The Washington Foundation for Long Term Care awards scholarships for higher education completed at a college, university, technical college, or higher education learning institute. Scholarship checks are made payable to the recipient and the college or institution where enrolled. Scholarships may not be used for classes or workshops that do not provide college credit toward a degree program. Complete scholarship application packets include the application and two letters of recommendation. Incomplete applications will not be submitted to the Selection Committee. Applications and letters of recommendation are due April 30, 2021.

Question Title

* 1. Applicant Name:

Question Title

* 2. Applicant Email (this email will be used to send follow-up instructions for Letters of Recommendation)

Question Title

* 3. Applicant Mailing Address

Question Title

* 4. Applicant Phone Number

Question Title

* 5. Please indicate your present employment status.

Question Title

* 6. Please provide the name and address of the facility where you work.

Question Title

* 7. What is your current position?

Question Title

* 8. How long have you been employed by the facility?

Question Title

* 9. Have you applied for enrollment, been accepted, or are you currently enrolled in a program of study related to long term care?

Question Title

* 10. What is your expected course of study?

Question Title

* 11. When is your expected date of graduation?

Question Title

* 12. For which field of study are you requesting scholarship assistance?

Question Title

* 13. What is your highest level of education earned so far?

Question Title

* 14. What was your overall grade point average? (indicate "unknown" if less than high school diploma earned)

Question Title

* 15. What is the name and location of the high school, college or university you currently attend?

Question Title

* 16. If currently enrolled in college, how many credit hours have you completed?

Question Title

* 17. If currently enrolled in college, what is your grade point average?

Question Title

* 18. What are other types of formal education, such as facility training/certification programs (example: Nurse Aide Certification Program) you have completed?

Question Title

* 19. Have you been accepted in a training program for the field of study listed above?

Question Title

* 20. When does your training begin?

Question Title

* 21. Describing your current financial needs, please tell us what impact the LTC Foundation scholarship may have for you?

Question Title

* 22. Please estimate the annual cost of study in your field (include tuition, fees, books, etc.):

Question Title

* 23. Please list your employment positions (including summer and part time positions) beginning with the present.

Question Title

* 24. Please describe your interest in long term care, commenting on your involvement to date in assisted living community and/or skilled nursing facility settings:

Question Title

* 25. Have you personally and/or professionally benefited from your experiences in long term care and what unique challenges do you believe this field holds?

Question Title

* 26. Describe three career goals and how you plan to accomplish them.

Question Title

* 27. By checking "Yes" and submitting this application, you certify that all information contained herein is true and correct. All Foundation scholarship nominees are required to request and submit two letters of recommendation to complete the application packet. Upon completion and WHCA's receipt of the application, you will be given instructions for submitting letters of recommendation. Letters of recommendation must be submitted by the scholarship application deadline of April 30, 2021.

T