2024 Scholarship Application

The Kidney Foundation of Ohio is proud to offer this scholarship opportunity designed to assist a kidney patient, or child of a patient achieve his/her academic goals and complete a college education or technical school. Financial support for recipients will range between $750-$1,500.

QUALIFICATIONS:

-Diagnosed with kidney disease (or be the child of a kidney patient)
-Demonstrate financial need
-Reside in the Foundation’s service area

-Graduate (or have received a GED) from high school by June 9, 2024
-Already accepted into a program or school

REQUIREMENTS:

-Completed electronic application

-Two (2) letters of recommendation (cannot be a relative)

-Official school transcript

RECIPIENT GUIDELINES:

-Scholarship will be made directly to the educational institution after certification of enrollment is received by Kidney Foundation of Ohio
-The educational institution must be accredited by a certified scholastic organization. Graduate or Doctoral candidates will not be considered.

-This scholarship is renewable for a maximum of four years if the recipient maintains a minimum C average, based on the institution’s standards, and completes the renewal form.

Application must be received by Friday, May 10, 2024 to be considered for this award cycle. To be considered for this scholarship, all application guidelines must be met in full. The selected recipient(s) will be notified in June 2024. Contact scholarship@kfohio.org with any questions.

Note: All recipients will be asked to allow the Kidney Foundation of Ohio to mention their name, institution, and testimonial along with photos in communications surrounding the awards, including on the Foundation’s website.

Save & Return

Create an account to be able to save progress & return to application at another time.

Applicant Information

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Date of Birth * +

Check all that apply: *

Hemodialysis or peritoneal dialysis patient

Kidney transplant recipient

On transplant wait list

Parent/guardian is on dialysis or has received a transplant

Other (explain below) Other (explain below)

If parent/guardian is on dialysis, or has received a transplant, please select which below. *

Dialysis

Transplant

Other Other

Full name of parent/guardian *

Medical Professional Information

Nephrologist Name *

Social Worker Name *

Dialysis or Transplant Institute Name *

Dialysis Unit or Transplant Hospital Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Educational Information

I am: *

Entering an accredited college, university, or technical school in Fall 2024

Currently attending an accredited college, university, or technical school

How many years do you have left until graduation? *

Name of accredited college, university, or technical school you attend or will be attending: *

Have you been accepted? *

Yes

No

Educational Institution Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Website *

Residential status for upcoming school year: *

On Campus Housing

Living with parent/guardian

Off Campus Housing

Other (explain below) Other (explain below)

Costs *

	Annual Costs
Tuition	Annual Costs
Room and Board (if applicable)	Annual Costs
Books/Supplies	Annual Costs

Academic Status *

Full-time

Part-time

Expected Outcome *

License

Associates Degree

Bachelors Degree

What do you plan to obtain your degree or license in? *

Financial Information

Are you currently employed? *

Yes

No

In what capacity? *

Full-time

Part-time

Employer *

Title/Position *

Employer Phone Number *

Do you plan to work while attending school? *

Yes

No

Yearly Gross Income of Applicant *

Yearly Gross Income of Total Household *

List income source(s) and amount(s) *

Number of household members *

Additional Information

Have you applied for other scholarship(s)? If yes, include name(s) and amount(s), and status of each request.

+-

Will you be using student loans to pay for college? If yes, what type(s) and amount(s).

How are you paying for educational expenses (i.e. parents are contributing, loans, scholarship, etc)? *

Essay Questions

Briefly tell us about your illness, or parent (or legal guardian) with illness, and how kidney disease has impacted your life/goals. *

Why should you be considered for this scholarship; what sets you apart from other applicants? *

How will this scholarship affect your educational path? *

Do you, or do you plan to contribute to the renal or transplant communities? If so, explain.

Provide any additional information about yourself that you feel is important for this application.

Please upload your official school transcript *

Please upload Letter of Recommendation #1 *

Please upload Letter of Recommendation #2 *

I guarantee the accuracy and truth of this application, to the best of my knowledge, and agree that the information in this application may be verified.

Applicant Signature *

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