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NSHSS Scholarship
Submission Form
First name
*
Last name
*
Email
*
Phone
*
Grade level
*
High School Name
*
Parent Name
*
Parent Email
*
Parent Email
*
Which career are you currently considering? (physician, PA, nursing, APRN, researcher, etc.)
*
Why are you interested in medicine? (200-500 words)
*
Why are you applying for the Docera Medical Intensive Scholarship? (100-200 words)
*
Tell us about a challenge you have overcome or an accomplishment you are proud of. (100-400 words)
*
Can you attend all scheduled live sessions?
*
Yes
No
I have a potential scheduling conflict
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