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PBPAS Scholarship Application Form

General Instructions to Applicants:

Legibility:

  • Must be a current PBPAS member.
  • Applicants should demonstrate a desire to provide service after completion of PA school to underserved communities through leadership in extracurricular activities and/or membership in civic organizations
Deadline:
  • All document must be attached in one email to pbpasociety@gmail.com

For more information and details of this scholarship, please click here!







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Donation

* Mandatory fields
*First name
*Last name
Organization
*Email
*Phone
*Address 1
Address 2
*City
*Zip
*PA License Number
PA School Attended
Healthcare Provider License Number
Registration type/Invitee reply
*Amount ($USD)
Payment frequency
Comment
 

CONTACT US


EMAIL

SissyHinojos@yahoo.com

© Permian Basin PA Society • 
Permian Basin PA Society is a 501(c)(3) non-profit organization


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