Skaggs Foundation

Scholarship Application

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The goal of the Skaggs Foundation Scholarship Program is to meet community healthcare needs. Please note: you are responsible for ensuring all relavant documentation arrives in our office by the stated deadline. Carefully review the eligibility requirements and deadlines for both the TEPCOR and the Cox Medical Center Branson Scholarships by clicking here or by calling 1-417-348-8002.

You may apply for either or both of these scholarships with this single application.

Date of Application:

For Academic Term:

For Academic Year:

Part Time or Full Time Student:

Did you receive a scholarship from Skaggs Foundation last term?:

General Information

Full Name

Last Name:

First Name:

Middle Initial:

Permanent Address

Street:

City:

State:

Zip:

Current Address

If different from permanent address.

Street (Include Apartment #):

City:

State:

Zip:

Contact Info

Home Phone:

Work Phone:

Mobile Phone:

Email Address:

Employment & Volunteer History

Current Employer:

Position:

Supervisor:

Department:

How long have you been employed here?

Absences in last 12 months?

Any disciplinary action in last 12 months?

If yes, please explain:

Volunteer Experience:

Do you currently have family members employed by Cox?:

Education History

Most recent school attended:

Dates Attended:

Highest level of education completed to date:

GPA:

If applicable, current course of study:

Expected graduation date:

Education Plans

Desired field of study:

Proposed degree:

Starting date of program:

Hrs completed toward this degree:

Hrs remaining to complete degree:

Expected completion date:

School:

School Address:

Current GPA:

I wish to apply for

 TEPCOR Scholarship Cox Medical Center Branson Scholarship

TEPCOR Eligibility: All residents of the Cox Medical Center Branson service area.
Priority is given to Taney County residents.

Cox Branson Eligibility: All residents of Stone and Taney Counties in Missouri, Boone County, Arkansas and the employees and family members of Cox Medical Center Branson.





By signing below, you agree to the following terms:

I affirm that the information provided on this application is true and complete and that I meet the scholarship criteria provided.

I accept full responsibility for ensuring receipt of my complete Submission Packet, including all relevant documentation, by the Skaggs Foundation office before the applicable deadline.

I understand that if I am selected for the scholarship program, I will receive an award to help pay for my expenses to attend an accredited institution of higher education while pursuing the clinical healthcare degree/certification as outlined above.

Signature:

Date:

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Giving About Us Scholarships & Grants Where To Donate Skaggs FoundationContact Us
Online Donation Planned Giving Campaigns & Events Foundation Board Foundation Team Distinguished Donors Grants Scholarships Apply: Grants or Scholarships Community Health Initiatives Cox Medical Center Branson Memorial/Honor Skaggs Foundation
P.O. Box 650
Branson, MO 65615
(417) 348-8002
foundation@skaggs.net