CBO CampMed Scholarship Application Form

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Provided by United Helpers

How to apply for the scholarship?

Step One: Submit your Camp Med Application on-line.
Step Two: Complete the Camp Med Scholarship Application (below).

Scholarship Award Notification

NAHEC Scholarships are not guaranteed until NAHEC accepts and approves your Camp Med Application.
NAHEC will contact the student with the final decision regarding the scholarship application.

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CampMed Scholarship Application

Student's Name*
Street Address*
Address*

City, State, Zip
Phone Number*
School*
Date of Birth*
Parent/Guardian Name*
Address*

Address, City, State, Zip
Economically Disadvantaged

An individual who comes from a family with an annual income below a level based on low-income thresholds according to family size published by the U.S. Bureau of Census, adjusted annually for changes in the Consumer Price Index, and adjusted by the Secretary for use in all health professions programs. The Secretary will annually publish these income levels in the Federal Register. The table below provides a breakdown of family income levels used to determine economic disadvantaged status. Family income is defined as the income of the trainee's parents regardless of the age of the trainee.

Size of Family Unit* - - Low-Income Levels**

1 - - $21,660
2 - - $29,140
3 - - $36,620
4 - - $44,100
5 - - $51,580
6 - - $59,060
7 - - $66,540
8 - - $74,020

* Includes only dependents listed on Federal income tax forms.
** Income Level Adjusted gross income for calendar year
Are you from an economically disadvantaged background (according to the federal definition above)?*
- Yes
- No
By typing my name in this field, I confirm that I am serious about exploring health careers and commit to attending camp every day.*
By typing my name in this field, I understand that If I am awarded a NAHEC Camp Med Scholarship, I agree to submit a one page essay that describes what I enjoyed about Camp Med and how attending has impacted my thoughts about healthcare careers.*

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Provided by United Helpers

CampMed Scholarship Application

Economically Disadvantaged

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