Peninsulas EMS Council
PO Box 2348
Gloucester, VA 23061
Phone: 804-693-6234; Fax: 804-693-6277
 


 

Regional Scholarship for Outstanding Contribution to EMS

By a High School Senior

 

This competitive $1000 scholarship will be awarded to a high school senior who has been affiliated with an EMS agency within the (insert region) EMS Region for at least six months, and who is currently enrolled or will be enrolled in an institution of higher learning or an accredited ALS training program in the coming year.

 

Checklist of items that must accompany this application form:

 

□      Proof of the applicant’s affiliation with a Virginia licensed EMS agency. (Statement on Agency Letterhead. Can be included as part of one of the letters of recommendation)

 

□      Evidence of high school senior status, with documentation of the applicant’s cumulative grade point average. (No minimum GPA is required, but will be considered in evaluations)

 

□      At least two letters of recommendation on appropriate letterhead attesting that the nominee’s academic and/or EMS performance is consistent with the highest standards. One of the two letters of recommendation must be from an agency officer attesting to the applicant’s level of activity within the agency.

 

□     Digital Photograph (minimum 300dpi) of the applicant (May be emailed to jmeyer@vames.org )

  

Name of Applicant:

 

Address:

 

Telephone: Home   Mobile Email:    

High School:
 

Anticipated Higher Education/ALS Institution:

 

Current Cumulative GPA:   This GPA is based on a point scale.

 

EMS Agency Affiliation: Member since (mo/yr) 

 

In your own words, please answer the following five questions. Each answer should be 250 words or less.

 

1.                  Who or what inspired you to become involved in EMS, and what do you like about volunteering?

  

 

 

 

 

2.                  If given the opportunity, what would you do to improve the EMS system in Virginia?

 

 

 

 

 

3.                  How do you balance your schoolwork and other academic commitments, your EMS work and your other obligations?

 

 

 

 

 

4.                  Why do you think that your continued education is essential?

 

 

 

 

5.                  What aspect of EMS is most important to you, and what impact does that have on your community?

 

 

 

I hereby certify that all information on this application is true and correct, and that the answers to the above questions were written entirely by me.

 

 Date:

 

This form and all attachments must be in the PEMS office no later than 4:30pm, May 12, 2008, to the address shown above.


I have read and understand that all forms, reference letters, and pictures must be in the office at 6104 Fiddler's Green, Gloucester, no later than 4:30 pm May 12, 2008.