E. Anne Spitzer, MD Memorial Scholarship Application

Instructions:

Complete the Application Form as completely and neatly as possible. Do not leave blank spaces.
Contact the references you have listed on the application and provide them with the online reference questionnaires.
Obtain copies of most recent high school and college official transcripts and attach to the completed application along with notification of acceptance to an accredited program. Repeat applicants don't need to resubmit high school/college transcripts that haven't changed since the previous year, i.e. you are no longer an active student at that school. Current transcripts are still required for submission with annual application submission.
Sign and date the application.
Completed application prior to the filing deadline as outlined in the program guidelines. Incomplete applications (i.e. missing references, transcripts,etc.) as of the filing deadline will not be considered.

E. Anne Spitzer, MD Memorial Scholarship Program Guidelines

We appreciate your interest in the Scholarship Program sponsored by the CalvertHealth Foundation. These guidelines are presented to answer questions you may have concerning the awards.

Who is eligible to apply?
This scholarship is open to students who graduated from a Calvert County High School and are pursuing a doctorate in medicine. Students must be admitted to an accredited medical school at the time of application with a minimum GPA of 2.5. Qualified applicants are selected without regard to race, creed, color, religion or gender.

Does financial need affect eligibility?
No; financial need does not affect eligibility. While financial need as determined by the number of other scholarships, grants and resources an individual has earned is reviewed by the committee and may affect the amount of assistance granted, it is not the sole or overriding determinant. CalvertHealth is interested in selecting the best possible candidates for the awards.

What specifies the award?

These awards are pre-determined scholarships.
While there is no pay back attached to this scholarship, either in cash or hours worked, awardees must apply for employment at CalvertHealth following graduation. See letter of intent for more information.

How and when to apply?

Fill out the accompanying application which includes three (3) reference questionnaires. References can also be emailed to foundation@calverthealthmed.org or submitted on the website at calverthealthfoundation.org/scholarship-reference.
Application should be submitted or postmarked on or before April 30. Monies will be awarded beginning in July.

Is re-application necessary for continual financial assistance?
Yes, interested students need to reapply each year by the deadline for continuation of the scholarship for the next school year.

Return complete applications including the application, essay, transcripts, acceptance letter and all references. If you have any further questions concerning the program, contact the CalvertHealth Foundation at foundation@calverthealthmed.org.

Application for the E. Anne Spitzer, MD Memorial Scholarship - Online Form

Name (First / Middle Initial / Last) *

Phone *

Email Address *

Home Address *

Date of Birth *

Name of High School and Graduation Date *

Name of Accredited Medical School to which you were accepted *

Total Tuition Costs per Semester *

Anticipated Medical School Completion Date *

Anticipated Internship Completion Date (if available)

List community activities in which you participate (e.g. civic organizations, volunteer experience) *

List high schools and colleges with the last four years (please submit your transcripts with your application)

School #1 - Name

School #1 - City, State

School #1 - Dates Attended

School #1 - Diploma Date

— Click to Add More Schools —

School for which assistance is requested *

Indicate the curriculum in which you have been accepted (ex: Nursing) *

Has your admission been approved by the university (Please attach your letter of acceptance) *

Yes

When will you graduate? (Month / Year) *

Anticipated expenses per semester:

Tuition *

Books *

Total per semester *

List all scholarships, loans and grants previously awarded to you, currently pending, or applied for:

#1 - Name of Scholarship and Sponsor

#1 - Year & Duration

#1 - Amount Awarded

#1 - Previous Award

#1 - Current Year

#1 - Applied For

— Click to Add More Scholarships, Loans and Grants —

List three (3) most recent employers:

Employer #1 (Dates / Employer and Address / Position / Reason for leaving)

Employer #2 (Dates / Employer and Address / Position / Reason for leaving)

Employer #3 (Dates / Employer and Address / Position / Reason for leaving)

Please disclose any relationship you may have with any of the following: Any officer or director or employee of the Foundation, Calvert Health System, Inc. or CalvertHealth Medical Center, any member of the Calvert County Medical Society or any substantial contributor to any of the above referenced entities.

In a short essay of 500 words or less, please explain why you have chosen a medical career as your career pursuit. 5000 character limit

List three (3) references that will provide comments concerning your abilities. One must be a previous or current instructor, and, if employed, your present employer. The remaining may be acquaintances other than parents and relatives.

Reference #1 (Name / Address / Phone / Occupation) *

Reference #2 (Name / Address / Phone / Occupation) *

Reference #3 (Name / Address / Phone / Occupation) *

Please stress to your chosen references to return their questionnaires by the application postmark deadline of April 30.

I certify the information above to be correct to the best of my knowledge.

Signature (Type Out Name) *

Date (Month / Day / Year) *

I voluntarily give CalvertHealth permission to make a thorough investigation of my educational background and past employments and all other facts within my scholarship application and release from liability or responsibility all persons, places of business and municipalities supplying such information.

Signature (Type Out Name) *

Date (Month / Day / Year) *

CalvertHealth E. Anne Spitzer, MD Memorial Scholarship Terms and Conditions

I affirm and certify that all the information and answers to questions herein are complete, true and correct to the best of my knowledge and belief. I understand that any misrepresentation, falsification, or omission of any facts called for in the application may render this application void and will be cause for being disqualified from the CalvertHealth E. Anne Spitzer, MD Memorial Scholarship program.
The program is intended to be beneficial to both the candidate and Calvert Health System. The CalvertHealth Foundation agrees to fund a portion of the candidate’s education upon meeting scholarship criteria and in return the successful applicant agrees to apply for employment with Calvert Health System.

Applying for a position does not imply guaranteed employment nor does the applicant have to accept employment if offered. The intent of the program is to select qualified candidates and he/she be considered with all other applicants. If the candidate is chosen and hired, he or she will receive wages equivalent to those received by other associates with the same job, title, and experience.

Signature (Type Out Name) *

Date (Month / Day / Year) *

Attach Your File(s)

— Click to Add More Attachments —

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