Anticipated total amount over the full term of this award.

$20,000.00

1. Is Occupational Therapy your second career choice i.e., you have been working in another field and decided to change careers to Occupational Therapy.
2. Are you the first generation in your immediate family to attend college?
3. English as a second language
   • A) Is your first language something other than English or are you fluent in a second language?
   • B) If yes, please list all the languages you are fluent in.
4. Disability
   • A) Do you identify as a person living with disabilities?
   • B) If yes, please state how your understanding of your experience with disability will help you to become an Occupational Therapist..
5. Underrepresented groups within Occupational Therapy.
   • Do you identify as an individual from an underrepresented population? (Groups include but are not limited to Black, Latinx, BIPOC, LGBTQ+)
   • If so, please state your group(s).
6. What are your personal and professional goals in the field of Occupational Therapy and how will the Debicki Foundation Scholarship help you achieve these goals?
7. Is there anything else you would like to share about why you believe you are qualified to receive this scholarship?
8. Scholarship Connect Student Consent
   • A) Consent Statement
     
     By clicking the checkbox below, I certify that all the information provided as part of the scholarship application process is accurate. I understand that as part of the scholarship application and selection process, my academic information, financial aid information, and other demographic information may be shared with individuals who are involved in the scholarship selection process and recipient reporting. This may include information from my Free Application for Federal Student Aid (FAFSA), my annual award information, my Cost of Attendance components (living expenses, personal expenses, travel, books, tuition, and fees), and items related to my current academic standing and career program. By agreeing to this electronically, I am authorizing DePaul University, and providing my consent, to release my information and allowing me to be considered for scholarship opportunities. I understand that if I do not agree to this release, I will be unable to proceed with my scholarship application. I further understand that by completing the signature below and selecting the “Finish and Submit” button in this electronic application, I am signing and acknowledging my consent. My submitted signature in this electronic application has the same legal effect, validity, and enforceability as affixing my signature to a paper document. I also acknowledge that my financial aid information is being released with my explicit written authorization as allowed by the Higher Education Act (HEA), HEA 483(a)(3)(E), affirmed by Congress in the final fiscal year 2018 omnibus spending bill, HEA 485B, 494, the IRC 26 USC 6103(I)(13) and HEA 20 USC 1098h(c)(2) .
   • B) Consent Statement Electronic Signature
   • C) Signature Date
9. Show 3 more