Welcome to the website for Virginia Environmental Health Association. A non-profit corporation organized by professionals and dedicated to promoting public awareness of environmental factors which affect general well-being of the populace. Head office in Williamsburg, Virginia.

SCHOLARSHIP APPLICATION
1. Name of Applicant
Permanent Address
City, State, Zip
Telephone Number
2. Are you an active member of the Virginia Environmental Health Association?	Yes, Number of consecutive months of membership? No
Are you an active member of a VEHA affiliate?	Yes, Number of consecutive months of membership? Affiliate Name
3. Education (Please list most current first and include high school and college)	School Name Dates, Degree, Major School Name Dates, Degree, Major School Name Dates, Degree, Major
4. Employment History (Please list present employer first)	Employer Address Years Employed Employer Address Years Employed Employer Address Years Employed
5. Brief Description of Responsibilities
6. In what institution are you presently enrolled?	College/University Name Address Telephone Number Email Address
7. Approximate expenses per year?	Tuition Books Room & Board Other Fees
8. Additional Pertinent Information
9. Are you applying for an Undergraduate Scholarship? Is your school and Institutional, Educational or a Sustaining member of NEHA?	Yes Is school accredited with EHAC (Environmental Health Accreditation Council Yes No Yes No
10. Please write a short summary of your professional goals and include your reasons for pursuing a career in environmental health and/or public health. (200 words or less)
11. Please list civic groups and other community activities of which you are a member. Also, please note any special honors received
12. A. Undergraduate. Please attach two (2) letters of support from faculty and one (1) letter of support from an active VEHA member. (Three (3) total letters must be received) B. Graduate. Please attach two (2) letters of support from faculty of applicant's college or university with a declared curriculum in environmental health science and one (1) letter of support from an active VEHA member. (Three (3) total letters must be received)
13. Please attach a copy of your official academic transcript from the school in which you are currently enrolled.
Date