American Academy of Pediatrics




Residents  »   AAP Resident Hardship Scholarship Program
Also see:
AAP Resident Hardship Scholarship Program

Are you a pediatric resident with financial need?

GENERAL INFORMATION:
The American Academy of Pediatrics offers financial hardship scholarships designed to help allay financial difficulties for residents in good academic standing. Each application will be reviewed carefully, and a moderate number of scholarships varying from $1,000 to $5,000 will be granted to interns and residents in most need. This past year, the Academy received 128 applications from residents, 54 of who were awarded scholarships.

All completed applications, which include the Resident Scholarship Application Form and the Program Director's Recommendation Form, must be submitted by April 22, 2016. Applications will not be processed if any items are missing.

QUALIFICATIONS OF APPLICANT:

  1. Be a pediatric resident in a training program (categorical or combined) and have a definite commitment for another year of residency or chief residency (not fellowship) in a pediatric program accredited by the Residency Review Committee.

  2. Have a substantial need for financial assistance.


HOW IT WORKS:

  1. Complete the Resident Scholarship Application Form and submit it by Friday, April 22, 2016.

  2. Confirm with your program director that he or she has received the link to the Program Director's Recommendation Form via email, has filled it out, and has submitted it by Friday, April 22, 2016. Please note that your program director will NOT receive the link to the Program Director's Recommendation Form until your portion of the application has been submitted and received by the Academy. Please allow your program director ample time to complete this form and indicate that your application will not be evaluated without this completed form. IMPORTANT: Your entire application will be forwarded to your program director along with the link to the recommendation form. If you do not wish for your program director to see your financial information, please contact Kimberley VandenBrook via email to kvandenbrook@aap.org immediately after submitting your application and request that your financial information not be forwarded.

 

You will receive confirmation of your completed application by May 20, 2016. If you have not received confirmation of your completed application by May 20, 2016, please contact Kimberley Vandenbrook. The scholarships will be reviewed and all applicants will receive notification by August 31, 2016.


Please note that the scholarship is considered taxable income. If you are chosen as a scholarship recipient, you will receive a 1099-MISC form for the 2016 calendar year.

This award is for financial need and not intended for use toward international rotations. The AAP offers the International Elective Award program to assist residents in completing elective rotations overseas. For more information, please visit http://www2.aap.org/sections/ypn/r/funding_awards/international_travel.html

If you have any other questions, after reading the instructions in full, please contact the Program Coordinator, Resident Initiatives, Kimberley VandenBrook, or call the Academy at 800/433-9016, extension 7134.

The 2016 Residency Hardship Scholarship Program is funded through the generosity of the AAP Friends of Children Fund Program.

RESIDENT SCHOLARSHIP SELECTION:
Resident hardship scholarship recipients are selected by the Section on Early Career Physicians Subcommittee on Residency Hardship Scholarships. The selection is made on the basis of an assessment of the resident's application and the Program Director's Recommendation Form. The Subcommittee on Residency Hardship Scholarships will make recommendations to the AAP Advisory Committee to the Board on Membership. Resident recipients will be notified by mail by August 31, 2016.

IMPORTANT DATES:

Friday, April 22, 2016 - Deadline for application and Program Director's Recommendation Form. No application will be evaluated if it is incomplete.

August 2016 - Scholarships will be mailed. Please do not call before August 31, 2016 as information is confidential and cannot be released before that date. Letters will be sent to all applicants by August 31, 2016.

RESPONSIBILITIES OF THE RESIDENT HARDSHIP SCHOLARSHIP PARTICIPANT

  1. Complete the Resident Hardship Scholarship Application Form and submit by Friday, April 22, 2016. The AAP will contact your program director regarding their recommendation. Please note that the program director's email address MUST be provided on the application form.

  2. Contact the Program Coordinator, Resident Initiatives at kvandenbrook@aap.org if you have not received a confirmation of your application by May 20, 2016.

  3. Notify the American Academy of Pediatrics of any address change as notification letters will be mailed by August 31, 2016 to the mailing address given on the application form.

  4. Upon receipt of the award, all resident recipients are asked to submit a thank-you letter to the program contributor.

  5. The American Academy of Pediatrics will maintain contact with you for 3 to 5 years to determine to what extent this program has contributed to your career in pediatrics. This survey will be forwarded to the email address we have on file. Again, your responses are used to evaluate and improve this program. We appreciate your participation in this follow-up.

RESIDENT SCHOLARSHIP APPLICATION FORM

ALL FIELDS ARE REQUIRED.
Please note: This online application will be submitted to your program director via email for verification. You MUST indicate your program director's email address below. If you have any questions about this application, please send an email message to kvandenbrook@aap.org or call 800/433-9016, ext. 7134.

