Christopher Meadows Paramedic Scholarship

Deadline: November 15, 2025

"*" indicates required fields

Personal Information

Name*

First Last

Date of Birth*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Education

High School Graduate?*

Yes

High School Name

High School Address

Street Address Address Line 2 City State ZIP Code

High School Graduation Date

College Graduate?*

Yes

College Name

College Degree/Major

College Address

Street Address Address Line 2 City State ZIP Code

College Date From:

College Date To:

Recent EMS Experience

Employer

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Position

Employed from:

To:

Recent EMS Experience (2)

Employer

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Position

Employed from:

To:

Other Work Experience

Employer

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Position

Employed from:

To:

Community Involvement

Organization Name

Organizations Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Position

From:

To:

Duties

Organization Name

Organizations Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Position

From:

To:

Duties

At which school are you currently enrolled in a paramedic program:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Course Instructor

Proof of Enrollment

Max. file size: 60 MB.

What is the expected cost of your program (tuition, books, supplies, uniform, internships, etc)?*

What other sources of financial aid have you secured?*

What is the dollar amount of that financial aid?*

Professional Reference & Letter of Recommendation

Name*

First Last

Relationship to you*

Letter of recommendation (attach file)*

Max. file size: 60 MB.

Essay (500 words) answering the question “Why do you want to be a paramedic and why do you feel you should you be awarded the Christopher Meadows Memorial Paramedic Scholarship?” and reflecting on the background about Christopher Meadows found in the application guidelines.

(or attach file below)

Attach essay file

Max. file size: 60 MB.

Special Considerations or Hardships you would like the interview committee to consider

Declaration: I certify that the information in this application is correct and accurate to the best of my ability.*

Certify

Signature*

Date*

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