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North Omaha Community Care Council
2023 Scholarship Application
Please take your time in completing this form. Documents can be downloaded and completed from the Scholarship Information page found
here
.
First Name
Email Address
Current Address
Last Name
Contact Phone Number
Permanent Address
Birthdate
Do you have a disability?
Choose an option
Race
Choose an option
Specify Other Race
How did you learn about the scholarship?
Do you know someone who is a member of the North Omaha Community Care Council?
Choose an option
Who do you know on the NOCCC?
What High School did you attend?
Location of High School
What College/University are you requesting a scholarship for?
Location of College/University
Scholarship Amount Requested
Student's Current or Planned Major/Degree
Current Year in College
Current Grade Point Average (GPA)
Do you intend to apply to a health professional school at any time after graduation? (examples: medical school, physician assistant, nursing, occupational therapy, physical therapy)
Choose an option
Will you apply to UNMC, UNO, Creighton University, or any other Nebraska University for addmissions to any of the healt professional schools they offer?
Choose an option
Which health professional schools are you aware of at UNMC? (Check ALL that apply)
Medicine
Nursing
Physician Assistant
Physical Therapy
Occupational Therapy
Pharmacy
Public Health
Other (Please spcify)
Other known health professional school
Upload a copy of current enrollment/registration
Upload File
Upload supported file (Max 15MB)
Upload your complete Financial Need Form
Upload File
Upload supported file (Max 15MB)
Upload your completed Essay
Upload File
Upload supported file (Max 15MB)
Your Signature
Clear
I certify that the infomaton included in this application is accurate and undestand that intentional misrepresentation will disqualify me from recieving this or future scholarship awards from the North Omah Community Care Council.
Submit
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