HOSA Scholarship 2026

DATE*

MonthDayYear
Date
Name*

FIRST NAMELAST NAME
CHAPTER*
CURRENTLY AFFILIATED WITH CHAPTER?*

YESNO
ADVISOR*
Address*

HOME ADDRESS

Street Address Line 2

CITYSTATE

ZIP
EMAIL*
example@example.com
UNWEIGHTED GPA ON A 40 SCALE*
Use for Scholarship*

HOSA International Leadership Conference- June 2026 (funds to be dispersed after registering for Nationals)College scholarship Postsecondary institution (funds to be dispersed to accepting college)
PROFESSIONAL REFERENCES (NO RELATIVES) FULL NAME
Reference #1 Name*

First NameLast Name
RELATIONSHIP TO APPLICANT*
TITLE*
Phone Number*
Please enter a valid phone number.
Letter of Reference*

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Reference #2 Name*

First NameLast Name
RELATIONSHIP TO APPLICANT*
TITLE*
Phone Number*
Please enter a valid phone number.
Letter of Reference #2*

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Reference #3 Name*

First NameLast Name
RELATIONSHIP TO APPLICANT*
TITLE*
PHONE*
Letter of Reference #3*

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Please upload each of the following documents to complete your application.
Current, Official Transcript*

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Personal Statement (350-500 Words)*

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Resume including:
- Leadership roles and offices held
- Awards and honors
- HOSA involvement
- Community service/volunteer activities with a brief description (minimum 1 paragraph each)
Resume*

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I verify that this scholarship application and the attachments included are accurate to the best of my knowledge.
SCHOLARSHIP APPLICANTS SIGNATURE*

Clear
DATE*

MonthDayYear
Date
Should be Empty:

Please upload each of the following documents to complete your application.