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NVMA Scholarship Application
This application will be submitted electronically when you complete the application.

Accompanying Letters of Recommendation should be directed to NVMA CENTENNIAL SCHOLARSHIP FOUNDATION, INC., PO Box 637, HASTINGS, NE 68902.

ALL INFORMATION WILL BE HELD IN STRICTEST CONFIDENCE BY THE SCHOLARSHIP COMMITTEE

After you click the "submit" button at the end of the form, you will be able to come back and edit the application if you wish. However, all of the questions marked with red asterisks require an answer before the "submit" button will work. If you wish to save a partially filled-out application to be completed later, enter any character as a "placeholder" response for questions requiring answers (those marked with red asterisks). You may later edit those "placeholder" responses.

When you click "submit," you will receive an email with a copy of your application. Prominent at the top of this emailed form is a button labeled "EDIT RESPONSE." Clicking the "EDIT RESPONSE" button is how you get back to your partially completed application form.

Enter your email address immediately below in order to receive an emailed record copy of your application.

Email address *
A. General Information
Responses to all questions are required. Type N/A in boxes where information is unavailable or if the question does not apply to your situation.
Name *
Your answer
Date of Birth *
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This year I am a *
Home Address, City, State ZIP *
Your answer
Home Phone Number *
Your answer
School Name, Address, City, State ZIP *
Your answer
School Phone Number *
Your answer
Father's Name, Phone Number, Address, City, State ZIP and Occupation *
Your answer
Mother's Name, Phone Number, Address, City, State ZIP and Occupation *
Your answer
Names and Ages of Siblings *
Your answer
Are You a Resident of Nebraska? *
B. Education
High Schools Attended (Include Dates Attended) *
Your answer
Date of High School Graduation *
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Pre-veterinary Education (List Schools Attended and Dates Attended)
Your answer
Total Credit Hours Earned *
Your answer
Cumulative Undergraduate Grade-Point Average (GPA) *
Your answer
Veterinary Education (List Schools Attended and Dates Attended) *
Your answer
Veterinary School GPA *
Your answer
Veterinary School Class Rank *
Your answer
Veterinary School Number in Class *
Your answer
C. Activities
Awards Received (for Pre-veterinary Undergraduate and Veterinary Education) *
Your answer
Leadership Positions (in Undergraduate and Veterinary Education) *
Your answer
Extracurricular Activites (Post High School/College and Civic, Charitable and Volunteer) *
Your answer
D. Employment
Present Employer (if any) -- Please List Address, Name of Supervisor and Length of Employment *
Your answer
Please list 3 places of previous (most recent) veterinary related work with and/or volunteer experiences: (include name & address ofemployer, position and duties) *
Your answer
E. Financial Assistance
Previous Scholarships Awarded (Name, Amount, Year Awarded) *
Your answer
Other Financial Aid Applicant is Currently Receiving *
Your answer
Is Financial Aid Available from Any Other Source (Parents, Employer)? If So, Explain Nature and Extent of Aid *
Your answer
Present Amount Borrowed to Fund College Studies *
Your answer
Earned Income, Last Three Years (Break Out by Year, and Include Income on W2, Other) *
Your answer
F. Personal Statement of Career Goals
It is our aim to get to know you as well as possible through this application. With this in mind, please describe why you feel you should be considered for a NVMA scholarship. Please include what you consider to be your most rewarding accomplishment since high school (excluding admission to veterinary school), and your perception of the role played by leadership and experiential learning in preparing to become a professional. In addition, describe your career goals following graduation and how you see yourself fitting into organized veterinary medicine.
Enter Your Personal Statement Below: *
Your answer
Certification
I certify that the above information is true and accurate to the best of my knowledge.
Entering Your Name Below Signifies Your Signature *
Your answer
Today's Date *
MM
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DD
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YYYY
Submitting Your Application
Once you complete the application and click on the "submit" button, your application information will be digitally transmitted to the Committee. Thank you for applying.
A copy of your responses will be emailed to the address you provided.
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