MEDICIAL ASSISTANT SCHOLARSHIP
APPLICATION

This is a Change Reaction Scholarship Application to receive funding to the UCLA Medical Assistant Program. Please visit their official website at health.uclaextension.edu/ucla-map to learn more about their program and to ensure you understand program requirements.
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TCR Scholarship application open from September 1, 2023 - October 13, 2023
UCLA Medical Assistant Program application open from September 1, 2023- October 31, 2023

Full Name*

Email Address*

Phone Number

Which organization referred you?

Disclaimer/ Program Description:

Please read the program guidelines and criteria and check the box below if you agree to the terms and conditions:

I understand the time commitment required for this program, and can accommodate my schedule to fit the needs of this program. See program here.
I understand that this career track requires me to work with blood.
This is a Change Reaction Scholarship Application to fund MAP program fees of $5,000, participants will be responsible for paying the initial UCLA MA application fee of $75 and HESi Exam Fee of $108. If you are not accepted into the UCLA MA program, we will reimburse you for the application fee and HESi Exam fee.
Receiving a TCR Scholarship does not guarantee admission into the UCLA MA program, these are two separate applications
Minimum Requirements to apply for the UCLA MA Program:

Eligible to work in the US
Has a high school diploma or a GED (official transcripts will be requested)
18 years old or older

I agree to the terms and conditions*

Personal Statement Questions:

What are your personal and/or professional goals?*

What motivates you to continue your education and pursue an MA Certification?

What do you know about this field of work? And do you have any experience related to this field?*

What qualities do you have that would make you successful in this field?*

How will this degree/certification impact you?*

Disclaimer/ Program Description:

Personal Statement Questions:

Other questions: