Wise Health System Auxiliary Scholarship Application Your application process will require transcripts of grades and test scores. Please have these documents ready prior to submission. Applicant's Name:* First Last Birthday:* MM slash DD slash YYYY Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address:* Enter Email Confirm Email Phone Number*Parent or Guardian's Name:* First Last Hight School Attending:* Schools to which you have applied:*School of Choice:* Degree Desired:* Grade Point Average:* Class Rank:* College Hours Taken:* Honors & Accomplishments:*School Activities:*Community and Volunteer Activities:*Work History:* Rate Yourself - On a Scale of 1 (Lowest) to 5 (Highest)I am a healthy person (eat right, exercise and get plenty of sleep).* 1 2 3 4 5 I am a dependable person (prompt, prepared can be counted on).* 1 2 3 4 5 I have high moral values (good sense of right and wrong).* 1 2 3 4 5 I have a good work ethic (do my best and always finish what I started).* 1 2 3 4 5 I get along well with others.* 1 2 3 4 5 Essay:*In this essay, describe your goals and your dreams for the future, You may consider writing about people or events in your life that have influenced your decision to pursue a degree in health care or related field. Please include important information about why you think you are a qualified candidate for this scholarship. Grades and Test Scores*Please attach your transcripts of grades and test scores to your application. Drop files here or Select files Max. file size: 50 MB. CAPTCHANameThis field is for validation purposes and should be left unchanged.