NCHIMA Scholarship Application Demographic InformationName * Name Name Name Type of Student * HIM Baccalaureate Student HIT Associate Student HIIM Graduate Student NC CAHIIM Educator Phone * Email * Street Address * Apt/Suite/Office City * State * Zip * Member NCHIMA * Yes No AHIMA ID * NC Resident * Yes NoCurrent Educational Institution Name of Program Director * Program Director Email * Name of School * School Address * Achievements Awards and Achievements Recent participation in community, school, or professional activities Supporting Documentation Upload Transcript Drop a file here or click to upload Choose FileMaximum file size: 50MB Upload Resume Drop a file here or click to upload Choose FileMaximum file size: 268.44MB Upload Two Letters of Recommendation * Recommendations from relatives, friends, or clergy are not acceptable. Drop a file here or click to upload Choose FileMaximum file size: 268.44MBOther Information Reason for choosing health information as a career. * Contributions I can make to the profession. * Any additional information you feel would be helpful for the scholarship committee. * Statement of AuthenticityStatement of Authenticity * I certify that the information above is accurate and authentic. Submit If you are human, leave this field blank.
