Dr. Benjamin Collins Maxwell Endowed Scholarship

Name(Required)

First Last

CWID(Required)

Email(Required)

I am currently a MS4 student(Required)

Yes

Are you a Rural Medical Scholar?(Required)

Yes

Do you have a connection to or did you graduate from a high school in Escambia County, AL?(Required)

Yes

Rural and Primary Care Intents(Required)

What other financial awards or scholarships have you received to apply toward the cost of your medical training?(Required)

In regards to the above, what is the total amount of scholarship or award monies you have received or are going to receive?(Required)

Scholarship Committee Review(Required)

I understand that the CCHS Scholarship Committee (composed of faculty, staff, and community members) will review my application and discuss my academic and clinical performance as well as my financial situation.

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