Harold & Edna Bragg Healthcare Education Scholarship Application Form

Harold and Edna Bragg Healthcare Education Scholarship Application Form

Please use the online form below to submit your Healthcare Education scholarship application.

Harold & Edna Bragg Healthcare Education Scholarship Fund

Personal Information
Name*
First Last
SS# or School ID
Birthdate*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Length of residence in Chelan area:*
Parent/Spouse/Guardian (if dependant)
Your School
Name of school you plan to attend*
Address of school you plan to attend*
Street Address Address Line 2 City State ZIP Code
Major Course of Study*
Have you been accepted?*
- Yes
- Not yet
Year to be enrolled?*

(1st, 2nd, 3rd, 4th, Post-Graduate, etc.)
Training Expenses
Tuition*
Per*
- Class
- Quarter
- Semester
- Year
Cost of Lab Fees*
Cost of Books*
Other fees*
Other expenses*
Describe
Financial information pertinent to educational goals*
(Scholarships, grants, savings, family or employer help, financial responsibilities, etc.)
Current Situation
I am currently attending*
My major course of study is*
Educational Background*
School Location Dates Field of Study GPA
Are you currently*
- Employed
- Employer
Position Title*
Hours working per week*
Employment History*
Employer Address Dates Responsibilities
List your career goals and how this course/program relates to your goals*
Are you available for a personal interview?*
- Yes
- No
I certify that to the best of my knowledge the information contained in this application is true and correct. I understand that this application will not be considered for review unless it is signed and dated. I also understand that no materials will be returned.*
- Yes (digital signature)
Phone
This field is for validation purposes and should be left unchanged.

88847

Harold and Edna Bragg Healthcare Education Scholarship Application Form

Harold & Edna Bragg Healthcare Education Scholarship Fund

Personal Information

Your School

Training Expenses

Current Situation

Tax Deductible Pledges

Pages

Follow the Foundation

About the Foundation:

School	Location	Dates	Field of Study	GPA

Employer	Address	Dates	Responsibilities