Membership Scholarship Name First Last PhoneEmail Are you, or have you previously been, a Women in healthcare member?* Yes No Unsure If yes, please provide your membership number:This number is located in your membership profile on the website. Chapter of Interest:*Central VirginiaChicagoDCDenverFloridaGeorgiaTorontoLos AngelesLouisianaMarylandMichiganNashvilleNebraska and IowaNew YorkNorth CarolinaOhioOregonPhiladelphiaPhoenixSouth CarolinaTexasEmployment Status* Student Part Time Full Time Unemployed Years in the Industry.*Please enter a number from 0 to 100.Highest Level of Education*High school or equivalentTechnical or occupational certificateAssociate degreeSome college coursework completedBachelor’s degreeMaster’s degreeDoctorateHealthcare Sector*Administration/Corporate FunctionsArchitecture/Engineering/ConstructionCommunity and Public HealthFinanceHealthcare AcademiaHealthcare DeliveryHealthcare TechnologyHuman ResourcesLawLife SciencesManaged CarePharmaceuticalsStudentOtherDescribe your current role?*Describe where you want to see yourself in 5 years?*Tell us why you want to be a part of the Women in Healthcare community?*How do you envision utilizing this scholarship to move towards a more gender equal world?*Describe your volunteer or community involvement.*Describe your current need.*Please upload a current resume or curriculum vitae.*Accepted file types: pdf, doc, docx, Max. file size: 2 MB.Please select an item below that best describes your race/ethnicity?* African American / Black Native American / Alaska Native East Asian Hispanic Latinx Middle Eastern Pacific Islander South Asian Southeast Asian White I prefer not to say Other