Scholarship Application

Applicant Details

To be eligible, please complete all required fields below.

First Name *

Last Name *

Email *

Phone *

Address *

County of Residence *

Applicant must live in a county served by IU Health Bloomington Hospital.

City *

State *

Zip Code *

Educational Status *

I am currently enrolled in an accredited healthcare program

I am a high school senior planning to enroll in an accredited healthcare program

Date of Birth *

Applicant's date of birth.

High School Attended *

High school applicant currently attends.

High School Graduation Date *

Applicant's high school graduation date..

Cumulative Grade Point Average (GPA) *

Enter your cumulative GPA using a 4.0 scale. Use numbers only (e.g., 3.75). If unsure, check with your school counselor.

Class Ranking *

Enter your class rank and size, title, or percentile.

Planned College or Technical School *

Please enter the name of the accredited college, university, or technical school you plan to attend.

Scholarship Repayment Agreement *

By checking this box, I certify that if selected for the Nancy Lumbley Scholarship and do not attend a college, university or technical school for any reason, the money awarded must be returned to The Local Council of Women.

Program Status Agreement *

By checking this box, I certify that I am currently enrolled in an accredited program of study in a healthcare field or a high school senior seeking to enroll in such a program.

Student Documentation *

Maximum file size: 10 MB

Upload your current grades (official transcripts not required). If currently enrolled in a healthcare program, also include acceptance documentation.

Personal Statement *

Please provide a personal statement describing your financial need, work and volunteer experience, goals for the future, and why you chose healthcare as your profession.

Scholarship Application

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