GAPA Student Scholarship Application

GAPA’s Student Affairs Committee will award two $1,500 scholarships annually.

Qualifications:
1.Currently an ACTIVE member of Georgia Association of Physician Assistants (GAPA)

2.PA student of an ARC-PA Accredited Program in Georgia
3.Successfully completed 2 semesters of the didactic year of your PA program by May 31st
4.GPA of at least 3.2
5.Must be able to submit PA program transcripts

Scholarship entries are accepted between April 15th and June 15th.

Please apply using this online application.

Awards will be announced before the challenge bowl at the Annual GAPA Conference.

Application Year *

Part 1: Personal Information

First Name *

Middle Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

PA Program Attending *

Graduation Date *

Part 2: Program Director Reference

I hereby certify that the above applicant is enrolled in our program as stated in this application, is in good academic standing and has a passing academic record.

PA Program Director Name *

Date * +

Part 3: Academic History

Please list all colleges and universities you have attended, starting with most recent. Note degree achieved if any. Include one copy of a cumulative grade report from the PA Program, and signed by your Program Director.

College/University #1: Years Attended *

School Name *

City, State *

Degree *

Please upload Cumulative Grade Report, signed by Program Director *

College/University #2: Years Attended *

School Name *

City, State *

Degree *

Other Colleges or Universities (optional)

Part 4: Employment History

Please list your employment experiences, noting the years you held each position and its location.

Check here if you have never been employed.

Occupation #1 (most recent)

Years Held

Location

Occupation #2

Years Held

Location

Occupation #3

Years Held

Location

Additional Employment History (optional)

Part 5: Informational Questions

How do you plan to impact the PA profession after graduation? *

Describe extra-curricular activities. *

Letter of Reference #1 *

Letter of Reference #2 *

Authorization

I attest that the contents of this scholarship application are true and accurate. I agree that if selected my photograph and correspondence may be published in future GAPA publications. I understand that the judging of the appointed scholarship committee is final.

Legal Name *

Date * +