ACG Diversity, Equity and Inclusion in Healthcare Scholarship Deadline for Submission: November 11, 2022 To be eligible, you must be a current student at Hawthorne Academy (Charlotte-Mecklenburg Schools) that participated in the program on October 25, 2022. Strong preference will be given to graduating Seniors or Juniors who are on a college bound track. An essay and high school transcript or proof of academic achievement are required. Online ApplicationName of Applicant* First Middle Last Name of Parent/Guardian 1* First Last Name of Parent/Guardian 2 (optional) First Last Primary Phone (Applicant)* Secondary Phone (Applicant)* Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Gender* Female Male Other Prefer not to answer How would you describe your race?*Choose OneAmerican Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteMore Than One RaceUnknownI prefer not to answerHow would you describe your ethnicity?*Choose OneHispanic or LatinoNot Hispanic or LatinoUnknownI prefer not to answerEmail (Preferred)* Application Criteria:I am on a college bound track and am currently a high school _______* Senior Junior Sophomore Freshman I participated in the ACG Prescription for Success: Careers in Medicine Program at my High School*SelectYESNORequired UploadsUpload Your Essay*Accepted file types: pdf, doc, docx, Max. file size: 50 MB.Please write a 500-750 word essay in which you explain your career aspirations, what you will do to improve healthcare, and what inspires you to pursue a healthcare career. Transcript and Grade Point Average*Accepted file types: pdf, doc, docx, Max. file size: 50 MB.Please provide your current GPA and attach your transcript or other documentation for verification as part of a combined document for upload.Deadline for Submission: December 31, 2021 CAPTCHA
