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* 1. First name

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* 2. Last name

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* 4. Mailing address

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* 5. Preferred phone number

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* 6. Email address

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* 7. Is your parent a Ridgeview employee?

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* 8. If yes, please list parent's name, title and Ridgeview department.

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* 9. What is your intended vocation or career you wish to enter as a result of your post-secondary education?

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* 10. GPA (will be verified)

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* 11. List all of the schools to which you have applied. Indicate whether or not you have already been accepted.

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* 12. Please list elective courses you have taken in your junior and senior years of high school. You may include PSEO, CIS or IB classes.

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* 13. List all SCHOOL activities in which you have participated during your four years of high school. Include the number of years and any special distinctions, awards or honors.

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* 14. List all COMMUNITY activities in which you have participated without pay during the past two years (e.g., scouts, church groups, volunteer work). Please indicate how long and what years you were involved with each.

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* 15. Describe any paid employment. Please provide company name, dates/years of employment and approximate number of hours worked per week.

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* 16. Describe any additional paid employment. Please provide company name, dates/years of employment and approximate number of hours worked per week.

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* 17. What personally drives you to want to pursue a career within health care?

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* 18. Describe a special attribute or meaningful achievement that sets you apart from other applicants and directly relates to your field of study and future goals.

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* 19. Pick an experience from your own life and explain how it has influenced your development. 

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* 20. If you had the authority to change your community in a positive way, what specific changes would you make? 

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* 21. What non-academic book have you read in the last two years that has been memorable to you. Why?

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* 22. What impact would this scholarship have on your education?

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* 23. In an essay of no more than 500 words, tell us something about yourself you have not already mentioned in the previous questions on this application.

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* 24. All applicants are required to submit two letters of recommendation from nonfamily members who can attest to your academic achievement, overall character and motivation. Please upload those documents here prior to final completion of this application. (Please save letters of recommendations in one single file, as you will not be able to upload two documents)

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* 25. I certify that I have filled out this application on my own behalf and give Ridgeview Medical Center permission to contact my school or references in regard to this scholarship.

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