Bill and Mary Russell Health Care Scholarship Application

Application Deadline: March 15, 11:59 p.m.
PURPOSE
The Bill and Mary Russell Scholarship provides financial assistance for those pursuing educational opportunities toward a career in nursing or a healthcare field. The 40 & 8 volunteer their time to sell donated towels and washcloths from Mosaic Life Care. 100 percent of all funds gathered support this scholarship. Together, Voiture 130 of the 40 & 8 and Mosaic Life Care Foundation have created a scholarship program as a tribute to the late Bill and Mary Russell. This tribute recognizes their many years of dedication and commitment at a local and state level with Voiture 130 and 40 & 8's efforts to support nursing and healthcare training.
ESTABLISHING THE SCHOLARSHIP
Mosaic Life Care Foundation is a 501(c)(3) public charity dedicated to championing education and empowering people to build healthy and thriving communities.
CRITERIA
Recipients must be accepted and enrolled in at least 12 hours of study for a regular semester or equivalent full-time status in an approved nursing or health-related program.
Pre-health programs are not eligible.
The committee may elect to invite some applicants to interview in person.
REFERENCE LETTERS
Provide two current letters of recommendation. Each letter must include date of letter, the author’s name, relationship to applicant, professional title of employment and place of employment.
Example:
Month/Day/Year
John Smith, Intern Supervisor
Vice-President
ABC Accounting
1234 Elm St.
City, State, Zip
Please have each reference author email their letter to christina.lund@mlcfoundation.com
INFORMATION REQUIRED FOR THIS APPLICATION
1. Personal Information

2. Employer Information

3. Narrative Information

4. Post-Secondary Transcript

5. High School Transcript

6. Proof of Acceptance and Full-Time Enrollment
DISQUALIFICATION
Failure to complete and provide a complete application will be automatic disqualification.
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County*
Email*
Phone*
Member of family is a veteran:*
- Yes
- No
EMPLOYER INFORMATION
Are you employed?*
- Yes
- No
Employer*
Length of Service*
Job Title*
Number of hours worked per week:*
Supervisor's Name*
First Last
Supervisor's Phone*
NARRATIVE INFORMATION
Please do not provide personally identifiable information.
Degree and planned career field:*
Career goals and feelings associated with your interest in healthcare; include why you are pursuing your selected career.*
Institution name to which you are accepted, date of acceptance, and expected graduation date:*
Explain your financial need, anticipated costs, and extenuating circumstances.*
List other monetary funds (financial aid, scholarships, grants) received including dollar amounts.*
What is attractive to you about St. Joseph and the Northwest Missouri region?*
Information related to your general work history (Length of service, number of weekly hours, anticipated number of hours you will work during the academic year):*
List awards or honors received in the last five years, including clinical excellence awards or other achievements.*
Volunteer Information within past year (include where, when, name of supervisor, hours served):*
List extracurricular activities including community involvement, hobbies and interests within the last five years.*
UPLOADS
REFERENCE LETTERS
Provide two current letters of recommendation. Each letter must include date of letter, the author’s name, relationship to applicant, professional title of employment and place of employment.
Example:
Month/Day/Year
John Smith, Intern Supervisor
Vice-President
ABC Accounting
1234 Elm St.
City, State, Zip
Please have each reference author email their letter to christina.lund@mlcfoundation.com
Transcript indicating: cumulative and semester GPA, class rank, scale used.*
Max. file size: 500 MB.
High school transcript:*
Max. file size: 500 MB.
Proof of acceptance and full-time enrollment in an accredited healthcare program:*
Max. file size: 500 MB.
Consent
In submitting this application, I certify that the information provided is complete and accurate to the best of my knowledge.
Incomplete scholarship applications will not be considered by the committee. Falsification of information may result in termination of any scholarship granted. This application becomes property of Mosaic Life Care Foundation.

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Bill and Mary Russell Health Care Scholarship Application

PURPOSE

ESTABLISHING THE SCHOLARSHIP

CRITERIA

REFERENCE LETTERS

INFORMATION REQUIRED FOR THIS APPLICATION

DISQUALIFICATION

EMPLOYER INFORMATION

NARRATIVE INFORMATION

UPLOADS

REFERENCE LETTERS

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