The Future of HealthcareCrossing Rivers Health Medical Staff Scholarship

On behalf of the Medical Staff of Crossing Rivers Health, we commend you for pursuing a career in a medical field. We believe in the next generation of medical professionals and are proud to make available the Crossing Rivers Health Medical Staff Scholarship as an investment in the future of healthcare.

The Crossing Rivers Health Medical Staff is a collaborative team of healthcare professionals whom have been granted privileges to provide care to patients at Crossing Rivers Health in Prairie du Chien. The Medical Staff represent a number of healthcare partners providing care to the Prairie du Chien area, including Crossing Rivers Health, Mayo Clinic Health System, and Gundersen Health System. You’ll find a complete listing of Medical Staff members on the reverse side of this letter.

One scholarship will be awarded annually to a graduating high school senior from one of the following school districts: Prairie du Chien, MFL MarMac, River Ridge, Seneca, Wauzeka-Steuben.

Qualified applicants who are entering an accredited college or university and planning to become a healthcare professional must demonstrate excellence in the following selection criteria: Academic achievement, accomplishments and community service.

Applications and supporting materials should be received no later than Monday, April 1, 2019. Mail to: Crossing Rivers Health Foundation, 37868 US Hwy 18, Prairie du Chien, WI 53821.

For the year 2019, the Crossing Rivers Health Medical Staff will be awarding one $1,500 scholarship. The scholarship recipient will be determined and notified by May 1, 2019.

Respectfully,

John A. Renelt, MDMedical Chief of Staff

Crossing Rivers Health Medical Staff MembersACTIVE MEDICAL STAFFStacy Blackburn, DOWalter Boisvert, MDNanci Cherry, MDChristopher Dale, MDDavid DeHart, MDWalter Downey, MDR. Timothy Fitzner, MDPeter Gierke, MDJames Jordan, MDRobert Key, MDBarbara Knisely, MDCarrie Kramer, MDMadhuresh Kumar, MDJennifer McLellan, MDAnna Myklebust, MDJohn Renelt, MDMichael Rogge, MDKristina Thompson, DPM

CONSULTING/COURTESY STAFFBilal Ahmed, MDDana Benden, MDMichael Case, MDJean Griesel, DOLogan Hoxie, MDVenkata Jampala, MDGlenn R. Johnson, MDScott Johnson, MDHyder Khan, MDTimothy King, MDSteven Mindrup, MDWillet Pang, MDJason Rexroth, MDThomas Richardson, MDJonathan Rippentrop, MDRamunas Rolius, MDClarke Searle, MDAmarjit Virdi, MD

ALLIED HEALTH PROFESSIONAL STAFF

PHYSICIAN ASSISTANTBrian QuickJean Tobin, PA-C

CERTIFIED REGISTERED NURSE ANESTHETISTDoris Barnes, CRNARyan McClendon, CRNAMichael Rider, CRNATodd Schissel, CRNA

FAMILY NURSE PRACTITIONERAlyssa Cram, FNPDebra Gallagher, FNPHolly Griswold, DNPHeidi Hochhausen, FNPPamela Myhre, FNPRochelle Neisius, FNPMisty Nemitz, FNPTammy Plondke, FNPCharlene Sauer, FNP

CERTIFIED NURSE MIDWIFETerri Payne, FNP, CNMMolly Schlegel, CNM, APNP

OPTOMETRYBrad Collins, ODPhilip Holzer, OD

Crossing Rivers Health Medical Staff Scholarship ApplicationApplicant’s Name: __________________________________________________________________

Home Address: ____________________________________________________________________

Phone: ______________________________

High School Name: _________________________________________________________________

Guidance Counselor’s Name: ________________________________________________________

GPA: _______________________________ ACT Score: ______________________________

College Enrolled: ____________________________________________________________________

Health Occupation Course of Study: _____________________________________________________

College Address: ____________________________________________________________________

Transcript & ACT Score: Provide a copy of your transcript and ACT score report.

Essay: On a separate sheet, in 500 words or less, please provide a description of the health profession you plan to enter into and why you have chosen this as a career.

Letters of Recommendation: Include at least 3 letters of recommendation from the following: High school principal or guidance counselor A teacher (preferably biology or chemistry) A representative of a community service organization from which you have been involved

Resume: Please provide a resume outlining academic and community organizations you belong to, honors you’ve received, work experience, accomplishments, etc.

Application and all of the above supporting materials must be received by April 1, 2019. Mail to: Crossing Rivers Health Foundation, 37868 US Hwy 18, Prairie du Chien, WI 53821.

All INFORMATION PROVIDED HEREIN IS TRUE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND MY APPLICATION AND SUPPORTING DOCUMENTATION BECOMES THE PROPERTY OF CROSSING RIVERS HEALTH FOUNDATION.

Student’s Signature ________________________ DATE

Parent or Guardian’s Signature ____________ DATE ______

Principal or Counselor’s Signature _____ ____________ DATE ____________