Form 1 FY 2017 NHSC SP Application Content

The National Health Service Corps Scholarship Program, Students to Service Loan Repayment Program, and the Native Hawaiian Health Scholarship Program

FY 2017 NHSC SP Application Content

Application for Participation in the National Health Service Corps Scholarship Program

OMB: 0915-0146

Document [pdf]
Download: pdf | pdf
2017 NHSC SP Application

Activation Email

The applicant will only see this page the first time. Documents linked on this page are also in the Supporting Documents
section

Section 1 - Assurances

If Applicant declines one of the assurance questions, they will receive a Not Eligible screen and can return to the
Application to make changes

Section 2 - Eligibility

Tool Tips and Drop Downs – Eligibility Section
#3

#4

#5

#5 additional questions if the answer is yes

#6

#8 additional question if the answer is yes.

Section 3 - General Information

General Information Section Tool Tips and Drop Downs

Error Message if the applicant submits a Social Security Number assigned to another email address in the system.
Most of the time the applicant has created another account in the past with a different email address

Section 4 – Background Information

Section 5 – Degree Information
NOTE: School Search Button will become active (change color) after Discipline and Degree information are completed

Degree Information Section Drop downs
Disciplines

Dentist Specialties

Dentist Degrees

Osteopathic Physician Specialties

Ostepathic Physician Degree

Allopathic Physician Specialities

Allopathic Physician Degree

Certified Nurse Midwife – There are no Specialties

Certified Nurse Midwife Degrees

Nurse Practitioner Specialties

Nurse Practitioner Degrees

Physician Assistant Specialties

Physician Assistant Degrees

Search School button will light up after Discipline and Degree fields are completed

School Search Section

Tool Tip on School Name

Error message if less than 4 characters are entered for school name

Example when the school name matches

If applicant clicks that there school is not listed in the search results

Message if the school name does not match a school in BMISS. Results will show all schools in State

Requesting a new School – Submitting a School Not Found Request

Drop Down for Accreditation Bodies

Adding a Point of contact is not mandatory, but all fields are required if they add one

Degree information page after submitting a School Not Found request

Tool Tip for program year enrolled

A Start and End date section will appear after applicant completes the program date section

Screen Applicant sees when they log back into their in process application

Section 6 – Letters of Recommendation

If the applicant enters their own email or a contact email submitted elsewhere in the application

If both recommenders have the same email address

Email to Recommender (Acacemic)

Email to Recommender (Non Academic)

Recommenders page

Email to applicant when Letter of Recommendation is submitted

Section 7 – Supporting Documents

Message indicating document upload was successful

Alert if an applicant does not upload all documents and tries to submit

Supporting Document Section when all documents are uploaded

Section 8 – Self-Certification

Section 9 - Review and Submit

Applicant will see this screen when they submit and every time they log back in.

If an applicant selects Edit Application, they will receive an alert before they can proceed.

If applicant edits an application, they will have to Self Certify, and Review and Submit again


File Typeapplication/pdf
AuthorEvans, Canden (HRSA)
File Modified2017-05-15
File Created2017-03-14

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