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:* Date Format: MM slash DD slash YYYY Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest 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).*12345I am a dependable person (prompt, prepared can be counted on).*12345I have high moral values (good sense of right and wrong).*12345I have a good work ethic (do my best and always finish what I started).*12345I get along well with others.*12345Essay:*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 CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.