Montana Health Information Management Association Scholarship Application

Scholarship is available to any person residing in the State of Montana who is actively studying health information management or health information technology at the associate, bachelor, master or PhD level.

Personal Data (All applications are confidential)

First Name *This question is required.

MI

Last Name *This question is required.

Email *This question is required. This question requires a valid email address.

Mailing Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Age

Martial Status

Number of Dependents

Employment Information

Place of Employment

Position Held

School/Program Information

Name of School/Program Attending *This question is required.

Street Address of School *This question is required.

City *This question is required.

State *This question is required.

Zip Code *This question is required.

The MHIMA Board will use this information to judge your merit as a scholarship applicant. Please include your plans for the future and need for this scholarship. Include a list of all your awards, scholarships and grants previously received toward your education expenses, as well as any student loans you may have.

1. Describe your education goals *This question is required.

2. Describe your vocational goals. *This question is required.

3. Personal Statement *This question is required.

4. Upload an "Official Copy" of Your Transcripts
*This question is required.

File: {{filename}} delete

5. Upload List of Awards and Recognition

File: {{filename}} delete

6. Upload List of Scholarships and Grants Received.

File: {{filename}} delete