Dr. Benjamin Collins Maxwell Endowed Scholarship

First Name *

Last Name *

CWID *

Email *

I am currently a MS4 student. *

Yes

Are you a Rural Medical Scholar? *

Yes

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

Yes

Briefly describe your connection to Escambia County *

Rural and Primary Care Intents *

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

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

Scholarship Committee Review *

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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