AMMP_ Association of Multicultural Members of Partners

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					                             Association of Multicultural Members of Partners
                                       2011 Scholarship Application
The Association of Multicultural Members of Partners (AMMP) is a volunteer organization open to all Partners
employees who are committed to the recruitment, retention, development, and advancement of multicultural
professionals into leadership roles throughout the Partners organization. In the early 1990s, the MGH Minority
Recruitment and Retention Committee issued a report analyzing the hospital’s employment statistics and efforts
to diversify the staff and institutional environment. At that time, the Committee recommended creating a task
force to focus on these issues and cultivate the talents of qualified diverse employees already in the Partners
organization. This task force evolved into AMMP, which continues to play an important role in Partners, and
strives to promote the participation and advancement of diverse employees in all levels and areas of the


The Association of Multicultural Members of Partners is committed to the advancement, recruitment, retention
and development of minority professionals into leadership roles at all levels and areas of the organization.
Proactive hiring, promoting, and retention of a diverse work force will enable Partners HealthCare System to
meet the emerging needs of an increasingly diverse patient population. Such a commitment will help to enhance
our strategic goals and to position Partners HealthCare System as a global leader in the health care industry.

AMMP seeks to achieve its mission in many ways, including sponsoring job fairs and educational seminars for
professional growth and networking opportunities, and by developing mentoring programs. In addition, each
year AMMP offers educational scholarships to assist qualified individuals in obtaining the skills and training to
advance into leadership positions within Partners. We hope that AMMP scholarships will expand access to
opportunities for underrepresented minorities at Partners.

To expand access to career opportunities at Partners by assisting employees in obtaining Associate’s, Bachelor’s,
Master’s or post-graduate degree, professional certificate, or prerequisites for professional degree.

1. The applicant must be committed to the AMMP philosophy and mission.

2. The applicant must be accepted into an approved program for either semester for which he/she has applied.
   He or she may be enrolled either as a part-time or full-time student working towards an
   Associate’s/certificate program, Bachelor’s or Graduate (Master’s) degree. The applicant may also be
   enrolled in pre-requisite courses in order to pursue a degree or certificate program.

2011 AMMP Scholarship Application                                                                                   1
   3. The applicant must be an MGH or Partners employee working at MGH in good standing and continuously
      employed by the organization for at least one year.

   Important Information:

      1. Although we encourage everyone to apply for the AMMP scholarship, please note AMMP members will
         be given priority in the selection process.
      2. During the selection process, scholarship applicants may be asked to interview with a member of the
         scholarship committee.
      3. AMMP scholarship recipients are required to participate in an AMMP sponsored volunteer activity. The
         extent of participation and time commitment are flexible and dependent on the individual’s availability.
      4. In order to fulfill this commitment, the award recipient must complete the volunteer activity within 1 year
         of receiving the scholarship award.

                  The list below is a sample of volunteer opportunities to select from for 2011-2012

   Scholarships Volunteer Opportunities                Suggested Time                   Contact Person
                                                         Allotment                     for the Program
AMMP Volunteer – greeter AMMP event                        1 hour                     Waveney Small Cole
Greater for MLK on Main Campus                            January           

AMMP Volunteer – greeter AMMP event                         1 hour                    Waveney Small Cole
Greater for MLK event off Campus                            January         

The Science Fair Mentoring Program matches         October to February from
middle school students with MGH staff who          8:30 -10:30 alternating                (617) 643-6291
                                                   Friday mornings at the       Email:
guide students in using the scientific method to
                                                   MGH or CNY,                            Joan McCarthy
prepare projects for the Timilty Middle                                                  (617) 724 - 3210.
School’s annual science fair.
AMMP Scholarship committee member                          4-6 hours                  Waveney Small Cole
Boston School – The MGH Youth Program                       2 hours                      Please contact
Volunteering opportunities to work with            (every other Friday early            Joan McCarthy
students from grade 3 through 12 Science                Oct to late Jan)              Rantimi Oluwasegun
Mentoring. Early October to late January                                
(option to co-mentor).                                                                   617-643-6291
Boston School – The MGH Youth Program                                                    Please contact
Science Mentoring Program, Timilty Science             8:30-11:30 am                    Joan McCarthy
Fair First week in February (option to choose          Monday –Friday                 Rantimi Oluwasegun
from one or more days).                                                 
Volunteer opportunity at MGH                               1-2 hours            Will need contact information for
Individual will need to submit a plan of the                                      whom or where you will be
volunteer activity                                                                        volunteering
Volunteer opportunity in your community.                   1-2 hours             Will need proof of completion
Individual will need to submit a plan of the                                     from your community leader
volunteer activity

   2011 AMMP Scholarship Application                                                                                2
Application Filing:
Scholarship applications must be submitted by June 10th to be considered for the 2011 Fall Semester and the
2012 Spring Semester. Applications will NOT be accepted after June 10th. Incomplete applications will be NOT
be processed and will be returned to you via house mail or can be picked up if requested.

