RUSHMORE AAHAM SCHOLARSHIP

1. Purpose – To provide educational scholarships to individual AAHAM members, spouse, child or

grandchild.

2. Eligibility – Any person who has been a Rushmore AAHAM member for at least one year and has paid
their current dues by March 31 of the year in which application is made. If a member’s dependent is
applying, the above eligibility criteria apply to the child’s parent or grandparent.

3. Application – Formal application must be received by the Rushmore Chapter of AAHAM by September 1.
Rushmore Chapter of AAHAM c/o Jill Heyden; PO Box 100; Faulkton, SD 57438-0100 or [email protected].
If you are emailing the application, please follow up to confirm receipt.

4. Selection – Applications that meet the established criteria will be considered by a review and selection
committee.

5. Awards – Scholarships will be awarded (as funds permit) in October as follows: (ONE YEAR AWARDS).
A. Rushmore AAHAM member ADVANCEMENT IN HEALTHCARE or Rushmore AAHAM member, spouse,
child or grandchild: $500.00 maximum for no more than 1 awarded annually.
 No member or dependent may receive more than one award.

RUSHMORE AAHAM SCHOLARSHIP AWARD PROTOCOL

1. Awards
2. Funding
3. Protocol
4. Application Forms
5. Transmittal, Confirmation, and Award Letters

AWARDS

The Rushmore AAHAM Scholarship Program provides for one classification of awards. The primary emphasis is
towards a member who makes application and qualifies. Consideration would be given to an application
submitted by a member, spouse, child or grandchild of a member. The classification of awards is as follows:

1. Member, spouse, child, or grandchild

 Member must have been a member of Rushmore AAHAM for at least one year and be a current
member as of March 31st of the application year.
 Must be a member, spouse, child or grandchild of a Rushmore AAHAM for at least one year.
 Maximum Amount of award is $500.00 per year which shall be less than or equal to the cost of
tuition and related expenses.
 No more than one (1) award shall be given per year for this program.

2. No member, spouse, child or grandchild may receive more than one award.

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FUNDING

Current and Future Funding

Funding shall come annually from the scholarship fundraiser (silent – not – so – silent auction). The amount of the
funding is set by the board of directors and can change the amount of the scholarship program; this shall be
reviewed every 2 years.

PROTOCOL

Application requirements and procedure:

A. Member applicant, spouse, child or grandchild applicant.

1) The member must be a current (paid) Rushmore AAHAM member on March 31st of the year in
which application for scholarship is made.
2) The member must have been a (paid) Rushmore AAHAM member for at least one year prior to
the application deadline of May 31st.
3) A completed and typed application form, including all attachments specified in the application,
must be submitted to Rushmore Chapter President by September 1st. Applications, which are
postmarked no later than September 1st, shall be accepted for consideration.
4) The applicant must also submit a written statement (no more than one page) giving evidence of
financial need, including a list of all other sources of financial aid such as scholarships, and a letter
of acceptance from the educational institution or a statement from the registrar indicating
enrollment.
5) An official transcript of grades and credits earned.

Selection:

A. Criteria
1) Preference will be given to applicants enrolled in studies leading to a certificate or degree in
health care or an associated field.
2) Selection will also be based on a review of the application and supporting documents, and the
evidence of financial need.
3) No preference should be accorded an applicant by reason of the applicant employment position,
job title or length of employment.

B. The review and selection committee will review the accepted applications and select the award
recipients. This selection shall take place on or about October 19th.

C. Award recipients will be notified on or about October 20th. Awards will be presented on about
October 20th.

PROFESSIONAL ACTIVITIES AND AWARDS

Please list, on a separate sheet, your professional achievements, honors and activities. Include memberships in
professional organization, offices held, papers published, committee memberships, convention program
participation, etc.

COMMUNITY AND CIVIC ACTIVITIES

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Describe, on a separate sheet, your participation in community and civic affairs. Included membership offices
held, honors, etc.
AIMS AND GOALS

Outline in approximately 500 words, on a separate sheet of paper, why you desire this scholarship. Include a
discussion of your aims and goals relative to your employment in patient account management.

