Fillable Gary Haigh EMS Scholarship Application (Billings Clinic)

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Gary Haigh EMS Scholarship Application (Billings Clinic)

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Gary Haigh
EMS Scholarship Application
The Gary Haigh EMS Scholarship was created in memory of Gary Haigh, an amazing individual who
worked in several departments at Billings Clinic including the Emergency Department, Declare, and
Regional Services. Gary was highly respected in his profession as an EMT, Paramedic, and EMS Trainer. He
became an EMT in 1983 and emergency services quickly became his passion and way of life. He served
the profession in many ways that touched communities across Montana. Unfortunately, Gary passed away
in 1997 from injuries received in a motor vehicle accident while on his way to teach an EMT class.
Through many memorial contributions from EMS providers and friends, Gary's family created the Gary
Haigh EMS Scholarship fund to carry forward Gary's commitment to rural health care.
The purpose of the scholarship is:
• To help an organization maintain or upgrade to a higher EMS System provider level, and/or,
• To help provide EMS continuing education for pre-hospital and/or emergency department personnel
Application Date:
Rural Health Care Organization
Requesting Funds:
Address:
Contact Person:
Title/Position of Contact:
Email address:
Type of Request: Employee/Volunteer Training Continuing Education Program
Total Training Cost:
Amount Requested:
Date Funding Needed by:
Project Description:
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Please submit the application package in one email to the following email address:
spratt@billingsclinic.org
In the email please attach:
• This application (saved with your information).
o To save with your information: Download the PDF application to your computer. Fill
out application. Save a copy to your computer. Attach saved copy with your
information to the email.
• Any additional information or documents
Or
Mail complete application package to:
Billings Clinic Foundation
P.O. Box 31031 Billings, MT 59107
If you have questions, please e-mail: spratt@billingsclinic.org
Action by Scholarship
Committee
Date:
Approved
Funding: $
Not Approved
Action by Foundation
Date:
Approved
Funding: $
Not Approved
President’s Signature:
D
ate:
for Billings Clinic Foundation office use only
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Gary Haigh EMS Scholarship Application (Billings Clinic)

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Completed 31 January 2021

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