Chatman Scholarship Application

FirstName:

Last Name:

Email:

Contact Number:

Current occupation/school:

Area(s) of medical interest:

What underrepresented group do you fall into

African-American/Black

Latino/Hispanic

Alaska natives

Hawaiian/Pacific Islander

Acceptance letter to medical school

First letter of recommendation from college or university professors-to be reviewed by MMC’s Diversity Committee

Second letter of recommendation from college or university professors-to be reviewed by MMC’s Diversity Committee

Completion of a 500 – 1,000 word essay on medical career goals-to be reviewed by MMC’s Diversity Committee

Photo of Applicant

MMC

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1272 Garrison Drive, Murfreesboro TN 37129-2598

Murfreesboro Medical Clinic | 615-893-4480