2008 Scholarship Application Checklist

National Kidney Foundation of Maine

Please use this sheet for yourself.You do not need to turn it in.

I meet the following criteria to apply for this scholarship:

_____ Maine State Resident or a dependent of a Maine State Resident

_____ I am attending school Fall 2008

_____ I am one of the following: (please check all that apply)

_____Dialysis patient

_____Dependent of a dialysis patient (claimed as a dependent on a Dialysis patient’s federal income tax return)

_____Kidney Transplant recipient

_____Dependent of a Kidney Transplant recipient (claimed as a dependent on a transplant patient’s federal income tax return)

_____ Nephrology Patient

_____Dependent of a nephrology patient (claimed as a dependent on a nephrology patient’s federal income tax return)

_____Tissue/Organ Recipient

_____Tissue/Organ Recipient Dependent (claimed as a dependent on a recipient’s federal income tax return)

_____Tissue/Organ Donor

_____Tissue/Organ Donor Dependent (claimed as a dependent on a donor’s federal income tax return)

_____ I can demonstrate financial need

Checklist of everything that needs to be included with your scholarship application

I have included the following documentation with my application:

_____ Verification of enrollment to a school in Fall 2008 (for continuing students)

_____ Letter of acceptance to a school for admission in Fall 2008 (for new students)

_____ Copy of you or your family’s 2007 Federal Income Tax Form

_____ Copy of your financial aid award letter/ proof of any other financial aid you are provided

_____ Educational Goals Essay

_____ Impact Essay

**Note: Applications that are not submitted with complete documentation will not be considered.

Questions/ Contact: NKFM 1-800-639-7220