REZIN ORTHOPEDIC SCHOLARSHIP
PROGRAM
REZIN
ORTHOPEDIC CENTERS, S.C.
VITAL CARE PHYSICIAL THERAPY
CENTERS
SCHOLARSHIP APPLICATION
$1,000
Awards for the 2004-2005 Academic Year
Scholarships are available to individuals
living in the counties of Grundy, Kendall, LaSalle, Livingston and Will who will be graduating in the spring of 2004 from high
school or who are currently enrolled in a university/community college.� Eligible applicants must be enrolling in or be
enrolled in the fields Medicine which includes, but is not limited to, pre-med,
physical therapy, occupational therapy, sports medicine, athletic training,
medical technician or nursing.�
Awards:
Two $1,000
scholarships will be awarded to individuals meeting the outlined criteria.� Scholarships may be renewed pending
reapplication and approval from the Scholarship Committee.
Scholarship
Criteria
3. Applicant must be enrolled in a minimum of 12 credit
hours per semester for the academic year.
Submission
Deadline
Application,
transcripts and supporting documents must be received by the
Rezin
Orthopedic Centers Scholarship Committee by
Award and
regret letters will be sent in May, 2004
Rezin
Orthopedic Centers, S.C.
Instructions
Please read
the following instructions carefully before completing the application.� Applications that
are incomplete or unreadable will not
be considered.� Applications received by
the Rezin Orthopedic Scholarship Committee after the deadline will not be accepted.
The Scholarship Committee
evaluates applicants on the following points:
� Presentation � overall neatness, readability and thoroughness
� Organization � essay response is clear and to the topic
� Content � essay answers the question completely & thoroughly
� Form & Structure � applicant followed directions
1.�������� Please type or print the application.� Attach a separate sheet if needed.� Fill in every line on the application.� If information is not available or not applicable write N/A.� Sign the completed application.
2.�������� Provide one letter of recommendation.
����������� 3.�������� A
copy of acceptable transcripts is required if you are a high school senior or a
����������������������� continuing
university/community college student.� If
this is your first semester at�
a
university/community college and no current transcripts are available, check
the� appropriate box in the application.
�����������������������������������
Acceptable transcripts
����������������������������������� 1. Official
high school or university/community college transcripts
����������������������������������� 2.
Unofficial high school transcript from admissions and records office
����������������������������������� 3.
Unofficial university/community college transcript from admissions
��� and records office
����������������������������������� Unacceptable documents as transcripts
1. High school or
university/community college Grade Reports are not
�����
transcripts
�����������������������
����������� 4.�������� Review
the criteria of this scholarship carefully.�
This scholarship requires a typed essay and additional documents so
please attach them to your application.�
Make sure that your name is on all supporting documents.
5.�������� Mail
application, transcripts and supporting documents to:
�����������������������
����������������������� Rezin
Orthopedic Centers, S.C.
����������������������������������������������� 1051
�����������������������������������������������
����������������������������������������������� Attention:� Eric Anderson
����������� 6.�������� All documents must be received by the
Rezin Orthopedic Centers Scholarship Committee by
Faxed
applications will not be accepted
REZIN ORTHOPEDIC SCHOLARSHIP
PROGRAM
SCHOLARSHIP APPLICATION
2004-2005
ACADEMIC YEAR
Student Name
______________________________________________________________________________
Student ID/Social
Security #� _____________________________________________Date
of Birth_________________________________
Street������������������������������������������
City����������������������������������������������������
State������ ������������Zip
Address� ________________________________________________________________________________________________________
Home Phone #
____________________________ Other Phone #___________________________E-mail
___________________________
Illinois Resident� Yes��No��������������
��������������� Gender and ethnic group�������� Gender������������ �Female������������������
��������������� are
requested for���������������� ����������������������������� �Male����������������������
��������������� statistical
use only������������������ Ethnic Background
������������������������������������������������������������������� �Native American������ �Asian or Pacific
Islander��������� �Hispanic
����������������������������������������������������������������������������������� �African American����� �Caucasian���������������������������� �Other
I am an adult
entering college for the first time and do not have current college
transcripts?�� Yes ��No
State City Name
������ High
School__________________________________________________________________________________________________
������ ����������������������������������������
Dates attended:���
From ______________�
to ________________
Month/Yr. Month/Yr.
��������������� �High School Diploma__________���������������� �GED___________
Month/Yr
I am seeking a(n):����������������������������������� ��Associate�s Degree������������������������� I will complete my degree________________�������
Month/Yr
������������������������������� ��Certificate ��������������������������������������� I
will complete my certificate ________________
��������������������������������������������������������������� ��Transfer to
______________________________________When?____________
Month/Yr
��������������������������������������������������������������� ��Bachelor�s Degree��������������������������� I will complete my degree________________
My academic major/program of study is
___________________________________.� My
cumulative high school or college GPA is ________.���� ACT/SAT results:��� Verbal: ______________�� Math: ____________�� Composite: ____________
I attended
credit hrs./clock hrs.� I am
currently enrolled at_____________________________ University/Community College
for the spring 2003
semester and will complete ________credit hrs./clock hrs. I will
have earned a total of ________college credits/clock hrs. by
the end of spring
2003.� I plan to enroll in ______ credit hrs./clock hrs. at
__________________________ University/Community College for fall, 2003
semester.
I certify that the above information is accurate and correct
to the best of my knowledge.�
____________________________________�������������������������������������������� __________________________
Student�s signature������������������������������������������������������������������������������� Date
Rezin Orthopedic Centers
Scholarship Program
PH:� 815-942-4875
Applicants are requested to write an essay describing their education and employment goals.� The essay should include a brief discussion of the applicant�s academic achievements, awards, extracurricular and leadership activities.� Applicants should include statements to illustrate why he/she would be the best candidate for the scholarship.� Also, the essay should include a discussion of the applicant�s area(s) of interest and field(s) of study in the field of Medicine.