Scholarship Application for Behavioral Heath Paraprofessional Certificate

Student Information

First Name

Last Name

Birthdate

Email Address

Cell Phone Number

Mailing Address

Country

Street

City

Region

Postal Code

Application Essay

Please provide a detailed self-description, including your background, experiences, and reasons for pursuing a behavioral health paraprofessional certificate. Describe your commitment to the field and how this scholarship will help you achieve your career goals. (Maximum 1 page)

Proof of Ohio Residency

Please attach the following documents to verify your Ohio residency:

A copy of your Ohio driver's license.

A recent utility bill with your name and Ohio address.

Agreement

By checking this box, I hereby certify that the information provided in this application is true and accurate to the best of my knowledge. Additionally, I understand that if I am chosen for scholarship funds, I must sign a participation agreement stating my intention to complete a one-year internship with a qualifying CBHC for one year.