Auxiliary Seeding Student Education and Training Scholarship for Children of Genesis Employees Application

Genesis Health Services Foundation

ASSET Scholarship for Children of Genesis Employees

Award

$1000 scholarship for tuition or fees incurred in the pursuit of two or four year undergraduate degree in healthcare, wellness, science, technology or related fields.

Eligibility and Requirements

Click here to read the Eligibility Requirements and Terms of Scholarship.

 

* - indicates a required field

 


 

Student Information
Last Name:* 
First Name:* 
Middle Initial:* 
Address:* 
City:* 
State:* 
Zip Code:* 
Home Phone:* 
Cell Phone: 
E-mail Address:* 
Parent (Qualified Genesis Employee) Information
Last Name:* 
First Name:* 
Middle Initial:* 
What is the relationship of the Qualified Genesis Employee to you:* 
Employee ID:* 
Number of years with Genesis:*
Department: *
Position:* 
Manager/Supervisor Name:* 
Entity:* 
High School Information
School Name:* 
Address:* 
City:* 
State:* 
Zip Code:* 
GPA:* 
Month/Year of Graduation:* 
College or University Information
MUST COMPLETE with College or University you plan to attend during 2014-15 school year.
College/University Name:* 
Address:* 
City:* 
State:* 
Zip Code:* 
GPA:*  - enter N/A if not yet in college.
Major:* 
Current Year in School:* 
Anticipated Date of Graduation:* 
Essays
The Genesis Values are safety, integrity, compassion, accountability, respect and excellence. Choose one of these values and in 2 or 3 sentences explain how and why it is important in your educational journey?
As one of three focus areas, Genesis is committed to the improvement of population health. Please explain in 2 or 3 sentences how you intend to positively influence population health and wellness in your chosen career or profession
Volunteerism is a key component of the Genesis Mission. Describe (in 500-600 words) the ways you volunteer in your community and the impact your volunteer work has had on others as well as what it has meant to you personally. Finally, provide a brief statement as to how you plan to incorporate volunteer activities into your life in the future. This essay can be emailed separately to scholarships@genesishealth.com. Include your name and words: ASSET ESSAY in your email.
The following must be submitted separately to scholarships@genesishealth.com
If you are a current high school senior:
  • High School Transcript
  • Two letters of recommendation (from non-relatives)
  • College letter of acceptance if available
  • Essay on volunteerism if submitting by email.
If you are a current college student:
  • High School Transcript
  • College Transcript
  • Two letters of recommendation (from non-relatives)
  • Essay on volunteerism if submitting by email.

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1227 E. Rusholme Street Davenport, IA 52803 563-421-1000