The Monroe Clinic Volunteers In Partnership Scholarship

Two $500.00 scholarships will be awarded to Monroe High School Seniors going into the medical
profession. The successful applicant will be selected on scholastic merit, citizenship, need and
expressed interest in the health care field. The information contained herein will be reviewed by a three
member scholarship committee and will remain confidential. Public announcement of the award will be
made. You may be called for an interview. The $500.00 scholarship will be paid directly to the attending
school of the recipient.

Return applications
To: The Monroe High School counselors

Date:
Name:
Home Address:
Phone Number:

School planning to attend:

Address of school

Health Related Field of Study:

Date of Acceptance:
Anticipated Degree:

Clinic Services: (608) 324-2000 Fax (608) 324-2469 Hospital Services: (608) 324-1000 Fax (608) 324-1114

A Catholic Institution sponsored by the Congregation of Sisters of St. Agnes

Please explain why you have chosen a career in health care. (Use additional pages as needed)

What specific job would you like to have in your field of health?

What Volunteer and/or paid job/s have you had in the past or are you currently doing that relates to your field?
Be specific, including how often and for how long if possible.

List your student and/or community activities, including offices held, years involved and/or hours
contributed if known that are different from the above information. (Use additional sheets as needed)

What are your reasons for applying for this scholarship?

Are you employed now or during any part of the year? If so, where? How do you expect your education
will be funded? Be as specific as possible. If you or your family has extenuating circumstances you
would like taken into consideration, please elaborate {for example, illness, multiple siblings in college}.

Please attach a transcript of grades from the past two semesters.

If you have any questions:

Call Volunteer Services at 608.324.1569