Deadline:  Open

 

Mission:

The RTH/BWH Believe and Achieve Scholarship was created by RTH in collaboration with Brigham and Women’s Hospital and Partners Healthcare. It was created in order to award deserving residents of the RTH community by supporting their personal ambition for job placement and career advancement through educational and vocational enrichment.

 

Requirements:

Your completed application and essay* should be submitted together with a letter of enrollment from the school you are attending to the RTH office, Attn: Anne Vinick at

2 New Whitney Street, Boston, MA 02115.   The Scholarship Committee will review applications on a quarterly basis in January, April, July and October. 

 

The scholarship applicants must be enrolled or have applied to an institution of higher learning or a vocational program that provides opportunities for licensing or other accreditation.  All programs must be accredited.

 

*Interview:

All applicants must interview with the Scholarship Committee.  Be prepared to discuss your interests, your educational and professional goals and any other experiences that motivated your decision to attend school.  You will be contacted by telephone to set up a time for your interview.  As there are many applicants to interview, it is very important for you to schedule a time as soon as possible.  All interviews will be conducted on the last Wednesday afternoon of the months indicated above.

 

*Essay:

All applicants are also required to write an autobiographical essay.  Please answer the following question:

What has motivated you to continue your education at this time and what obstacles, if any, have you overcome in preparation for your current educational undertaking?

 All essays must be double-spaced in 12-font type. 

 

*If you received this scholarship previously and no information has changed, including your major and the school you are attending, you are not required to interview or write an essay.  You must only complete and submit the application.

 

Applicants may reapply at any time as long as the $4000. limit has not already been exhausted.

 

Process for Awarding Scholarships:

Once the Committee has accepted and reviewed all of the applications for a particular quarter, decisions will be made no later than fourteen (14) days after the end of the quarter.  Applicants will receive a letter approving or denying their request.  Awards will be sent directly to the educational institution.

 

Scholarship Amounts:  Applicants can apply for up to $4000.  See below for application


 

THIS FORM CAN BE PHOTOCOPIED. Incomplete applications will not be considered.

 

A.    PERSONAL DATA

 

____________________________________________________________________________________________________

LAST                          FIRST                         M.I.                                         SOCIAL SECURITY #

 

____________________________________________________________________________________________________

PERMANENT ADDRESS                CITY                           STATE                        ZIPCODE

 

(_______)____________________________

TELEPHONE #

 

____________________________________________________________________________________________________

PRESENT ADDRESS (if different)  CITY                          STATE                        ZIP CODE         

 

(_______)_________________________      ___________________________________

TELEPHONE #                                                EMAIL ADDRESS

 

 

B. EDUCATION HISTORY    List all high schools and colleges/universities/training programs, etc…you have attended.  Attach an additional sheet if necessary. 

 

                       

 

Name and address

of school

 

 

# of years  attended

 

Did you graduate? Yes/No

 

Dates Attended

 

Degree or diploma earned

 

 

 

 

 

 

 

 

 

 

 

  

  

 

 

 

 

 

 

   

  

 

 

 

 

 

 

  

  

 

 

 

 

READ CAREFULLY: Please fill out section C if you are attending a two- or four-year college or university.  Fill out section D if you are attending a vocational or training program.

 

C. EDUCATION DATA (College/University)

 

__________________________________________________________________________

SCHOOL NAME                        

 

__________________________________________________________________________

 NAME OF DEGREE PROGRAM                          INTENDED DATE OF GRADUATION

 

________________________________________________________________________

SCHOOL NAME                   ADDRESS              CITY          STATE             ZIP CODE

 

(Please use school address where scholarship award should be sent)

 

(______)_____________________          Cost of program per year:   $______________

SCHOOL TELEPHONE

 

(Check one):   _____  This is a full-time program       _____  This is a part-time program

 

 

Possible area(s) of academic concentration/major or undecided:

 

____________________________________

 

 

D. EDUCATION DATA (Vocational/Training Program)

 

________________________________________________________________________

SCHOOL NAME                        

 

__________________________________________________________________________________________________________________

SCHOOL ADDRESS                                    CITY                           STATE                 ZIP CODE

 

­­­­­(______)___________________________

SCHOOL TELEPHONE NUMBER

 

 

INTENDED

COURSE TITLE

CREDITS

EARNED

ACTUAL

COST

DATE COURSE STARTS

DATE

COURSE ENDS

CERTIFICATE/

DEGREE EARNED

 

1.

 

 

$

 

 

 

 

2.

 

 

$

 

 

 

 

3.

 

 

$

 

 

 

 

4.

 

 

$

 

 

 

 

 

                  

                        

 

 

 

 

 

 

 

 

    TOTALS: _______       $________

 

 

E. WORK EXPERIENCE

 

List any job (including summer employment) you have held during the past three years:

 

Specific Nature of Work             Employer                               Dates of Employment        Part-time or

                                                                                                                                 Full-Time?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F. EXTRACURRICULAR, PERSONAL AND VOLUNTEER ACTIVITIES

Please list your principle extracurricular, community and family activities and hobbies in order of their importance to you.  (Use additional sheets if necessary)

 

Activity                         Place                           Approx. #  hrs./month             Dates

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

G. AWARDS AND HONORS

 

Please describe any academic or community distinctions or honors you have won, beginning in the ninth grade.

 

____________________________________________________________________________

 

____________________________________________________________________________

 

____________________________________________________________________________

 

__________________________________________________________________________

 

 

H.  OTHER ACTIVITIES (additional space on next page)

Are there any other community activities, events, fundraisers, etc… in which you have   participated?

 

_________________________________________________________________________________

 

_________________________________________________________________________________

 

_________________________________________________________________________________

 

_________________________________________________________________________________

 

 

I. SCHOLARSHIP INFORMATION

 

Are you applying for other scholarships this year?    Yes_______     No________

 

If you have been awarded any of these, please list them:

 

NAME OF SCHOLARSHIPS                                                                   AMOUNT

                        

   

 

 

 

 

Do you plan on taking out student loans?  Yes _______   No ________

 

 

AMOUNT REQUESTING (up to $4000.): $___________________

 

Text Box: How did you hear about this scholarship?
ð       Newsletter/What’s Up
ð       Through a friend
ð       By an RTH staff person
ð       Other ___________________
 

 

 

 

 

 

 

 

 

 

 


I declare that the information reported above is true, correct and complete to the best of my knowledge.

 

________________________________________________________________________

SIGNATURE OF APPLICANT                                                                   DATE

 

If under 18 years old:

 

                                                                                                                                   

NAME OF PARENT/GUARDIAN                                                          TELEPHONE #                         

 

 

SIGNATURE OF PARENT/GUARDIAN                                                     DATE

 

 

 

Text Box: For Committee Use Only
 
Date Rec'd: ___/____/___ Rec'd By: ________
Interview Date:____________ Time: ________