ADDENDUM

Include on a separate sheet any additional comments, which may distinguish your application from those of other
applicants. This is not a required part of the application, but is for your use, if desired, in adding anything you feel
would aid acceptance of your application.

FINANCIAL NEED

Please submit a one-page, double-spaced statement giving evidence of financial need. Demonstration of financial
need may be considered in selecting recipients of the scholarship award. Include a listing of all other sources of
financial aid such as scholarships.

I hereby certify that all answers to these questions and all statements in the application are true. I agree and
understand that any misstatements of material facts contained in this application may cause forfeiture upon my
part of all rights to any scholarship sought hereunder.

I further certify and agree to reimburse Rushmore AAHAM the full amount of the scholarship should I fail to
successfully complete (passing grade) a minimum of six semester hours of academic credits in an accredited
college or university subsequent to receipt of the scholarship and within three years of the date on which I receive
the scholarship.

AAHAM Member Signature_________________________________ Date______________________________

*APPLICATION MUST BE POSTMARKED NO LATER THAN SEPTEMBER 1st.*

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 RUSHMORE AAHAM SCHOLARSHIP APPLICATION
$500.00 AWARD
(Please print or type)

Name of Applicant:_____________________________________________________________________________
Home Address:________________________________________________________________________________
City: _________________________________________ State: __________________ Zip:____________________
Home: ( )_________________________________ Work: ( )_____________________________________
Chapter Affiliation: _____________________________________________________________________________
Continuous Member Since: ________________________ Member Number: ______________________________
What is your occupational title?
___________________________________________________________________
Employer Name: _______________________________________________________________________________
Address: _____________________________________________________________________________________
City: _________________________________________ State: __________________ Zip:____________________
How long have you been employed in your present position?
____________________________________________
How long have you been employed in the health care field?
_____________________________________________
What professional certificates or permanent civil classification do you now hold?

EDUCATIONAL AND PROFESSIONAL TRAINING – List below, in chronological order, the name(s) of the institution(s)
and address(es) for all undergraduate and graduate work. School Dates (years) Degree/Year or Credit Hours
Earned beyond BA/BS, and area of study.

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Name of Applicant:_____________________________________________________________________________
Permanent Address:____________________________________________________________________________
City: _________________________________________ State: __________________ Zip:____________________
Telephone: ( )_____________________________ Birth Date: _____ / _____ / _____
Name of AAHAM Member
Parent/Guardian:_____________________________________________________________________________
Home Address:________________________________________________________________________________
City: _________________________________________ State: __________________ Zip:____________________
Home: ( )_________________________________ Work: ( )_____________________________________
Chapter Affiliation: _____________________________________________________________________________
Relationship to Applicant:__________________________ Member Number: ______________________________
Applicant’s expected year in college during next academic year: (check one)
_____1st (Freshman) _____First year graduate or professional school
_____2nd (Sophomore) (beyond a Bachelor’s degree)
_____3rd (Junior)
_____4th (Senior) _____Continuing graduate or professional education
_____5th (Undergraduate)

Expected college degree or certificate: _____________________________________________________

Expected date of completion: Month: ___________________________ Year: _____________________
For what academic period does the student want financial assistance? (Check all that apply)
_____Full academic year 20____ _____Spring term, Year 20____
_____Fall term, Year 20____ _____Summer term, Year 20____
_____Winter term, Year 20____

PLEASE NOTE:

 An official transcript of grades must accompany this application.

 A letter of acceptance from the school or a statement from the registrar that the applicant is enrolled
must accompany this application.

I hereby certify that all answers to these questions and all statements on this application are true.

I agree and understand that any misstatements of material facts contained in this application may cause forfeiture
upon my part of all rights to any scholarship sought hereunder.

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I further certify and agree that in the event I do not complete my course of study, I will reimburse Rushmore
AAHAM a pro-rated percentage of the scholarship award based on the date of termination from the secondary
educational facility.

Applicant’s Signature __________________________________________ Date ___________________________

AAHAM Member’s Signature ____________________________________ Date ___________________________

*APPLICATION MUST BE POSTMARKED NO LATER THAN SEPTEMBER 1ST . *

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