Pharmacy Student Scholarship Application Please read the general information and instructions for this scholarship before completing this form. Name* First Last Email* Address While At School* Street Address City State / Province / Region ZIP / Postal Code Phone*Student ID Number* Birthdate & Birthplace* Name of College Enrolled* Current Class Standing* P1 Year P2 Year P3 Year P4 Year Cumulative Grade Point Average (GPA)* Undergraduate GPA* Graduate GPA, if applicable How long have you been an Alaska resident?* Name and Address of High School Attended*Parent's Name, Address and Phone Number*Other Awards or Honors ReceivedUpload Your School Transcript Here*Max. file size: 256 MB.Upload Your First Letter of Recommendation HereMax. file size: 256 MB.Your reference can email his/her letter to akphrmcy@alaska.net instead with your name in the Topic Line. Letters must be received before November 30th. AKPhA is not responsible for non-receipt of emailed letters. Upload Your Second Letter of Recommendation HereMax. file size: 256 MB.Your reference can email his/her letter to akphrmcy@alaska.net instead with your name in the Topic Line. Letters must be received before November 30th. AKPhA is not responsible for non-receipt of emailed letters. Upload Your Personal Statement Here*Max. file size: 256 MB.One to two pages addressing: 1. Alaskan Background 2. Financial need for this scholarship 3. Current Higher Education Status 4. Career Goals 5. How you plan to help AKPhA in helping othersCertification* I agreeAll of the information provided is complete and accurate to the best of my knowledge. I hereby give AKPhA permission to share this information for the purpose of recruitment, public relations and possible employment. I further certifiy that I am currently enrolled as a fulltime student and will use the AKPhA award toward the expenses related to my college attendance. I hereby acknowledge that it is my responsibility to keep AKPhA informed of any address change. Furthermore, I am aware that any scholarship check I may receive will be issued to the financial aid office of my college of pharmacy on my behalf. Falsification of information may result in termination of any scholarship granted and render me disqualified for further consideration of this scholarship. All application material becomes the property of AKPhA. Δ
