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Haberman-Williams MaMHCA
Scholarship Application
2015-16 Scholarship Year
Application instructions:
1. Please complete all sections of the application form.
2. Obtain an official copy of a transcript from the most recent academic work (undergraduate or graduate).
3. Write a biographical statement (two typed, double-spaced pages). Essay must address career goals, interests, and work, volunteer, and/or school/field experience relevant to the guidelines of the award.
4. Obtain two letters of support from professional references. Letters should be written by a candidate's professors or practicum/internship supervisor.
5. Please submit all information together and mail it to:
Haberman-Williams MaMHCA Scholarship Committee
c/o MaMHCA
17 Cocasset Street
Foxboro, MA 02035
|Name: |
|Address: |
|City: |State: |Zip: |
|Phone: |E-mail: |
Education
|University/College: |Degree Program: |
|Student Status: FT ___ PT ___ |Projected Graduation (mm/yy): |
|Credits Earned to date: |Practicum site (if applicable): |
|Internship Site (if applicable): | |
Employment
|Employed: Not applicable ___ FT ___ PT ___ |
|Employer: |
MaMHCA Membership (required to be eligible for award)
|Member of MaMHCA? Yes ___ No ___ |
MaMHCA Board of Directors Commitment
|I agree to participate in MaMHCA Board of Directors Meetings during my scholarship year. |
|Yes ___ No ___ Signature: ________________________________________________ |
Application Checklist
Please be sure to include the following with your application:
____ Official transcript
____ Biographical statement
____ Two letters of support from professional references
................
................
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