GENERAL

Name

Age

Sex

Social Security Number

Marital/Domestic Status

Is your spouse or partner also a pediatric resident applying for this scholarship?
YES NO
If yes, what is their name?

No. of Children

MAILING ADDRESS:
 
Street

City

State

Zip

Permanent Address,
if different than above.
(Street City State Zip)
Home Telephone

Office Telephone

Primary E-mail Address

Describe any extenuating circumstances we should consider. Please remember this is a hardship scholarship. (please limit response to 250 words or less).

3000 characters left.
Please describe how you will use the funds (please limit response to 250 words or less).

Have you received an AAP Resident Scholarship in the past? YES NO
How did you hear about this program Internet/AAP website
Flyer e-mail
Department Chairperson
Program Director
Program Coordinator
Chapter Executive Director
"What's New" E-mail from AAP
Other Residents
Other (please specify)

EDUCATION
Present Program Director Name

Program Director E-mail Address

Present Department Chairperson Name

Present Department Chairperson Address

Medical School of Graduation

Medical School Location

Date of Graduation

SUMMARY OF PEDIATRIC TRAINING TO DATE
 
PGY-1 - Hospital Name, City, and Dates From - To

PGY-2 - Hospital Name, City, and Dates From - To

PGY-3 - Hospital Name, City, and Dates From - To

PGY-4 - Hospital Name, City, and Dates From - To

PGY-5 - Hospital Name, City, and Dates From - To

You will have fulfilled at least 1 year of an approved
pediatric residency by July 1 (indicate year)

Name of hospital/approved residency program for next year

Are you enrolled in a combined training program?

YES        NO

If YES, please indicate which program.
Internal medicine/Pediatrics
Pediatrics/Emergency medicine
Pediatrics/Medical genetics
Pediatrics/Physical medicine and rehabilitation
Pediatrics/Psychiatry/Child and adolescent medicine
Pediatrics/Dermatology
Pediatrics/Anesthesiology
Will you be a chief resident starting July 1, 2016?

YES        NO

 

FINANCIAL
Based on Academic Year July 1, 2016 - June 30, 2017

  • Make sure all categories are listed as yearly and NOT monthly figures
  • Do not put spaces between numbers or commas.  40,000 not 40, 000
  • Do not put text where numbers should be.  For instance, under “Other”, do not put daycare $10,000.  Enter $10,000 and put daycare in the “Please specify” field.
  • Do not use a dollar sign ($) before you enter your amount. 1,000 not $1,000.  If you use the dollar sign, it will show up as $0.00 in the results.
  • All fields are required, including the "Other" fields.
  • In the financial fields below, you MUST indicate 0 (zero) for line items that do not apply to you.

IMPORTANT: Please click on the question mark next to each category for further clarification on the financial fields below.

(A) INCOME
      Anticipated Gross (Pre-Tax) Income for 2016 - 2017

Resident Income $
Spouse Income$
Other Income$
(For other, please specify.)
TOTAL GROSS (PRE-TAX) INCOME
Will be calculated upon submission.
(B) NON-LOAN ANNUAL EXPENSES
      Anticipated Annual Expenses

Food/Personal Items $
Clothing $
Rent/Utilities* $
(*Do not include mortgage payment.)
Transportation $
Tax $ (federal/state/local)
Insurance $
Medical Expenses $
Other $
(For other, please specify; ie, medical.)
TOTAL NON-LOAN ANNUAL EXPENSES
Will be calculated upon submission.

(C) TOTAL ASSETS

Equity on Home $
Investments $
Savings $
Other $
(For other, please specify.)
TOTAL ASSETS
Will be calculated upon submission.
(D) TOTAL LIABILITIES
      (balance on loan)

Car 1 Loan $
Car 2 Loan $
Home Loan $
Bank Loan $
Student Loans $
Credit Card Debts $
Spouse Debt, Loans, Etc. $
Other $
(For other, please specify.)
TOTAL LIABILITIES
Will be calculated upon submission.

(E) ANNUAL LOAN EXPENSES
     What you are obligated to pay for the 2016/2017 academic year. Please do not submit the entire amount of your loan (only what you owe for the year)

Car 1 Loan $
Car 2 Loan $
Mortgage Payments $
Bank Loan $
Student Loans $
Credit Card Debts $
Spouse Debt, Loans, Etc. $
Other $
(For other, please specify.)
TOTAL 2016-2017 LOAN EXPENSES
Will be calculated upon submission.
 
TOTAL LOAN & NON-LOAN EXPENSES DUE FOR 2016-2017
Will be calculated upon submission.

I hereby certify by checking this box that all questions have been answered accurately and completely to the best of my ability. I also certify that all financial information submitted within this application is correct and has been double-checked for accuracy.


The 2016 Residency Hardship Scholarship Program is funded through the generosity of the AAP Friends of Children Fund.





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