🎓 BRIDGING HealthCARE CoMMUNITIESLicensing Scholarship Application Name * First Name Last Name Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Preferred Pronouns: * Graduation Date: * Institution Attended: * Degree Earned: * Field of Study: * Are you registered to take to a licensing or certification exam? * Yes No If yes, please specify which exam(s), and date(s) of scheduled exam. * Have you taken any of these exams? Yes No If yes, please specify which exam(s), your preparation methods, and resources used: What is the total estimated cost for your licensing or certification process? Include exam fees, preparation materials, travel, and any additional expenses. * Have you encountered financial challenges in affording these costs? Please describe any obstacles and how they have impacted your preparation. How would receiving this scholarship impact your journey toward a healthcare career? What motivates you to pursue a career in healthcare, and how do you plan to contribute to your community in this role? If you are not awarded the full scholarship amount, what is the minimum support that would still make a significant difference for you? Is there any additional information about your financial situation or academic journey that you would like to share? Thank you!
