Henneck Family Scholarship Application

Applications are accepted year-round

Please complete PARTS I, II, and III of the application.
Applications with missing or incomplete information will not be considered.

Part I

Please answer all questions completely. If a question does not apply to you, answer with either N/A or 0.

Name(Required)

First Last

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Date of Birth(Required)

Name of conference, seminar, institution you are attending?(Required)

Date of conference, course, or seminar.(Required)

What is the continuing education or certification you are seeking to complete?(Required)

What is the cost of the course, certification, or seminar? $(Required)

Are you currently employed at NCMC?(Required)

Yes

If yes, in what department?

Are you single, married, divorced, widowed?(Required)

If married, please indicate your spouse’s name:

First Last

What is your spouse's occupation?

What is your spouse's monthly gross income?

Do you have dependents (not including yourself)?(Required)

Yes

If so, how many?

How did you hear about this scholarship?(Required)

Part II

Essay(Required)

(Please attach a Word document that includes answers to both questions)

Explain why you are applying, how this scholarship will help your professional development and/or advance your career within your field?
What would it mean to you to win this scholarship award?

Accepted file types: docx, pdf, Max. file size: 25 MB.

Part III

Resume(Required)

(Please attach Word documents or pdfs here)

A current resume indicating your academic history, employment history, achievements, and awards.

Accepted file types: docx, pdf, Max. file size: 25 MB.

Reference(Required)

(Please attach a Word document or pdf here)

Please provide a letter of reference from your department manager or director.

Accepted file types: docx, pdf, Max. file size: 25 MB.

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North Colorado Medical Center Foundation is now Weld Legacy Foundation! Learn More

Henneck Family Scholarship Application

Applications are accepted year-round

Please complete PARTS I, II, and III of the application.
Applications with missing or incomplete information will not be considered.

Part I

Part II

Part III

Impact Multiplied

Get In Touch

Quick Links

North Colorado Medical Center Foundation is now Weld Legacy Foundation! Learn More

Henneck Family Scholarship Application

Applications are accepted year-round

Please complete PARTS I, II, and III of the application.Applications with missing or incomplete information will not be considered.

Part I

Part II

Part III

Impact Multiplied

Get In Touch

Quick Links

Please complete PARTS I, II, and III of the application.
Applications with missing or incomplete information will not be considered.