Scholarships will be given to qualifying awardees

Scholarship winners:
Scholarship Recipients will be announced July 22, 2011 and will be honored at a ceremony on September 8,

Scholarship Funds:
Scholarship awards will be made payable on behalf of the winner to the institution that the recipient plans to
attend. (At this time you will be asked to provide contact information for your institution). Funds will be made
available no later than September, 2011.

2011 AMMP Scholarship Application                                                                                  3
                               Association of Multicultural Members of Partners
                                         2011 Scholarship Application
I.      Demographic Information:
Please complete all sections of this application in order to be considered for an AMMP scholarship. Any
incomplete sections will disqualify you from consideration. PLEASE PRINT OR TYPE.

1. Name _________________________________________________________________________
            Last                                                 First                                   M.I.

2. Home Address __________________________________________________________________
                      Street                              City/Town                      State   Zip

3. Mailing Address _________________________________________________________________
   (if different)  Street                    City/Town               State Zip

4. Home Tel. # ___________________                 Work Tel. # ___________________________________

5. Employee I.D. # ________________                Name of Partners Institution/Dept.__________________

6. Date of Hire _______________                    Current Position _______________________________

7. Name of Supervisor ___________________                 Supervisor’s Work Tel.# ____________________

8. Supervisor’s Work Address/Dept. ___________________________________________________
                                         Street                          City/Town               State   Zip

9. Self Identification (Optional):  Male           Female

     Black/African American          Asian       Hispanic    Pacific Islander     Native American      Alaskan
     Other __________

10. Are you an AMMP member? ____no                 _____ yes

                   If no, please visit our website for more information on becoming a member

                   If yes, what year did you become a member? ___________

                   In what ways have you been involved in AMMP within the last year?


11. Have you ever been a recipient of an AMMP Scholarship?  No  Yes (if so, year?) _______

12. Proof of good standing: In order to verify that you are an employee in good standing, please have your
    immediate supervisor sign below.

2011 AMMP Scholarship Application                                                                                  4
  _______________________________________                   _____________________
    Supervisor’s Signature                                        Date
    _______________________________________                       _____________________
    Supervisor’s name (printed)                                   MGH phone number

II.      Academic Information:

Name of School ___________________ Address ______________________ Phone #__________________

Expected date of enrollment ___________________ Full-time ______ Part-time _______

Expected date of completion: ________________ Student ID #: ____________________

 Certificate Program  Assoc. Degree  Bachelor’s Degree        Master’s Degree  Ph.D.  Other _______

 Pre-requisites for _____________________

III.   Application Requirements:
4-5 page Essay: New Applicants
2 page Summary: Past Recipients

The Essay/Summary section of this application gives you an opportunity to present yourself to the committee in
a way that grades and tests scores cannot. The committee will use your essay or summary to determine
your ability to organize your thoughts, to present yourself in a clear and concise manner. Please take
into consideration your Essay or Summary will have significant weight during the selection process.

 New Applicants 4-5 page Essay
In your Essay: Tell us about yourself, your educational goals and why you should be selected for an
AMMP Scholarship. Also explain how the achievement of these goals will impact you, your community,
AMMP, and MGH/Partners HealthCare Systems, Inc. Please note: Your essay MUST be four to five
pages in length, double-spaced and typed.

 Past Recipients 2 page Summary
In your summary: Update us on the progress of your education since receiving your last Scholarship
Award. In brief details tell us how it has helped you. Include evidence of your effort such as grades,
feedback from your professor and class participation. Also tell us, going forward what are your
educational goals should you be a recipient of the 2011AMMP Scholarship Award? Please note: Your
summary MUST be two pages in length, double-spaced and typed.

IV.      Requirements Checklist:

To be considered for this scholarship, please submit all required documents.
        Completed application form (signed by you and your supervisor)
        Two letters of recommendation (from supervisor, manager, or community leader)
        Proof of acceptance into a degree or certificate program
        Essay or Summary
2011 AMMP Scholarship Application                                                                            5
          Proof of course/tuition cost

If you have questions about the application process, please contact us at

FORWARD your completed applications to:
    AMMP Scholarship Committee
    Founders House, 3rd Floor, Room 316
    Boston, MA 02114
                      Applications sent electronically cannot be processed.

My signature below indicates that the information contained in this application is truthful and accurate.

_______________________________________                        __________________________
Applicant’s Signature                                          Date

We request your supervisor’s signature demonstrating that he/she approves and endorses your application.

_______________________________________                        _____________________
Supervisor’s Signature                                         Date

                            Be sure to keep a copy of your application for your records.

2011 AMMP Scholarship Application                                                                           6

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