APPLICATION FOR THE COLLIN COUNTY VETERINARY MEDICAL ASSOCIATION SCHOLARSHIP


The Collin County Veterinary Medical Association (CCVMA) Scholarship will be a minimum of $1000. The Scholarship will be rewarded to any high school senior student(s) that are pursuing higher education or training in the Veterinary field. The scholarship may be used for tuition, fees, books, or any legitimate expenses associated with higher education. The CCVMA can determine whether the funds go directly to institutes of higher education or to the recipient themselves. The decision to distribute funds all at one time or to split the gifts per semester or school year will be at the sole discretion of the CCVMA. The CCVMA also holds the right to split the maximum allowance among multiple recipients.


SECTION 1: Applicant Information

Applicant Name (first/middle/last) _________________________________________________

Address: ______________________________________________________________________

Name of Parent(s) or Guardian(s) __________________________________________________

Phone # where CCVMA selection committee can reach you: _____________________________

E-Mail Address: ______________________________ Cell Phone # _______________________

Have you ever been employed or associated with a local veterinary clinic? If so, please list clinic or hospital name(s): ____________________________________________________________________________________________________________________________________________________________

List any other employer or business you have either been employed with or volunteered at that is animal related: ______________________________________________________________________________________________________________________________________________________


SECTION 2: School Information

Name of High School:___________________________________________________________

Please indicate the school/college which you’ve been accepted or plan to attend:

__________________________________________________________

List any schools you have been accepted to:

______________________________________________________________________________

What are your goals for the next 3-5 years? __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

How would you use this scholarship to help reach those goals?

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please list any awards you have received, clubs and organizations to which you belong, or community activities ( you may also list hobbies): ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________


SECTION 3: In Your Own Words


Please finish this sentence: “The thing that drives me to want to work in the veterinary field is.....”

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________




____________________________________________________

                            Applicant Signature                                       Date


*If you have any other information for the selection committee to consider, you may attach additional pages to this application. 




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THIS SECTION TO BE COMPLETED BY VETERINARIAN/ MENTOR/ TEACHER


How long have you known the applicant and in what capacity?                                                          

                                                                                                                                                              

Do you feel like applicant will make a positive impact in the field of veterinary medicine?

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Comments, recommendations, and other information to consider about the applicant:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________




Collin County Veterinary Medical Association Scholarship


Collin County Veterinary Medical Association     190 E. Stacy Road, Suite 306-184     Allen, TX 75002     
texasccvma@gmail.com 972-656-9008 (voicemail only)

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