Get NHSC Verification Regarding Disadvantaged Background 2014-2024

Students from a disadvantaged background have either participated in or would have been eligible to participate in Federal Programs such as the Scholarships for Disadvantaged Students Loans to Disadvantaged Students or the Nursing Workforce Diversity Grant Program/ CRITERIA FOR DISADVANTAGED BACKGROUND STATUS 1. National Health Service Corps Scholarship Program U.S. Department of Health and Human Services Health Resources and Services Administration VERIFICATION REGARDING DISADVANTAGED BACKGROUND For School Use Only Must be Completed by Financial Aid Official Name of Student Last 4 digits SSN XXX-XX- The Financial Aid Official identified below certifies that the above-named student is is NOT from a disadvantaged background criteria described below. Come from an environment that has inhibited them from obtaining the knowledge skills and abilities required to enroll in and graduate from a health professions or nursing school Environmentally Disadvantaged. The following are provided as examples of Environmentally Disadvantaged for guidance only and are not intended to be all-inclusive. Examples Person from high school with low average SAT/ACT scores or below the average State test results. Person from a school district where 50 percent or less of graduates go to college. Person who has a diagnosed physical or mental impairment that substantially limits participation in educational experiences. Person for whom English is not his or her primary language and for whom language is still a barrier to academic performance. Person who is first generation to attend college. OR 2. Come from a family with an annual income below a level based on low-income thresholds established by the U*S* Census Bureau adjusted annually for changes in the Consumer Price Index Economically Disadvantaged. The Secretary defines a low income family for various health professions and nursing programs included in Titles III VII and VIII of the Public Health Service ct as having an annual income that does not exceed 200 percent of the Department s poverty guidelines. A family is a group of two or more individuals related by birth marriage or adoption who live together or an individual who is not living with any relatives. SUBMITTED BY Signature Date Name Title E-Mail Address Name of School Student may upload signed form to the NHSC Scholar Portal https //programportal*hrsa*gov/ OMB No* 0915-0146 Expiration 04/30/2014. Come from an environment that has inhibited them from obtaining the knowledge skills and abilities required to enroll in and graduate from a health professions or nursing school Environmentally Disadvantaged. The following are provided as examples of Environmentally Disadvantaged for guidance only and are not intended to be all-inclusive. The following are provided as examples of Environmentally Disadvantaged for guidance only and are not intended to be all-inclusive. Examples Person from high school with low average SAT/ACT scores or below the average State test results. .