FLORENCE HELLMAN SCHOLARSHIP
APPLICATION
Deadline: February 15th
Return completed Application to 100 Nixson Hall
CRITERIA:
1. Must be a Health Education and Promotion major.
2. Must be admitted to the masters or doctoral program
3. Must have at least a 3.00 G.P.A. at the end of the Fall semester preceding this application.
4. Must have participated on a voluntary basis or for pay in health related services not required by the
curriculum-e.g. public, private, voluntary, campus, community, international and/or professional health
associations.
Name: ____________________________________________
Kent State ID: ______________________
Date: _________________________
Email: ___________________________@kent.edu
Address _____________________________________________________
City _____________________ State _____ Zip _________
Phone (
) ________________
Major ___________________________________________ Minor (If Any) ____________________
Hours complete at end of Fall Semester _____________________________ G.P.A. _____________
Courses completed at KSU in the Health Education Department:
Course Number
Title
Credit Hours
_____________
_________________________________________________
__________
_____________
________________________________________________
__________
_____________
________________________________________________
__________
_____________
________________________________________________
__________
_____________
________________________________________________
__________
Involvement in Community Health Services or Programs:
Name and Address of Organization
_________________________________
Dates
Supervisor
Paid or Voluntary
____ to ____
____________________
P
V
____ to ____
____________________
P
V
____ to ____
____________________
P
V
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
Please answer the following three questions (please print or attach a separate typed document)
1. Briefly describe your specific responsibilities for each of the organizations above.
2. What did you contribute to each of the programs in which you were involved?
3. In what ways did the experiences benefit you?