Scholarship Form – Michigan Perfusion Society

Michigan Perfusion Society Scholarship Form

Dan Zwada Scholarship

Name

Mailing Address

Contact Phone Number (XXX)XXX-XXX

CAAHEP Accredited Perfusion Program

Program Position

DidacticClinicalOne Year Program

Program Director

School Address

Please list below your Educational Achievements since High School

Please list below your Community Achievements since High School

Please list below any Medical Achievements since High School

Are there any financial hardships of relevance during your Perfusion Education

Yes (please explain below)No

Please explain your financial hardship, if you answered yes above

Essay Questions: Please type the answers below. Responses need not to be lengthy, but rather content critical. Please site any references you might have used during your discussion:

As a current student in a Perfusion Educational Program, what was your motivating factor for a career path in perfusion? Why Perfusion, Why Me?

Given a review of the historical aspects of perfusion during your education, what do you see as the future of the profession, and specifically as a Perfusionist within the medical field, what your role will encompass?

Please submit a current Curriculum Vitae

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NOTE :

If selected for this award would you be able to attend the summer Michigan Perfusion Society meeting August 17th, 2024. If your are unable to attend, it will be necessary to provide an acceptance video that we can play during the meeting to introduce you to our society. (Format must be playable on a windows laptop)

YesNo

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