Scholarship Application Forms for persons in nursing or medical school

 Purpose:  

The Christopher Condon Cool Doctor Foundation will provide scholarships to medical and nursing students intending to work with children who have life-threatening illness and who demonstrate the qualities that Christopher Condon considered “cool”.

Criteria: 
·         Applicant must be enrolled in medical or nursing school.
·         Applicant must be intent on working in the area of childhood life-threatening illness or research.
·         Applicant must demonstrate positive qualities which would influence interactions with     children.



Application Process:  Applicant must submit the following items:
·         Completed application form
·         Two letters of recommendation from the applicant’s choice of teachers, professors, administrators, counselors, employers, or individuals with significant knowledge of applicant’s experience and involvement.
·         Official and recent transcript.
·         Essay addressing the following:  Describe your personal qualities and how these will enable you to have positive interactions with the children in your care.
·         Evidence of registration in an accredited medical or nursing institution.
                             
Specifics: 

DEADLINE for scholarship application is March 1 annually.  Awards will be granted by May 30.
Refer to the http://www.cooldoctorfoundation.com/ website for information about the foundation that may help you understand the boy behind these scholarships.

If there are questions regarding the application process, please e-mail cooldoctorfoundation1@gmail.com.

When all parts of the application process are complete, please mail to:

Christopher Condon Cool Doctor Foundation
1064 Peninsula Drive
SlidellLA 70460



Application

                             

Please type or print your answers.  If application is illegible it will be returned to you.

1.

Last Name:

First Name:
2.
Mailing Address:
                          Street: 

                          City:                                         State:                                ZIP:


3.

Daytime Telephone Number:  (          )

4.

Date of Birth:    Month                              Day                               Year

5.

Currently enrolled in:

Number of years attended:

 


6.

I will be attending the following school in the Fall of 20____: 


Proof of acceptance or current student enrollment from the above school is required prior to receipt of funds.

7.

Projected coursework for the  year:




8.

Grade Point Average (GPA): __________    (On a 4.0 scale) 
Attach proof of GPA.  Your most recent official school transcript required. 

9.

ACT Score:__________
      Or                                             .
SAT Score: __________
10.

Name & address of parent(s) or legal guardian(s):   Use reverse side of application if you need more space.

Name (s)


Street:  ___________________________ City:___________________  State: ______ ZIP:________
                   
Home phone of parents or legal guardians:   (      )

11.

Name and city of high school(s) attended:




State  years attended:

12.

List college(s) you have attended.

Year
Began

Year
Ended    
Year
Graduated
If applicable
Type of Degree
Received
If applicable

A.





B.





C.








14.
List expenses you expect to incur per semester or quarter:   (Approximate figures acceptable)                                             .

A.
Tuition:                     $
B.
Books:                      $
C.
Room & Board:        $
D.
Other expenses:      $                                             Describe below under comments
E.
Other expenses:      $                                                                        “
Comments:



15.
List other financial assistance you will receive per semester or quarter:                              


A.
Personal:                                    $
B.
Other Scholarship(s):                 $                         Describe below under comments
C.
Grants:                                        $                                                               “
C.
Student Loan(s):                         $                                                               “
D.
Other Financial Resources:        $                                                               “
Comments:



Use an additional sheet if you need more room to list financial information requested in items 14 & 15.        
                                                                                                                                                           
16.
What are your educational and professional goals and how do you plan to arrive at them?





















17.
List or describe your academic honors, awards, memberships, sports and activities, and other noteworthy involvements, hobbies, or work experience:





















18.
Essay---- Describe your personal qualities and how these will enable you to have positive interactions with the children in your care.
Submit your response on the last sheet provided with this application.



 

 

 

 

STATEMENT OF ACCURACY


I hereby affirm that all information and forms provided by me are true and correct to the best of my knowledge.  I also consent that my picture may be taken and used for any purpose deemed necessary to promote the Foundation’s scholarship program.


I hereby understand that if chosen as a scholarship winner, I must provide evidence of enrollment/registration at the accredited medical or nursing school of my choice before scholarship funds can be awarded.



Signature of scholarship applicant: _________________________________ Date:_____________________
                                                                       









Cool Doctor Scholarship Application


Personal Essay

Describe your personal qualities and how these will enable you to have positive interactions with the children in your care.