South Dakota Chiropractic Foundation

SOUTH DAKOTA CHIROPRACTIC FOUNDATION

Grant opportunities to South Dakota students currently attending
Accredited Chiropractic Colleges

All applications must be typed.
Applications need to be submitted by April 1st

Applicants must have completed the 1st trimester at school to be eligible and have a GPA of 2.50 or better.

Name
Current Address
Home Address
Current Phone Home Phone

Feel free to use additional space if necessary to complete your application.

Marital Status single or married
Number of Dependents
School Term

If married, does your spouse work or go to school? Please explain.

Do you receive financial support from parents, other scholarships, grants, etc? Please explain.

Schools attended: State dates and degrees from high school to current status.

List three Chiropractic Physicians you are acquainted with. Please list names, addresses and phone numbers: (please no relatives)

Statement of need for this grant.

We wish you luck with school and your venture into the chiropractic profession. If you are a recipient of this grant a check will be sent directly to the school. The money awarded needs to be used for Institutional purposes only. Thank you and good luck. Once you have established yourself as a physician we would ask that you consider donating back to the Foundation in order to provide grants to future students.

School Information:

(Name of Student) is in good standing academically at:
(Name of School)

Address of School
Address of School
Dated:
Signature:
Grade Point Average:

School Seal:

PLEASE MAIL, FAX OR E-MAIL APPLICATION TO:

Michelle Carr 627 W. 7th St Miller, SD 57362 Phone: (605) 853-2675 Fax: (605) 853-3111 Email: carrtc@hur.midco.net