Paul Spear Appalachia Scholarship About the scholarship Two students per class will be chosen to receive the Paul Spear Appalachia Scholarship. The scholarship is based on the applicant’s desire to provide healthcare in the Southeastern Ohio and/or Appalachia area and financial need. The award covers half of the tuition for both the didactic and clinical phases of the Program as long as the student maintains a 3.0 GPA throughout the Program. In repayment of the scholarship, the student commits to a one-for-one service agreement to practice in the Southeastern Ohio and/or Appalachia area for each year of the scholarship award (2 year maximum). First Name Last Name Email Cell Phone Address 1 Address 2 City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code declaration of application I would like to apply for the Paul Spear Appalachia Scholarship. I understand the award is based on the desire to provide health care in the Southeastern Ohio and/or Appalachia area and financial need. I also understand that during the selection process, information regarding my outstanding federal student loan(s) will be gathered and reviewed by the selection committee. If awarded the scholarship, I agree to practice in the Southeastern Ohio and/or Appalachia area as repayment of the scholarship on a one-for-one year basis. Signature submitting your name above denotes an electronic signature Date Which area best describes where you spent the major portion of your high school years?* Large city (population 500,000 or more) Suburb of a large city City of moderate size (population 50,000 to 500,000) Suburb of moderate size city Small city (population 10,000 to 50,000 other than suburb) Town (population 2,500 to 10,000 other than suburb) Small town (population less than 2,500) Rural / unincorporated area After completion of the PA Program, in which area of medicine do you see yourself practicing? If Other: After completion of the PA Program, in which geographical area do you see yourself practicing?* Large city (population 500,000 or more) Suburb of a large city City of moderate size (population 50,000 to 500,000) Suburb of moderate size city Small city (population 10,000 to 50,000 other than suburb) Town (population 2,500 to 10,000 other than suburb) Small town (population less than 2,500) Rural/unincorporated area Would you be willing to practice in a socioeconomically deprived area?* Yes No Not Sure Will you be receiving financial support for your PA education that obligates you to practice in a specific location after graduation?* Yes No Not sure If Yes, where? Why should you be selected to receive this scholarship? (500 word maximum) CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.