Florida Academy

of Nutrition and Dietetics

Scholarship Application

Scholarship Application


Please select the scholarship:
Please select the desired scholarship.
Applicant Status
Last Name (*) 
Please provide your Last Name.
First Name (*) 
Please provide your First Name
Middle Initial 
Maiden Name 
Present Address (line 1) (*) 
Please add a value for Present Address (line 1).
Present Address (line 2) 
Present City (*) 
Please add a value for Present City.
Present State (*)  
Please select a value for Present State.
Present Zip Code (*)  
Please add a value for .
Permanent Address (line 1) (*) 
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Permanent Address (line 2) 
Permanent City (*) 
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Permanent State (*)  
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Permanent Zip Code (*)
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Email Address (*)  
is not a valid e-mail address.
Telephone Number (*)  
Please add a value for Telephone Number.
Country of Citizenship (*)  
Please add a value for Country of Citizenship.

Date of Birth


   
Month (*)  
Please add a value for your Birth Month.
Day (*)  
Please add a value for your Birth Day.
Year (*) 
Please add a value for your Birth Year.
Resident of Florida? 

Education (High School, College, or University) List all attended:


High School Name (*) 
Please add a value for .
Location (City, State) (*) 
Please add a value for .

Years Attended


   

From


   
Month 
Year 

To


   
Month 
Year 
Diploma 
GPA 
GED 
Year Attained 


 

College #1


School Name 
Location (City, State) (*)  
Please add a value for .

Years Attended


   

From


   
Month 
Year 

To


   
Month 
Year 
Major 
GPA 
Degree Earned/Expected 


 

College #2


School Name 
Location (City, State) (*)  
Please add a value for .

Years Attended


   

From


   
Month 
Year 

To


   
Month 
Year 
Major 
GPA 
Degree Earned/Expected 


 

College #3


School Name 
Location (City, State) (*)  
Please add a value for .

Years Attended


   

From


   
Month 
Year 

To


   
Month 
Year 
Major 
GPA 
Degree Earned/Expected 


Honors Received (Include dates presented) 
 

Expected date of graduation


Month (*)  
Please add a value for your Birth Month.
Day (*)  
Please add a value for your Birth Day.
Year (*) 
Please add a value for your Birth Year.
Extracurricular Activities (Include employment, volunteer work, offices held in professional organizations.) 

Financial Need

Please give a % breakdown of how your expenses are covered (should total 100%). Take into consideration tuition, housing, meal plan, living expenses, etc.
% contributed (example: contributions from parents, prepaid tuition plan)  
% borrowed (example: student loans) 
% earned (example: student contributions from working/employment) 
% scholarship (example: any scholarship received, Bright Futures) 
Other scholarship aid received (example: any contributions that do not fit the above categories) 
How many dependents do you have (including yourself)? 
Estimated annual family income 
Are you employed during school? 
Hours Per Week 
Do you work when out of school? 
Hours Per Week 
Additional information you would like for us to consider 
Please write a brief statement of your professional goals and reason for choosing the field of Dietetics 

OFFICIAL TRANSCRIPTS

Please provide an official transcript from each college and/or university you have attended to the scholarship chair. Transcripts must be received by the scholarship deadline. Please have them sent to Lori Johnson, lorinelson7@gmail.com.  If official digital transcripts are not available contact Lori for a mailing address.

 

REFERENCE FORMS

Request one (1) Florida Academy of Nutrition and Dietetics Foundation Scholarship Reference Form. Reference Form will be submitted online. THE REFERENCES MUST BE FROM:

  1. a registered dietitian or
  2. a faculty member

Please have one reference that is a Registered Dietitian or a Faculty Member complete the form through the link on the scholarship home page.

 

 

 

 



Electronic Signature (required). Please check this box if you agree your information is accurate. FAND is not responsible for any information not provided.
 

Florida Academy of Nutrition and Dietetics

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