Mike McNeil Scholarship Fund - Application Details

To aid in completing the form, we have outlined the questions on the online application form. Responses are required for all questions. We recommend completing all the questions within a Word or other document prior to going online to complete the form, as the system will not save your progress and you will need to begin again if you do not finish the application. Applicants will be notified in writing by mid-October.

If you have any questions, please contact Angela Westhoff, President/CEO or Lori Vigue, Administrative Support Specialist. 

Maine Health Care Association
317 State Street, Augusta, ME 04330
Tel: 207.623.1146
Office Hours: 8:00 a.m. to 5:00 p.m. Monday thru Friday 

MMSF Online Application Form

All applications MUST be completed using the online application form.

Application and supporting documentation due by August 9, 2024.

In addition to the online application, please provide copies of acceptance letter or current transcript from two or four-year program and two written references. These can be emailed to lvigue@mehca.org or mailed to Maine Health Care Association, 317 State Street, Augusta, ME 04330, attn MMSF.

Page 1: Contact Information
1. Check one:  New Applicant  Previous Applicant
2. Applicant’s Name:
3. Home Address:
4. Home Telephone:
5. Work Telephone:
6. Email Address:
7. Do you have work experience in long term care?  Yes  No
8. If yes, how long?

Page 2: Education
1. High school attended:
2. Graduation (or GED) date:
3. School for which scholarship aid is requested:
4. Academic program you are enrolled(ing) in:
5. Degree or certification you are seeking:
6. If already enrolled, current GPA:
7. Semester start date:
8. Expected graduation date:

Page 3: Employment
1. Current Employer:
2. Current Employer’s Address:
3. Current Employer’s Telephone
4. Present Position
5. Date Started (month/day/year)
6. Immediate Supervisor
7. Previous Employer
8. Previous Employer’s Address
9. Position Held
10. Date Started (month/day/year)
11. Date Ended (month/day/year)
12. Previous Immediate Supervisor

Page 4: Other
1. Other: Special Training / Awards/ Volunteer Work (please describe below)

Page 5: Estimated Cost of Education per Semester
1. Tuition & Fees
2. Room & Board (if applicable)
3. Books

Page 6: Recommendations
1. Describe why you are applying for this scholarship:
2. Describe your interest in your chosen field of study:
3. Describe your future plans and commitment to long-term care:
4. Required:  I understand that incomplete applications will not be considered.