Choose Ohio First Scholarship Application
For First Time Students Enrolled in one of the following Health Care Programs:

Last Name

First

Address

City 

State Ohio Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Phone Number   (740/389-1212)  

Email address 

Social Security No. (121-12-1212)

Academic Curriculum Select One Associate of Applied Science Health Information Technology Associate of Applied Science Diagnostic Medical Sonography Associate of Technical Study Medical Assistant Technology Associate of Applied Science Medical Laboratory Technology Associate of Applied Science Nursing Technology (RN) Associate of Applied Science Occupational Therapy Assistant Associate of Applied Science Physical Therapist Assistant Associate of Applied Science Radiologic Technology Associate of Applied Science Surgical Technology Medical Billing and Coding Certificate Healthcare Management Certificate Medical Assisting Certificate Nursing Aide Training (STNA) Certificate Phlebotomy/Medical Laboratory Assistant Certificate

Have you attended MTC under another name? No Yes If yes, give that name:   

High School/JVS name:   

GPA (4.0 Scale):   

Choose Ohio First Scholarship Essay

All applicants must submit a 150-500 word essay addressing the question: “What’s next for you and the world of Healthcare?”
Explain the impact you believe the Choose Ohio First Program would have on you during your path to degree completion, and where an earned degree from MTC may take you next. (Limit to no more than 500 words.)

By checking this box, I hereby release my photo and information to be used in any way to promote the college, scholarships and the Marion Technical College Foundation.

I certify that the information which I have provided is correct. Furthermore, I certify that I am not in default on any Title IV loan made for attendance at any institution and do not owe a refund on any Title IV grant received for attendance at any institution. If I am applying for a scholarship, I give my permission for the Financial Aid Office to review my academic record.

Signature:    Date: 00/00/0000

Marion Technical College provides equal opportunities regardless of race, color, national origin, sex, disability, age,  military status, or sexual orientation.