Get Scholarship Award Program Application - Health And Welfare

Completing the Scholarship Award Program Application - Health And Welfare is a straightforward process designed to facilitate reimbursement requests for EMS volunteer testing fees. This guide will walk you through each step needed to successfully fill out the form online.

Follow the steps to complete your application effectively.

1. Press the ‘Get Form’ button to access the application form and open it in your chosen document editor.
2. Begin by filling in your candidate name in the designated field provided at the top of the form.
3. Next, indicate the date of your computer-based test in the appropriate date field.
4. In the mailing address section, provide your complete mailing address, ensuring accuracy for correspondence purposes.
5. Specify the name of your agency affiliation in the provided field.
6. Moving to the reimbursement request section, indicate the level for which you are requesting reimbursement, along with the corresponding testing fee and CHC request as listed in the table.
7. Calculate the total reimbursement amount requested and fill it in the designated space.
8. Obtain the necessary signatures; ensure the signature of the agency chief, director, or president requesting reimbursement is included.
9. Fill in the name and title of the signatory along with the agency name and address in the required fields.
10. Record the date of completion in the date section provided.
11. Once all fields are completed, save your changes. You may also download, print, or share the form as required before submitting.

Start your application process online by completing the Scholarship Award Program Application - Health And Welfare.