Elizabeth City State University Wachovia Pre Pharmacy Student Recruitment Scholarship Application Instructions 1. The DEADLINE for scholarship applications is April 15. Award recipients will be notified no later than June 1. 2. Refer to criteria below for eligibility requirements. 3. Refer to application process below for a list of the supporting documents needed (i.e., references, high school transcripts, etc.) Incomplete applications will not be considered. 4. Type or print legibly. Illegible applications will not be considered for review. Purpose: Elizabeth City State University supports the recruitment and training of future pharmacists from ECSU s 21 county service area. Therefore, scholarships are being made available to two deserving Elizabeth City State University freshmen who wish to pursue future admittance to the UNC Chapel Hill/Elizabeth City State University Doctor of Pharmacy Partnership Program. Our goal is to promote the profession of pharmacy in underserved areas such as the 21 counties surrounding ECSU. The 21 county service area includes the following counties: Beaufort, Bertie, Camden, Chowan, Currituck, Dare, Edgecombe, Franklin, Gates, Halifax, Hertford, Hyde, Martin, Nash, Northampton, Pasquotank, Perquimans, Tyrrell, Vance, Warren, and Washington Award Components: Up to three (3) $1,250/semester scholarships will be awarded to incoming Elizabeth City State University freshmen. These scholarships are merit based. Scholarships will auto renew each semester, unless recipient does not fulfill scholarship eligibility requirements (detailed below) or scholarship funds become unavailable. Scholarship recipients may receive this award for up to six semesters of undergraduate studies through Elizabeth City State University. Upon admission into the UNC Chapel Hill/Elizabeth City State University Doctor of Pharmacy Partnership Program, scholarship awards are subject to change. Upon pharmacist licensure, recipients may receive a final award if they initially choose to practice as a pharmacist in one of the 21 counties served by Elizabeth City State University. Criteria: 1. Students must be enrolled full time at Elizabeth City State University to receive the award. Failure to obtain enrollment or failure to continue enrollment will result in revocation of scholarship award. 2. Applicants must have a high school GPA of at least 3.0 to be considered for this scholarship. Scholarship recipients whose ECSU GPA falls below 3.5, may have their scholarship status reviewed by the Scholarship Program Committee. 3. Scholarship recipients will be selected by a scholarship committee using a points based rubric. During application reviews, additional points will be granted to students who graduate from the 21 county area served by Elizabeth City State University. However, students from outside this area are still encouraged to apply. 4. It is preferred that applicants have participated in a Wachovia Pharmacy Fellows Summer Program. However, participation in the Wachovia Pharmacy Fellows Summer Program is not required to apply for the scholarship.
5. Scholarship award recipients will be appointed an advisor to mentor and monitor their prepharmacy coursework progression. This mentorship is designed to help students succeed in gaining admission into the UNC Chapel Hill/Elizabeth City State University Doctor of Pharmacy Partnership Program. Failure to maintain an adequate relationship with the appointed advisor and follow the planned academic coursework may result in review of the student s scholarship status. Application Process: Applicants must submit all of the following items: 1. Completed application form including the personal statement found at the end of the application form. 2. An unofficial high school transcript proving academic eligibility and reporting the applicant's GPA 3. Two letters of recommendation from two highly regarded individuals. Preference will be granted to applicants who submit at least one of the two letters of recommendation from a pharmacist who speaks positively and highly of the applicant. (Letters must accompany the application and be in a sealed and signed envelope.) The DEADLINE for the scholarship application is April 15. Applications that are incomplete or postmarked after this date may not be considered. Please enclose all scholarship application documents in one envelope and mail or submit application to: Jennifer L. Robertson, PharmD Elizabeth City State University 1704 Weeksville Road, Campus Box 973 Elizabeth City, NC 27909 jlrobertson@mail.ecsu.edu
Elizabeth City State University Wachovia Pre Pharmacy Student Recruitment Scholarship Section 1: Personal Information Please Print in blue or black ink or Type Your Answers Last Name First Name Middle Initial Mailing Address City State Zip Code County Home Phone Number ( ) Email Address Work/ Cell Phone Number ( ) Date of Birth (MM/DD/YYYY) Did you participate in the Wachovia Pharmacy Fellows Summer Program Yes No If yes, how many pharmacy intern hours did you complete? Section 2: Education Fill out this section in its entirety and have an unofficial high school transcript submitted along with this application. Name of High School: School State: Zip Code: Graduation Date (may be anticipated graduation date): Current GPA: SAT or ACT Scores: Have you APPLIED to Elizabeth City State University? Yes No Have you been ACCEPTED to Elizabeth City State University for the upcoming semester? Yes No Anticipated Major for Undergraduate Studies:
Section 3: Achievements / Honors Please use the section below to list any notable achievements or honors you have received during your high school career. Be sure to list the most recent achievements/honors first. Award/Honor Date Received Brief Description of Award/Honor Any additional awards/honors that you wish to report may be submitted on another page. Please attach additional page to this form.
Section 4: Extracurricular Activities Please use the section below to list any extracurricular activities that you were involved in while in high school. These extracurricular activities may be affiliated with your high school or community. Be sure to record years of service and positions held in any organization. Name of Organization: Dates of Involvement: Number of Years Involved: Additional Comments: Name of Organization: Dates of Involvement: Number of Years Involved: Additional Comments: Name of Organization: Dates of Involvement: Number of Years Involved: Additional Comments: Any additional information that you wish to report may be submitted on another page. Please attach additional page to this form.
Section 5: Community Service Use the section below to list any community service that you have performed inside and outside of school. List the organization if applicable, as well as dates of service, hours of service performed, and a brief description of the service provided. Section 6: Work Experience Have you ever been EMPLOYED by a pharmacy? Yes No Pharmacy Information (list most recent first) State: Zip Code: State: Zip Code: Position (indicate here if Wachovia Pharmacy Fellows Intern) Dates of Employment State: Zip Code:
Have you ever VOLUNTEERED hours in a pharmacy? Yes No Please list volunteer pharmacy hours below including contact information for your supervising pharmacist. They may be contacted by the Scholarship Committee. Pharmacy Information Contact Person and Information Number of Hours Name: Telephone Number: ( ) Email State: Zip Code: State: Zip Code: Name: Telephone Number: ( ) Email Name: Telephone Number: ( ) Email State: Zip Code: List any additional work experience that you wish to report below. Employer Position Held Dates of Employment
Section 7: Personal Statement/ Essay Why have you chosen to pursue a career in the profession of pharmacy? What goals have you set for yourself once you receive your Doctor of Pharmacy (PharmD) and become a registered pharmacist? Please limit your response to the space provided. Section 8: Letters of Recommendation Please include two sealed letters of recommendation along with this scholarship application. Make sure the letters are from highly respected individuals in their profession. At least one letter should be written by a pharmacist if possible.