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Scholarships - Massachusetts Society for Respiratory Care

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					Dear Respiratory Therapy Student, The Massachusetts Society for Respiratory Care (MSRC) is pleased to offer scholarships to support your education. Our awards are based on academic achievement, community service, and your potential for success. All applicants must be Massachusetts members of the American Association for Respiratory Care (AARC). Scholarships offered: 2 (two) $600.00 Scholarship to two qualified applicants from each Massachusetts Associate Degree Program in Respiratory Care: Berkshire Community College Bunker Hill Community College Massasoit Community College North Shore Community College Northern Essex Community College Quinsigamond Community College Springfield Tech- Community College

1 (one) $1500.00 Scholarship to one applicant from a Masters of Science in Respiratory Care Leadership: Northeastern University Procedure: All applications must be include the following items: Incomplete applications will not be accepted for consideration.
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Completed scholarship application (typed or in Word preferred) Program Director Evaluation Unofficial transcript Proof of AARC Membership

Applications may be found for download on our website at www.msrcol.org, under Scholarships.

Mail completed application to: Denise Aveni, RRT 59 Sevoian Drive Methuen,MA 01844 Cell phone: (978) 807-3959 Email: avenid@comcast.net

Applications must be postmarked by May 31, 2009
Scholarship recipients and all other applicants will be notified by July 15, 2009. Scholarship awards will be presented at the MSRC 32nd Annual Meeting, September 30, 2009. -1-

MASSACHUSETTS SOCIETY FOR RESPIRATORY CARE (MSRC) SCHOLARSHIP APPLICATION General information To be completed by applicant: Name: ________________________________________________________________________ Mailing Address: _______________________________________________________________ City: _________________________________________________________________________ State: _________ Zip: __________

AARC Member #: _______________________ Home phone with area code: _______________________________________ Work phone with area code: _______________________________________ Email Address: __________________________________________________ School: ________________________________________________________ Program Director: _______________________________________________ Program Director phone #: ________________________________________ Applicant Signature: _____________________________________________ Date: __________________________________________________________

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MASSACHUSETTS SOCIETY FOR RESPIRATORY CARE (MSRC) SCHOLARSHIP APPLICATION Student Questionnaire To be completed by applicant: Name: __________________________________________________ Date: _______________ (Add additional sheet if needed.) 1. Why did you choose respiratory care as your profession?

2. What are your short and long term goals in respiratory care?

3. What is your perception the MSRC/AARC?

4. To what professional organizations do you belong?

5. Please list community service volunteer activities.

6. Please list class officer positions and any honors earned.

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MASSACHUSETTS SOCIETY FOR RESPIRATORY CARE (MSRC) SCHOLARSHIP APPLICATION Academic Achievement To be completed by applicant and verified by Program Director: Name: __________________________________________________ Date: _______________ Please include all completed respiratory therapy courses, and any required science or math courses. Add an additional sheet if necessary. An unofficial transcript may be submitted if desired. Course Name School Date Units Completed Grade

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ GPA (Respiratory Care and other RC required courses only): __________ ______________________________________________________________________________ Program Director Signature (verification of accuracy) Date -4-

MASSACHUSETTS SOCIETY FOR RESPIRATORY CARE (MSRC) SCHOLARSHIP APPLICATION Program Director Evaluation To be completed by the Program Director: Name of applicant: ______________________________________________________________ School: _______________________________________________________________________ Please complete the following questionnaire regarding this student. 5 = Outstanding 4 = Very good 3 = Average 2 =Fair 1 = Poor _________ Motivation for health science career: genuineness and depth of commitment. _________ Maturity: personal development, ability to cope with life situations. _________ Interpersonal relations: ability to get along with others, rapport, cooperation, attitude toward supervision. _________ Empathy: sensitivity to the needs of others, consideration, etc. _________ Judgment: ability to analyze a problem, common sense, decisiveness. _________ Resourcefulness: Originality, skillful management of available resources. _________ Reliability: dependability, sense of responsibility, promptness, conscientiousness. _________ Communication skills: clarity of expression, articulation. _________ Perseverance: stamina, endurance. Please add any information pertinent to the student’s eligibility for this Award: (Add additional sheet if needed) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I have checked this application for completeness and accuracy. Program Director name (printed): ________________________________________________ Program Director Signature: _______________________________________ Date: ________ -5-


				
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