Find A Provider




 

Community & Wellness » Scholarships » Kathleen Canella Family Scholarship Application Kathleen Canella Family Scholarship Application

Kathleen Canella Family Scholarship Application

These scholarships are awarded to students pursuing higher education in a medical field(excluding physicians). The Kathleen Canella Family Scholarship(s) shall be awarded on the basis of financial need and scholastic history.
To be eligible, you must plan to continue your education beyond high school at an accredited community college, technical institute or four year college or university providing medical education. 

The Kathleen Canella Family Scholarship will be awarded to students graduating from Holy Trinity Catholic High School and Fort Madison Community High School.

APPLICATION PROCESS:

Please complete the following application form. Your application is not complete until we receive:

Kathleen Canella Family Scholarship
Fort Madison Community Hospital Foundation
5445 Avenue O, PO Box 174
Fort Madison, IA 52627

Print a paper copy of this application.

Required fields are marked with a

Today's Date
Name
Street Address
City
State
Zip Code
Email Address
High School Attended
Year of High School Graduation
College, University or Technical Institute you plan to attend
Year you plan to attend college
Semester you will begin
In the following box, please write a letter stating why you believe you should be a recipient of this scholarship including how you meet the criteria, your career objectives, and how you hope to obtain them.

Characters Remaining.

By submitting this application, I hereby apply for the Kathleen Canella Family Scholarship to be awarded at an awards ceremony in May.
I accept I do not Accept
If I am awarded a scholarship, I authorize Fort Madison Community Hospital to use my name in any press release or publication related to the Kathleen Canella Family Scholarship Award.
I Accept I do not Accept
I would like attach additional criteria requested to my online application. I understand I can only upload one document.
If you would like to submit more than one file one, please email additional files to Carrie Green at cgreen@fmchosp.com with "Your Name-Scholarship" in the subject of the email.
SPAM Validation
Question: Which is an ocean?
Answers: Pacific, fork, spoon or knife..

Answer:

Patient Stories

This was my first hospital stay in 40/50 yrs. except for some outpatient exams/treatments, so there are no co...

View All Stories >>