Healthcare Financial Management Association Virginia-Washington DC Chapter Robert Thomas Continuing Education Scholarship Application Name ____________________________________ Social Security No. __________________ Street Address _________________________________________________________________

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Nov 10, 2013 (4 years and 3 days ago)

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Healthcare Financial Management Association


Virginia
-
Washington DC

Chapter

Robert Thomas Continuing Education Scholarship Application


Name ____________________________________ Social Security No. __________________


Street Address ______________________
___________________________________________

City ________________________________ State ___________ Zip _____________________

Home Telephone ______________________ Work Telephone ________________________

Name of college or post secondary school where you

will study:

Name
__________________________________________________________________________

Street Address _________________________________________________________________

City _________________________________ State ___________ Zip ___________________
_

Present Education Level: (Circle one)

Grade 11 12 College 1 2 3 4 Graduate 1 2 3 4 5 6

Degree or Education sought with field of emphasis:

______________________________________________________________________________

____
__________________________________________________________________________

Guidelines

The scholarship award will be made on the basis of an essay. The essay should describe
the applicant’s academic goal, how the scholarship will help the applicant achieve
this goal
and how the applicant expects his or her career to be improved. The essay should not
exceed two typewritten, single spaced pages.


All applicants for the Robert Thomas Scholarship must be members of the Healthcare
Financial Management Association
. Judging of the essay will include (but not limited to)
organization, grammar, punctuation, clarity and logic of expression.


Signature _______________________________________ Date ________________________



This form should be mailed to the address giv
en below and must be postmarked no later than
August 31, 2013
.


Steve Quiriconi

Bon Secours

5801 Bremo Road

Richmond, VA
2
3226