Dr. Jerry Church Community Health Sustainer’s Award

Application Deadline: April 15th of every year

Named for one of Two Harbors’ best-known physicians and designed for residents of Lake County, Minnesota, who are seeking a career in rural health care, this $1,000 scholarship is gifted in two annual $500 sums.

Eligibility Requirements:

Be accepted to the College of St. Scholastica RN Nursing Program, the University of Minnesota Duluth School of Medicine, or Lake Superior College RN Nursing Program.
Career goal of being a family practice physician, nurse practitioner or registered nurse in a rural health care setting.
A graduate of Lake, Cook or a St. Louis County High School, or a resident of Lake County, Minnesota, at the time of application and award.

Note: * = Required Field

Personal Information
First Name*
Middle Name*
Last Name*
Email Address*
Address*
City*
State*
ZIP Code*
Parent(s) / Guardian(s)
Guardian 1
First Name*
Last Name*
Guardian 2
First Name*
Last Name*
Education Information
Name & Location of High School*
Year of High School Graduation*
Grade Point Average*
I have been accepted to the following College / University:
College Name*
College City*
I Will Begin (or Began) Classes On:*
Anticipated Major / Minor:*
Are Parents and/or Siblings Currently Attending College?*
- Yes
- No
If Yes, How many?*
Total Projected Annual Cost of College:*
How do you plan to pay for college:
Paid by Student*
Paid by Family*
Other Scholarships*
Grants / Student Aid*
Student Loans*
Other*
Total*
Employment/Community Involvement
Are You Currently Employed:*
- Yes
- No
Employer / Position Held:*
Community / Volunteer Activities:*
Student and/or Community Leadership Roles:*
Awards or Special Recognition:*
Career Goals
In 300 words or less, how would you define your career goals?*
Important: When filling out this online application, it is best that you don't leave the page or your information could be lost. If you are attaching a document please note in this field "See attachment."
Or, Upload a Separate Career Goals Document: (.doc or .pdf formats only)
Max. file size: 300 MB.
Letters of Recommendation
Please upload at least one letter of recommendation: (.doc or .pdf formats only)*
Max. file size: 300 MB.
*
- I hereby apply for this scholarship according to its terms.

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Dr. Jerry Church Community Health Sustainer’s Award

Personal Information

Parent(s) / Guardian(s)

Education Information

How do you plan to pay for college:

Employment/Community Involvement

Career Goals

Letters of Recommendation