The Aroostook County Medical Society Scholarship Fund

The Aroostook County Medical Society (ACMS) disbanded several years ago, and they granted their remaining funds to the Maine Medical Education Trust (MMET) to provide grant support for students from Aroostook County who are enrolled in an accredited medical school. Scholarship up to $1,000 per student per year will be awarded until all funds are expended. Applications are due by May 31.

Applicant Information

Full Name *

SSN #

Mailing Address *

City *

State *

Zip Code *

Legal Residence *

City *

State *

Zip Code *

# Years at Legal Residence *

Phone Number *

Email Address *

Date of Birth *

Place of Birth *

Please explain your connection to Aroostook County (if NOT by birth or current legal address).

Family Information

Parent's Names *

Address(es) *

Parent's Occupations *

Education Information

High School *

Graduation Date *

Pre-medical School *

Graduation Date *

Present Medical School *

When did/will you enter medical school? *

When do you expect to receive your M.D. or D.O. degree? *

Have you attended any other medical schools? *

Yes

If so, when and where?

What specialty, if any, have you selected or do you intend to select?

Please tell us something about yourself. *

Where do you think you might like to practice? *

Are you applying, or have you in the past applied, to the Maine Medical Education Foundation Loan Program (through FAME)? (If no, please submit a letter of recommendation or copy of acceptance to medical school) *

Yes

I have completed this application with accurate and true information. *

Yes

The MMET reserves the right to request additional information, if needed.

Maine Medical Association

The Aroostook County Medical Society Scholarship Fund

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