Saint Francis Healthcare Scholarship Program Application Learn more about the Saint Francis Healthcare Scholarship Program Fields marked with an * are required. The deadline for 2022 applications is 5 pm on June 30, 2022.For Which Scholarship Are You Applying?*More information on available scholarships Steven C. Bjelich Executive Scholarship - The Steven C. Bjelich Executive Scholarship is available for students pursuing a master’s degree in healthcare administration and awards a $5,000 per year scholarship to one recipient every two years. Other Scholarships Personal InformationName:* Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. First Last Mailing Address:* Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Primary Phone Number:*Email Address:* Marital Status:* Married Single Divorced Members of Household:Please list the members of the household that YOU provide support forNameAgeDoes this person attend school? (Yes / No)Do you financially support this person? (Yes / No) EducationHigh School / GED:*Name of SchoolDates AttendedYears Completed College / Technical School:Name of SchoolDates AttendedMajor Field of StudyYears Completed Student ID Number:* Graduate School:(if applicable)Name of SchoolDates AttendedMajor Field of StudyYears Completed Current School Attending:* What Degree and Area of Healthcare Are You Currently Pursuing?* Have You Completed Your First Year in a Professional Curriculum of an Accredited Healthcare Program?* Yes No Anticipated Graduation Month / Year:*Enter "01" in the "day" field if exact graduation date is not known Month Day Year Special Achievements / Honors and Recognition: Extracurricular Activities / Community Involvement: Profession(s) or Trade(s) for Which You are Registered / Licensed: Financial InformationEstimate your financial resources for one year.How Are You Funding Your Education?* Student Income:*Please enter a number greater than or equal to 0.Spouse Income:*Please enter a number greater than or equal to 0.Parental Support:*Please enter a number greater than or equal to 0.Child Support:*Please enter a number greater than or equal to 0.Scholarships / Grants:*Please enter a number greater than or equal to 0.Tuition Reimbursement:*Please enter a number greater than or equal to 0.Student Personal Savings:*Please enter a number greater than or equal to 0.Other Support:*Please enter a number greater than or equal to 0.Have You Previously Received a Saint Francis Healthcare Scholarship?* Yes No If Yes, When?* How Did You Hear About the Saint Francis Scholarship Program?* EmploymentCurrent Employer: Job Title:* Number of Hours You Work Per Week:Please enter a number greater than or equal to 0.List Other Types of Work You Have Done in the Past: Essay QuestionPlease answer the question below in an essay format. Your answer should be no more than one page, typed, double-spaced and attached to your application. The healthcare scholarship committee will score essays based on how thoroughly you answer the question; whether you use examples to illustrate your points; and whether you use correct grammar, punctuation and sentence structure. Essays are worth one-third of the total application score. Why did you choose to study in your particular medical field and how do you think this field has been impacted by COVID-19?Essay Response Upload:*(5MB max file size)Max. file size: 5 MB.Additional Items to UploadCollege Transcript:(5MB max file size)Max. file size: 5 MB.Letter of Verification of Enrollment:(5MB max file size)Max. file size: 5 MB.Academic Letter of Recommendation:(5MB max file size)Max. file size: 5 MB.Personal Letter of Recommendation:(5MB max file size)Max. file size: 5 MB.AcknowledgementI certify that all of the above information contained in this application is complete and accurate. I understand that Saint Francis Healthcare System Foundation has the right to verify this information and that any information found to be false will disqualify this application.* Yes Fields marked with an * are required.NameThis field is for validation purposes and should be left unchanged.