Scholarship Application Form

The Academic Scholarship Application must be received at the NHF Colorado office by May 1, 2023–no exceptions. NHF Colorado will accept applications postmarked on the due date. Illegible applications are not acceptable. Applications completed by anyone other than the applicant will not be accepted. Incomplete applications will not be considered. Selected recipients will be contacted after June 30, 2023.

Please be sure to attach all supporting documentation in the area provided below. Incomplete applications will not be considered.
If you are completing the fillable PDF instead, you must send ONE email to info@cohemo.org with the completed application and all of the required documentation outlined below.

Application Checklist

Completed application
Resume/Work history
Letters of recommendation (2) mailed in an enclosed envelope, emailed to info@cohemo.org, or have the recommender use this link.
High school/college/university transcript (can be unofficial transcript)
Copy of acceptance letter from college/university (incoming freshman only)

Applicants Name (Required)

Applicants Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

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Applicants Phone Number (Required)

Applicants Email (Required)

Applicants Date of Birth

Month

Day

Year

The applicant is:

Person with a bleeding disorder/carrier
Family member of someone with a bleeding disorder

Type of Bleeding Disorder (Required)

College, University, or Trade School Name (Required)

Major/Field of Study (Required)

Enrollment Date

Month

Day

Year

Anticipated Graduation Date

Month

Day

Year

Intended Status

Full time student
Part time student

List any extracurricular activities and indicate if they were high school or college activities (Required)

List any special recognition or awards you have received (Required)

List NHF Colorado Chapter experiences (Required)

List other volunteer experience INCLUDING Chapter volunteering if applicable (Required)

Essay Narrative
Please describe your future vision, educational and career goals. Describe the role that the Bleeding Disorder has played in influencing these goals. Indicate how receiving the scholarship will help you to meet these goals. Please limit your narrative to 300 words. The narratives will be evaluated in terms of content as well as grammar and style. Narratives should be in essay form--not an outline or list.

Essay Narrative (Required)

FILE UPLOADS (Required)

Please upload the following: A copy of your resume including employed positions, dates of employment, and duties. Incoming Freshman provide a copy of your acceptance letter to your college/university. Transcripts for the school in which you are currently enrolled (high school seniors entering college should send their high school transcript)

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Letters of Recommendation
Please include at least two letters of support. These letters must be included for your application to be complete and must be in a Sealed Envelope or they can follow the “Academic Scholarship Letter of Recommendation Form” link on the scholarship page and above. Alternatively, the recommender may also email their letter directly to info@cohemo.org. Do not upload letters on this application form. Submitting more than two letters will not affect your chances of being selected. Deadline for receiving this information is May 1, 2022.

One letter must be from a teacher, instructor or professor who taught you in a class and should address your potential to achieve your academic goals.
One letter can be from an employer, church leader, health care provider or other professional person who is involved in your life.

In writing this letter of reference have them include comments reflecting your knowledge and insight pertaining to the following areas: the individual's educational and career goals, how this individual's bleeding disorder
and/family member's bleeding disorder has affected their educational and career goals, how you see this individual utilizing the scholarship, and any other information that you feel would be important for the committee reviewers to know.

Transcripts
Please mail an official or unofficial transcript (“issued to student” transcripts are not acceptable) from the school in which you are currently enrolled sent to NHF Colorado. This transcript must be sent by postal mail to NHF Colorado, uploaded below, or emailed to info@cohemo.org. If you are currently enrolled in school, please have your most recent transcript sent. High school seniors entering college should send their high school transcript.

Declaration of Applicant
I certify that the information I have submitted is true and accurate to the best of my knowledge. Disclosing false information may jeopardize my award at any time. If there is a change in any of the information presented in the application, I will promptly notify the Colorado Chapter of the National Hemophilia Foundation.

I acknowledge and understand that the Scholarship Board may contact selected references applicant provided in the application.

Applicants certify the information provided on the application is correct to the best of their knowledge. Falsification of information will automatically disqualify an applicant from receiving any scholarships.

Students agree that if awarded a scholarship, NHF CO may share their name and scholarship information with the local media, television, radio and/or the NHF CO website.

Signature of Authentication (Type Full Name) (Required)

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