2019 Hardship Scholarship Application

The American Academy of Pediatrics offers financial hardship scholarships designed to help allay financial difficulties for residents and fellowship trainees 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 residents and fellowship trainees in most need. For complete instructions and information for this program please click here (AAP Member login required).
Deadline: Friday, April 12, 2019
 
GENERAL INFORMATION
All fields are required
Marital/Domestic Status *
Is your spouse or partner also a pediatric resident or fellowship trainee applying for this scholarship? *
0/250 words
Have you received an AAP Hardship Scholarship in the past? *
How did you hear about this program (choose all that apply)? *
 

EDUCATION AND PROGRAM INFORMATION
Current Training Status: *
 +
PROGRAM DIRECTOR

PEDIATRIC TRAINING
Are you enrolled in a combined residency training program? *
Will you be a chief resident starting July 1, 2019? *

FINANCIAL INFORMATION
Based on Academic Year July 1, 2019 - June 30, 2020
*Make sure all categories are listed as yearly and NOT monthly figures
*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.
*All fields are required, including the "Other" fields. Please 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. 

INCOME: Anticipated Gross (Pre-Tax) Income for 2019-2020
Total Gross (Pre-Tax) Income:
$0.00

NON-LOAN ANNUAL EXPENSES: Anticipated Annual Expenses
Total Non-Loan Annual Expenses:
$0.00

TOTAL ASSETS: 
Total Assets:
$0.00

TOTAL LIABILITIES: Balance on Loan
Total Liabilities:
$0.00

ANNUAL LOAN EXPENSES: What you are obligated to pay for the 2019/2020 academic year.
Please do not enter the entire amount of your loan that you submitted under Total Liabilities unless you are at the end of the loan and will be paying the balance off within the academic year.  
Total Loan Annual Expenses
$0.00
Total Loan and Non-Loan Expenses due for 2019-2020
(will be calculated upon submission)
$0.00

CERTIFICATION *
Awarded scholarship?
Please sign here: *
clear
REMINDERS
  1. Complete and submit this application form by April 12, 2019.
  2. Confirm with your program director that he or she has received the link to the Program Director's Recommendation Form via email and has completed and submitted it by April 30, 2019. Please note that your program director will not receive the link to the recommendation form until after your application has been received and processed by the Academy. Allow your program director ample time to complete the 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
  3. You will receive confirmation of your completed application by May 31, 2019.
  4. 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 2019 calendar year. 
  5. If you have any othe​​r questions, please send an e-mail message to kvandenbrook@aap.org or call the Academy at 630/626-6134.
The 2019 Hardship Scholarship Program is funded through the generosity of Johnson & Johnson.  
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