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Scholarship Application

Please keep a copy of this application as it contains information you will need for future payments. Print or save the confirmation page after submitting the application for your records. Failure to follow ALL instructions will result in non-consideration for the scholarship.

Policies and Procedures for the Atrium Health Navicent Auxiliary
Grace Barnes Memorial Scholarship Application

The scholarship fund is to be used by a qualifying student in the area of allied medical field/nursing. The Scholarship Fund Committee will review all application forms. Personal history, financial need, and acceptance by school will be essential to apply. ALL required documentation must be submitted in order for the committee to consider your application packet. The decision of the Scholarship Fund Committee is final.

The Medical Center Atrium Health Navicent Auxiliary will disburse scholarship funds ($750.00 per semester or $500.00 per quarter) to the institution indicated by the recipient. Any unused money will be refunded to the Auxiliary.

Checks will be issued to the institution on a quarter/semester basis. Please provide the following with your application.

  1. Three letters of recommendation signed by the author and emailed directly from the author to volunteer@navicenthealth.org. The subject line should read - Grace Barnes Scholarship - Recommendation - Your Name. These CANNOT be from relatives.
  2. Official transcript from your most recent college or high school. Must be in sealed envelope from the institution providing it. These may be sent to the following address:

    3. Volunteer Services, Atrium Health Navicent
    Attn: Grace Barnes Scholarship Committee
    777 Hemlock Street #153
    Macon, GA 31201

  3. Proof of acceptance from recognized institution which you intend to use scholarship for.
Applications should be submitted electronically via this form.

DEADLINE
Completed application packets must be received no later than July 15. Failure to comply with all of the above requirements and instructions will result in non-consideration for the scholarship!

Applicants' financial need and desire to pursue a career in a field of allied health/nursing/ medicine must be established.

All money will be sent directly to the education institution on behalf of the recipient and is to be used for tuition, books, meal plan, and dormitory cost (does not cover off-campus housing). Any unused money will be refunded to the Auxiliary.
A copy of tuition invoice is required to be furnished by the student each quarter/semester to the MCNH Auxiliary Scholarship Committee. The next quarter/semester will not be paid until invoice has been received. If student fails to provide the scholarship committee with tuition invoice as soon as he/she has registered, the scholarship may be terminated without notice.

The recipient must maintain full time student status while receiving the Grace Barnes Memorial Scholarship. (Individual exceptions will be considered by the scholarship committee.) A full time student is emolled in a minimum of 12 quarter hours or 18 semester hours of course work. A minimum cumulative grade point average of 3.0 must be maintained. The recipient will be responsible for providing written proof (official transcripts only) of such scholastic standing each quarter or semester to the scholarship chairperson as soon as grades are obtained. If student fails to provide the scholarship committee witlt their official transcript after each quarter/semester, the scholarship may be terminated without notice.

Letters confirming receipt of the Grace Barnes Memorial Scholarship will be sent to scholarship recipients around August 15.

Medical Center Navicent
Health Auxiliary
Grace Barnes Memorial Scholarship

Section I (Demographics)

Marital Status?


Living |


Living |
Section II (Academics)




Have you taken the college entrance yet?






Section III (Financial)

Are you currently employed?
If yes, what type?
Section IV (References)

Give the names and addresses of three adults, not relatives, who know you and who can give information about you. For example, you may include a recent teacher, counselor or employer. (Separate from your 3 written letter references.)




Section V (Goals)






Scholarship Agreement
Medical Center Navicent Health Auxiliary

STUDENT CERTIFICATION

I declare that the information reported is true, correct and complete.
  1. I HAVE READ THE POLICIES AND PROCEDURES FOR THE MCNH AUXILIARY GRACE BARNES MEMORIAL SCHOLARSHIP.
  2. THE DECISION OF THE SCHOLARSHIP COMMITTEE IS FINAL.
  3. FURTHER PERSONAL AND/OR FINANCIAL INFORMATION WILL BE PROVIDED TO THE COMMITTEE IF REQUESTED.
  4. SCHOLARSHIP FUNDING IS TO DEFRAY COST OF ALL OR PART OF TUITION, BOOKS, MEAL PLAN AND DORMITORY (DOES NOT COVER OFF-CAMPUS HOUSING) AND IS TO BE SENT DIRECTLY TO THE EDUCATION INSTITUTE ON BEHALF OF THE RECIPIENT.
  5. IN THE EVENT STUDENT CEASES COURSE OF STUDY IN RELATED HEALTH FIELD, SCHOLARSHIP FUNDING WILL NO LONGER APPLY.
I have read and clearly understand the above agreement.