduate or graduate degree program relevant to medicine, public health, nursing, healthcare administration and other related areas. RUCADEV and partners will provide multiple resources and options for eligible applicants to finance their education, including a $500 cash donation. To be eligible to receive support, the applicant must demonstrate financial need, good academic background, and a desire to give back to the community.

To apply, you must submit your completed application through the application form below.

By submitting this application, I certify that: *

I have read and I understand the conditions of the RUCADEV/ARIZONA-CORP Education Scholarship Seed Funds program as explained in the current Notes to Candidates for Scholarships. I affirm that I plan to pursue a career in a health care field as defined in those documents. I understand that this scholarship is available only to qualified candidates who need the skillset in their daily duties. I waive the right to access letters of recommendation written on my behalf. If selected as a Seed Funds scholar, I agree to participate on a Seed Funds scholar leadership panel and / or present my experience as a Seed Funds scholar in an appropriate forum if called upon to do so. I certify that the information given on this form and any attachments is, to the best of my knowledge, correct and complete.

SECTION 1: PERSONAL INFORMATION

Full Name of Applicant *

Email *

Phone

Permanent residence *

Address Line 1

City

State / Province / Region

Postal Code

Country

Your address at school (If different from permanent residence)

Address Line 1

City

State / Province / Region

Postal Code

Country

Date of birth *

Check one: I am from *

Fontem
Alou
Wabane
Other

Parent or supervisor name *

Parent or supervisor contact *

SECTION 2: SCHOOL INFORMATION

School name *

School Address *

School Mentor *

Contact information of mentor *

Current cumulative GPA of applicant

Current school average of applicant

Health care degree(s) type sought *

SECTION 3: SCHOOLS ATTENDED

List the secondary school from which you graduated, and all higher education institutions attended. Include summer, study-abroad, exchange programs and your current institution (up to six) (State the School Location and Dates Attended) *

List college activities (student government, sports, publications, school-sponsored community service programs, student-faculty committees, arts, music, etc.). List in descending order of significance. You will have space for eight college activities (Include the Activity, Date and Office)

List high school activities (student government, sports, publications, school-sponsored community service programs, student-faculty committees, arts, music, etc.). List in descending order of significance. You will have space for four high school activities (Include the Activity, Date and Office)

List all extracurricular activities related to health care that you have been involved with (health campaigns, homeless services, environmental protection/conservation, advocacy activities, work with religious organizations, etc.). Do not repeat items listed previously. List in descending order of significance. You will have space to list six (include the activity, role and dates) *

Why are you interested in becoming a health care professional? *

SECTION 4: GOALS, OBJECTIVES, MOTIVATION AND VISION

Lists your goals, objectives, and aspirations in the health care field *

Why do you need this scholarship? *

How will the Seed Fund scholarship help you achieve your goals, objectives, and aspirations? *

How will you impact your community at the end of your education /training? *

List awards, scholarships, publications or special recognitions you have received. List in descending order of significance (include the Award/scholarship/publication/recognition and date) *

Phone

RUCADEV/ARIZONA-CORP Education Scholarship Seed Funds Application

SECTION 1: PERSONAL INFORMATION

SECTION 2: SCHOOL INFORMATION

SECTION 3: SCHOOLS ATTENDED

SECTION 4: GOALS, OBJECTIVES, MOTIVATION AND VISION

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