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McDaniel's Scholarship Application

Foundation of Yuma Regional Medical Center
Richard Michael McDaniel Scholarship Application

* Indicates required information
Last Name: * 
First Name: * 
Street Address: * 
City: * 
State: * 
Zip Code: * 
Phone Number: * 
E-Mail Address: * 
Date of Birth: *  Calendar (mm/dd/yyyy)
Resume / Curriculum Vitae: 
Current transcripts or acceptance letter: 
Work Experience / Briefly describe your experience to date in providing oncology-related care: * 
What degree are you currently pursuing (that would be funded with this Scholarship)?: * 
Are you currently enrolled or accepted into an accredited program?: * 

Name of School: * 
Name of Program: * 
Are you planning on working in Yuma County for at least one (1) year following the end of this award?: * 
Describe how this award will enhance the quality of care that you provide to patients with cancer: * 
If you are awarded a Scholarship, the Foundation will expect you to apply your expertise to providing quality cancer care here in Yuma County for at least one (1) year following the end og the award. Please describe how you will do this: * 
Scholarship Request Amount: * 
Are you currently employed by Yuma Regional Medical Center? 

If Yes, please describe in the box below whether you have applied for the YRMC Education Assistance Program, whether or not your EAP application was accepted, and the amount that you are currently receiving for the 2015 year through the EAP: 
What is the difference between your tuition and the amount you're being compensated through the Employee Assistance Program? Please note that the Scholarship Request Amount cannot exceed the difference. 
Please provide the following documentation as applicable: Education Assistance Application notice of acceptance, anticipated tuition costs, other scholarships received. 
Authentication * 

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