Ohio Lactation Consultant Association

Application for Scholarship

Mission Statement

To be the voice of Ohio lactation consultants in their efforts to transform society into a breastfeeding culture. To empower, support, and educate our membership enabling them to be articulate agents for change.

 

Each year the Ohio Lactation Consultant Association provides scholarships to further education in the area of lactation. Applicants must be currently residing or employed in Ohio. Each scholarship is awarded up to $500.00 and can be used for professional development or any related expenses. Membership in OLCA is not required to receive a scholarship, but is encouraged.  Applicants will be chosen from the following categories (please check your category):

______Health Professional

______Lay person/Para-professional (e.g.: LLL, peer helpers or Grads teacher)

______Medical Student

______Other; please specify_______________________________________________

NAME________________________________________________________________

CREDENTIALS________________________MEMBER OF OLCA?________________

ADDRESS_____________________________________________________________

CITY_________________________________STATE_________ ZIP CODE_________

PHONE (home)__________________________(work)__________________________

EMAIL____________________________________(please include for receipt confirmation)

PRESENT EMPLOYER___________________________________________________

CURRENT RESPONSIBILITIES____________________________________________

HAVE YOU RECEIVED THIS SCHOLARSHIP BEFORE? _____WHAT YEAR? ______

Please answer the following questions on a separate paper, typewritten if possible.
  1. Please state your goal and purpose for requesting this scholarship.
  2. How will your request advance OLCA’s mission?
  3. In what way(s) have you been active promoting, supporting, and/or protecting breastfeeding in your local community, place of employment, etc.?
  4. Will your employer make a contribution towards your stated goal? (over)
  5. Please include the following with your completed application:
    1. Separate sheet with answers to previous questions.
    2. Two letters of recommendations.

All completed applications, together with all necessary supplemental documents, must be post-marked by February 28 annually. Mail to:

          OLCA Vice President

2105 S Linda Dr

Bellbrook, OH 45305

 

Form revised on 19/11/03, 11/07