Healthcare Scholarships Application Form

Nora Messinger, Committee Chair
Registered Nurse and Nurse Practitioner

INFORMATION AND APPLICATION

Gualala Rotary awards health care scholarships for current healthcare workers in the local community who want to continue their education. Our current committee chair is Nora Messinger.

In 2022, scholarships were awarded to Samantha Allen, Celeste Carbajal, Micheline While, Sheila Ruiz-Higuera, Lesbeth Santana, and Phil Kaufman.

Applications are accepted throughout the year. To apply, fill out the form below. NOTE: this form is NOT interactive due to Web site security.

  1. Copy and paste the fields into a text editor, such as Micorosoft Word or Google Docs.
  2. Fill out each field. You may write as much as you like.
  3. Save your file.
  4. Send your file as an email attachment to Nora Messinger at themessingers93@gmail.com
  5. Or, you may fill out the form by hand,or by typewriter, and mail it to Gualala Rotary Club, attn: Nora Messinger, P.O. Box 1166, Gualala CA 95445

APPLICATION FORM FOR ROTARY HEALTH CARE SCHOLARSHIP
Date:
Name:
Email:
Phone:
Address:
City:
Current Occupation:
Current Employer:
Length of time with this employer:
Current Certification:
Experience in Health Care:
What program are you applying for:
Expected costs:
1. Tuition and fees
2. Room and Board
3. Books and supplies
4. Other (specify)
What is your commitment to remain in our local community?
Where do you see yourself in 5 years?