EMS Minority Student Scholarship Guidelines TO BE CONSIDERED FOR A SCHOLARSHIP, APPLICANT MUST: 

Meet all program admittance criteria as applicable (i.e. background check, drug screening, 18 years of age, be a current resident of Michigan and a legal citizen of the United States).



Be a member of one of the following racial/ethnic minority groups: African American, Asian, Native Hawaiian, Pacific Islander, Hispanic, and American Indian (federal and state recognized tribes) OR be a woman.

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Anticipate completion of high school diploma and/or GED at the time of application with a minimum overall GPA of 2.0 in at least one of the following disciplines: biology, health science and/or mathematics OR achieve a minimum overall GPA of 2.0 in one of the following disciplines: biology, health science and/or mathematics at the end of any collegiate level or professional trade school program as applicable.

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Demonstrate an interest in pursuing a career track in EMS and show potential for becoming a future employee of Emergent Health Partners emergency medical staff.

APPLICANT MAY NOT: 

Be employed by Emergent Health Partners or its members or be a spouse, child, stepchild, grandchild, brother, sister, sister- and/or brother-in-law of an employee of Emergent Health Partners or its members.



Possess a criminal record that would preclude the applicant from State licensure.

ADDITIONAL CONSIDERATION GIVEN TO APPLICANTS WHO: 

Show a commitment to public service with demonstrated involvement in community outreach programs (volunteering, mentoring youth, counseling etc.).

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Aspire to a career in the EMS field.

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Has been a displaced worker for a minimum of 6 months.

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Is a single parent and/or guardian.

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Demonstrates financial need – the applicant must have access to transportation to class and clinical sessions and be able to purchase uniform and class supplies.

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Is overcoming any documented disability as defined by the Americans with Disability Act of 1990 (ADA) - the documented disability may not preclude the applicant from fulfilling any of the cognitive and/or practical aspects of the EMS training program. The HVA Center for EMS Education is a member of Emergent Health Partners.

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Application Instructions Biographical Information 

Please carefully complete the biographical information (name, address, etc.). Be sure your information is accurate and complete for notification and eligibility purposes. You must be a U.S. Citizen or legal resident of the U.S. to apply.

School/Extracurricular Activities 



Awards, Honors, Special Skills or Talents tell us about the honors you have received, or special skills you have, that are most meaningful to you and whether they were on a local (school, county, or district), state or national level. If your school system requires volunteer service as a condition of graduation, please indicate the amount and type required for graduation.

Community Activities   

If your school system requires volunteer service as a condition of graduation, please indicate the amount and type required for graduation. Please indicate the name and description of community organizations that you actively participated in either during school or post-graduation. Please provide a brief description of any awards or honors you may have received for your work with community organizations.

High School Academic Information   

If your school offers Honors, Advanced Placement or an International Baccalaureate curriculum, please indicate any such classes and/or programs you have attended. Indicate your official class rank at the end of your junior/senior year. This ranking should be based on your school's formal policy for determining rank. If you are uncertain of your ranking, please consult your academic counselor. An official high school and Collegiate/Trade School (as applicable) transcript is required to verify overall GPA. Mail the official transcript to: United Way of Washtenaw County Attn: EMS Scholarship Committee 2305 Platt Road Ann Arbor, MI 48104

College and/or Trade School Academic Information 

Indicate the courses you have completed that are relevant to your pursuing a career in EMS.

Employment Information 

Indicate your current employment status, type of work, income, number of hours weekly and amount of time served in current position. If you have any questions about this application, please contact United Way of Washtenaw County, 734.677.7234 or [email protected]. 2

EMS Minority Student Scholarship Application Check box to indicate the scholarship for which you are applying:  EMT Program  Paramedic Program

Name: Address: City:

State:

Cell Phone:

ZIP:

Home Phone: YES

NO

Are you a U.S. citizen or legal resident? Are you a high school graduate? Do you have any relatives currently employed by Emergent Health Partners or its subsidiaries? Do you have a relative (specifically mother, father, grandmother, grandfather, sibling, aunt or uncle) that is a State of Michigan licensed Basic EMT, EMT-Intermediate, or Paramedic? Do you have a criminal record that would preclude you from obtaining a State of Michigan EMS license? Do you have reliable transportation or the ability to access resources for transportation to class? Do you have the ability to purchase the required uniform and class supplies? (Approx.$300) Do you have any disabilities that would preclude you from fulfilling the cognitive and/or practical aspects of the EMS training program? Do you plan on pursuing a career as a licensed EMT or Paramedic?

An official transcript is required from each high school, college and/or trade school attended. HIGH SCHOOL INFORMATION School: Address: City:

State:

ZIP:

Phone: Year of Graduation:

GPA:

Class Rank: ________ out of _____________ 3

SCHOOL AND EXTRACURRICULAR ACTIVITIES Include any awards or honors that you received. Describe any special skills or talents you acquired during high school. If your high school required volunteer service as a condition of graduation, indicate the amount and type required.

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COLLEGE/TRADE SCHOOL INFORMATION School: Address: City:

State:

ZIP:

Phone: Year of Graduation:

GPA: COLLEGE/TRADE SCHOOL INFORMATION

School: Address: City:

State:

ZIP:

Phone: Year of Graduation:

GPA: COLLEGE/TRADE SCHOOL INFORMATION

School: Address: City:

State:

ZIP:

Phone: Year of Graduation:

GPA: COLLEGE/TRADE SCHOOL INFORMATION

School: Address: City:

State:

ZIP:

Phone: Year of Graduation:

GPA:

An official transcript is required from each high school, college and/or trade school attended. 5

COMMUNITY ACTIVITIES Indicate the community organizations that you actively participate in and any awards or honors received as a result of your participation.

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CURRENT EMPLOYMENT INFORMATION Employer: Address: City:

State:

ZIP:

Phone: Supervisor: Current Position: Date of Hire:

Hourly Wage:

Hours per week:

Type of work, current duties:

I,__________________________________________, attest that all of the above information is correct and true. I understand that falsification of information will result in my application being denied further consideration for the scholarship. Signature: Printed Name:

Date:

Please mail the completed application, along with a copy of the required EMS license*, if applicable to:

United Way of Washtenaw County Attn: EMS Scholarship 2305 Platt Road Ann Arbor, MI 48104 *If you are applying for the Paramedic Program Scholarship, you must hold a current State of Michigan EMS license and have completed (or plan to complete within the first semester of enrollment in the program) a college level anatomy and physiology class with a passing grade (C or better). 7