Online Scholarship Form

I agree to the following
1. I certify that I meet eligibility requirements for the application for a Wagner Scholarship Fund Grant.
2. I understand that the scholarship award is a competitive process, and that awards are made on a best qualified basis.
3. If awarded a grant, I will faithfully pursue degree attainment in Health Administration/ Management or a related field.
4. I understand that in the event I fail to satisfactorily complete degree requirements, maintain good academic standing, or if I withdraw from school, I will be required to return the scholarship funds to the Scholarship Fund within three months.
5. My signature below also authorizes publicity release in event of an award.