1
APPLICATION FOR THE ICOM SCHOLARSHIP
The application deadline for the 2018/19 Academic Year is July 13, 2018. Please call 208.282.4787 with questions.
Eligibility:
To be eligible for this scholarship, students must:
Be accepted to and enroll in the Idaho College of Osteopathic Medicine;
Have a GPA of at least 3.5; and
Be Idaho residents.
(Preference will be given to students who hold a degree from Idaho State University).
Personal Information
Name: Idaho Resident?
Address:
City, State Zip:
Phone: Email:
University Address (if different):
City, State Zip:
Phone:
Essay
T
he essay must contain a minimum of 200 words and a maximum of 500 words.
E
ssay: Describe why you chose to be a Doctor of Osteopathic medicine, what you have been doing to prepare, and how
you plan to support the ICOM mission. Include any relevant jobs and volunteer opportunities.
Yes
2
Ce
rtification:
T
o the best of my knowledge, the information I have submitted is true and correct as of the date of this application, and the essay
submitted is my original work. I understand that Idaho State University Foundation may contact Idaho College of Osteopathic
Medicine (ICOM) to obtain my GPA and other pertinent information to determine eligibility for this scholarship. I hereby consent to
disclosure of any such information.
Electronic Signature: Date:
3
S
ubmission:
Y
our completed application must be emailed to the email address listed below.
Applications must be received by 5 pm
on July 13, 2018.
E
mail Address: kortsusa@isu.edu
Awards:
A
pplicants will be notified of results no later than August 27, 2018.
Questions:
I
f you have questions about this application, please direct them to Sue Korte Regetz, Donor Relations Coordinator, ISU
Foundation at 208.282.4787 or kortsusa@isu.edu
.
Q
uestions about the overall scholarship process and/or awards should be directed to Nicole N. McMillin, Director of
Financial Aid, ICOM, nmcmillin@idahocom.org
.
Note: Idaho State University in conjunction with ICOM will only use information obtained through the scholarship application
process to determine eligibility for this scholarship and will not share the information with anyone outside the scholarship process.