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Meritus Health
  
  Academic Assistance - Preliminary Application

 

Name
Address
City
State
  Zip
County
Phone
Email
College attending/ applying to
Expected Graduation date
Course of Study
(Identify degree & major concentration)
Current overall G.P.A.
G.P.A. in major
List any associations, awards, honors, activities or other accomplishments which you belong to or have received.  (We do not require the listing of any activities, honors, etc. which may, by the nature or title of the organization, indicate race, religion, color, sex, national origin, age, etc.)

Have you been approved to receive financial aid from any other source?



If yes, from whom?
Are you an employee or a dependent of an employee at Meritus Health and/or its affiliates?

The following must be received by the deadline date to complete this application.

a) Certified copy of high school transcripts or most recent college transcript.

b) Certified copy of SAT and ACT scores if not currently a college student. (You need not submit your SAT/ACT scores if they are already included on transcripts.)

This is a preliminary application only.  Additional information may be required at a later date.

 

By clicking here, you hereby affirm that the above information is complete and accurate to the best of your knowledge.

 

© 2011
Meritus Health
11116 Medical Campus Road
Hagerstown, MD 21742
301-790-8000

TDD: 1-800-735-2258