Scholarship ApplicationMdHIMA Scholarship Application Demographic InformationName * Name Name Name Street * Apt/Suite/Office City * State * Zip * Email * Phone * Current Employer Program Information Name of Program * Years Attended * Grade Point Average * Program Director Phone Program Director Email Contributions List here any contributions to the health information profession, honors, awards, recognition, and potential for leadership. * Goals and Interests In 250 words or less, please use the space below to indicate how you got started in the HIM field and what some of your long term goals would be: * If you are human, leave this field blank. SubmitMembersAwardsPhoto GalleryScholarshipsVolunteer
