2016 Western Virginia EMS Council Award Nomination For

Outstanding Contribution to EMS

by a High School Senior


Please fill out the following information below.


This competitive $1,000 scholarship will be awarded to a high school senior who has been affiliated with an EMS agency within the (insert region) EMS Region for at least six months, and who is currently enrolled or will be enrolled in an institution of higher learning or an accredited ALS training program in the coming year.

Nominee's Information

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